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Resources

Abbott, J.A., Jarvis, S.K., Lyons, S.D., Thomson, A. and Vancaille, T.G. (2006). Botulinum Toxin Type A for Chronic Pain and Pelvic Floor Spasm in Women. Obstetrics & Gynecology, 108(4), pp.915–923. Available at https://doi.org/10.1097/01.aog.0000237100.29870.cc

Crowley, T., Goldmeier, D. and Hiller, J. (2009). Diagnosing and managing vaginismus. BMJ, 338(jun18 1), pp.b2284–b2284. Available at https://doi.org/10.1136/bmj.b2284

De Kruiff, M.E., Ter Kuile, M.M., Weijenborg, P.T.M. and van Larikveld, J.J.D.M. (2000). Vaginismus and dyspareunia: Is there a difference in clinical presentation? Journal of Psychosomatic Obstetrics & Gynecology, 21(3), pp.149–155. Available at https://doi.org/10.3109/01674820009075622

Goldstein, A.T., Pukall, C.F. and Goldstein, I. eds., (2009). Female Sexual Pain Disorders. Wiley. Available at https://onlinelibrary.wiley.com/doi/book/10.1002/9781444308136

KABAKÇI, E. and BATUR, S. (2003). Who Benefits from Cognitive Behavioral Therapy for Vaginismus? Journal of Sex & Marital Therapy, 29(4), pp.277–288. Available at https://doi.org/10.1080/00926230390195515

Lahaie, M.-A., Boyer, S.C., Amsel, R., Khalifé, S. and Binik, Y.M. (2010). Vaginismus: A Review of the Literature on the Classification/Diagnosis, Etiology and Treatment. Women’s Health, 6(5), pp.705–719. Available at https://doi.org/10.2217/WHE.10.46

Lamont, J.A. (1978). Vaginismus. American Journal of Obstetrics and Gynecology, 131(6), pp.632–636. Available at https://doi.org/10.1016/0002-9378(78)90822-0

Melnik T, Hawton K, McGuire H. (2012). Interventions for vaginismus. Cochrane Database of Systematic Reviews. Available at https://doi.org/10.1002/14651858.CD001760.pub2

Pacik, P.T. (2014). Understanding and treating vaginismus: a multimodal approach. International Urogynecology Journal, 25(12), pp.1613–1620. Available at https://doi.org/10.1007/s00192-014-2421-y

Pacik, P.T. (2009). Botox Treatment for Vaginismus. Plastic and Reconstructive Surgery, 124(6), pp.455. Available at https://doi.org/10.1097/prs.0b013e3181bf7f11

Reissing, E.D., Binik, Y.M., Khalif, S., Cohen, D. and Amsel, R. (2003). Etiological Correlates of Vaginismus: Sexual and Physical Abuse, Sexual Knowledge, Sexual Self-Schema, and Relationship Adjustment. Journal of Sex & Marital Therapy, 29(1), pp.47–59. Available at https://doi.org/10.1080/713847095

Reissing, E.D., Binik, Y.M., Khalifé, S., Cohen, D. and Amsel, R. (2004). Vaginal Spasm, Pain, and Behavior: An Empirical Investigation of the Diagnosis of Vaginismus. Archives of Sexual Behavior, 33(1), pp.5–17. Available at https://doi.org/10.1023/b:aseb.0000007458.32852.c8

Seyed, H. and Saadat (2014). Vaginismus: A Review of literature and Recent Updated Treatments. International Journal of Medical Reviews Review Article International Journal of Medical Reviews, pp.97–100. Available at http://www.ijmedrev.com/article_68899_2eacf2633ecf512c46c639eac6e2e015.pdf

ter Kuile, M.M., van Lankveld, J.J.D.M., Groot, E. de, Melles, R., Neffs, J. and Zandbergen, M. (2007). Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors. Behaviour Research and Therapy, 45(2), pp.359–373. Available at https://doi.org/10.1016/j.brat.2006.03.013

Watts, G. and Nettle, D. (2010). The Role of Anxiety in Vaginismus: A Case-Control Study. The Journal of Sexual Medicine, 7(1), pp.143–148. Available at https://doi.org/10.1111/j.1743-6109.2009.01365.x

Categories
Ready, set, SEX!

Positions

Hopefully, by now we have well and truly established that sex is more than just penetration. If you are progressing with your dilators, it could be a good time to start experimenting with positions that allow for more control during penetrative sex. 

The goal here is to control the depth of penetration and move at a pace that makes you feel most comfortable. Below are some suggested positions you might like to try with a partner when you feel ready. 

But first, some important reminders: 

  • If these positions cause you any pain stop immediately, you don’t want to reinforce the pain fear loop 
  • Communicating with your partner is key, make sure to communicate at every step, this should be pain-free and enjoyable for you
  • Tweak these positions to suit you and your partner
  • You don’t need a partner with a penis, you can use fingers or toys 
  • Lube! Use lots and lots of lube (if you are using toys make sure to use the right kind – see our lube topic here)

On Top 

Positioning yourself on top of your partner allows you to have more control over the pace and depth of penetration. Start with your partner laying down flat on their back. Next, your partner should bend their knees and place their feet flat on the mattress. This position will allow you to climb on top (either facing away or towards your partner) and lean against their thighs for support. By leaning on your partner, you can concentrate more on relaxing your pelvic floor through deep belly breaths. Keep close attention to your inner thighs and try not to clench them. Instead transfer some of your weight onto your partner’s body and focus on relaxing your inner thigh muscles. 

Spooning

Spooning is a great position to limit clenching your thighs or pelvic floor muscles. Start by laying down on your side, then bring your knees up towards your tummy, almost as if you are crouching (or forming an S shape). Your partner should lay down next to you in a similar position. Your butt will act as a cushion here, and you can control the depth of penetration by sliding your legs down (into I shape) for deeper penetration. You can stay in an S shape or crouch to decrease the depth of penetration. Focus on your breathing and communicating with your partner. This position also allows for a clitoral reach-around from your partner or the opportunity for you to clitorally stimulate yourself, as this is a hands-free sex position.

‘Outercourse’ 

Tongues, toys, and touching! Oral sex, mutual masturbation, and ‘outercourse’ are great choices for enjoying sex without penetration. Focus on what brings you pleasure and release yourself from the pressure to have penetrative sex. 

Some studies have shown that only 18.4% of people with a vagina orgasm from penetrative sex alone

If you don’t find this type of sex enjoyable and you experience pain from touching outside around the vulva you could have vulvodynia, check out or glossary to learn how this is different from vaginismus.