The V-Spot: My Coitus is Interruptus by Chronic Pain

Hello Yana,

I’m a college student and I feel like I’m emotionally ready to seek out romantic and sexual relationships. The problem is, I feel like I have a lot stacked against me physically. I’m living with a pelvic floor disorder that requires me to do daily physical therapy in order to keep my vaginal muscles healthy, which can sometimes feel like an uphill battle.

I am also on a very high dose of an SSRI (selective serotonin reuptake inhibitor antidepressant). While I feel so much healthier emotionally and mentally, I think that the high dose has led to anorgasmia (difficulty reaching orgasm after ample sexual stimulation). I’ve never had partnered sex, but so far, solo sex has just left me sweaty, dissatisfied, and sometimes sore.

All together, these things have discouraged me from earnestly trying to seek out any kind of partner. Is there any hope for me to find a sexual partner at this moment in my life, or should I wait on sex until I’m off of my meds sometime in the future?

Thank you,

Waiting it Out


Dear Waiting,

Medication has become a big, regular part of many people’s lives and, by extension, many people’s sex lives. Which is to say both that 1.) you’re not alone in this struggle and 2.) that waiting to begin enjoying a sex life until medication is no longer relevant to you might be unnecessary self-inflicted punishment.

First, let’s normalize the reality that having sex with another person is a custom job. This is true for me, for you, and for any potential sexual partners whether they have chronic pain, take meds, or are seemingly skating through life without an ailment or care in the world (um, who is that person? I would love to meet them). Building a new sex life with anyone requires conversation, specific directions, and sharing of our personal limits and enthusiastic Yeses.

People often fail to recognize that they have just as much power in a new sexual relationship to set the pace, mood, and content of the experience as their partners do. Empower yourself to set the bar as high as you’d like it to be in terms of making communication paramount.

This doesn’t need to be complex. How much would it set your mind at ease if a new partner were to ask you if there was anything that they should know about your body or what you want from sex? And meant it? And listened to your answers?

Well guess what? YOU can do that. You can open the door to honest and open conversations about your sex life!

What is it that you want from a sexual experience? For many people with pelvic pain, classic penetrative sex is one of the more physically aggravating sex acts. Good news! That’s not the only way to have and enjoy sexual pleasure with another person! And if you’re struggling with anorgasmia, exploring other avenues of sex and pleasure may be especially important…continue reading…


I’ve Had Enough With Vaginismus

Content Note: Sexual trauma addressed in this week’s column.

Hi Yana,

I really appreciate your column and the work that you do. I have a really embarrassing sex problem. I was sexually abused throughout various parts of my life, starting in my childhood and going into my twenties. I have vaginismus, but with therapy and dilation, it’s slowly but surely gotten better. I’m seeing someone new who I really like, and the vaginismus is coming back. I feel very safe and cared for with this person, so it’s both perplexing and embarrassing. I feel like I can never escape the sexual abuse of my past and move on to have healthy sexual relationships. Help!

— Reaching for Relief

Dear RR,

First, it’s crucial for you to hear, know, and reaffirm to yourself that neither the sexual abuse inflicted on you nor the resultant vaginismus is your fault. While it’s extremely common for sexual abuse survivors to feel shame and embarrassment as a result of their abuse and/or its aftereffects — in your case, vaginismus — these feelings of shame and embarrassment are misattributions of responsibility for the abuse onto you rather than rightfully onto your abuser/s. Again, neither the abuse or vaginismus are your fault.

I can only imagine how painful and frustrating it is to have to manage the aftereffects of these traumas inflicted on you in this new relationship with someone so great.

Vaginismus — the unexpected tightening of the PC muscles/vaginal canal during sexual penetration resulting in physical pain and discomfort — is an especially upsetting and fickle symptom of trauma as its root causes are often both physical and mental/emotional. It sounds like you’re doing all of the right things by digging down to these two roots via therapy and dilation.

Whether we have a trauma history or not — and so many of us do — our bodies aren’t always going to cooperate with our minds during sex…continue reading…