The Penis Process

My husband and I have inserted the penis three times so far and I thought it might be helpful to some if I detailed the process that we go through to make sure it's as successful as possible.  We've had a slightly different process each time, but I'll lay out the one I feel has been the most effective.

At least an hour before we start I take Valium - this is to calm my mind and help me with the major anticipatory anxiety that I feel about the penis.

I prepare the Penis Insertion Station (I've never really called it that) by laying several towels down on the bed, as well as some hand towels, lubrication, and a large dilator/dildo.  The reason for all the towels is that we are using Coconut Oil as our lubricant, by recommendation of my PT, and man is it messy!  Oil does not come out in the wash and we don't want to stain our sheets.

A note about the Coconut Oil: I was telling my PT that when I tried keeping the dilator in for long periods of time, it felt like my body was absorbing all the lubricant and then when I pulled the dilator out my vagina was dry and it felt like the dilator was taking some of my skin with it (painful!).  So she suggested that using an oil-based lubricant would be better because water-based lubricants will be absorbed by your body at a much faster rate.  She suggests Coconut Oil specifically because she says it's all natural and inherently antibacterial.  It also smells good, but you can get an unscented kind if you don't like the smell.  She also said that using Olive Oil is great too (Coconut Oil is a bit expensive).

Back to the process: I take a warm bath for about 30 minutes and just lay there and read my book and really try to relax all my muscles.

When I get out of the bath it's time for stretching and penis entry.  So first I lay down on the towels that are on the bed and my husband uses his finger (lubricated) to go around the pelvic clock and try to work out any tension that I feel in any of my muscles.  My PT taught him how to move my legs in different ways so that the muscle is in the best position for relaxation whenever we hit a sensitive spot.

After we've worked on the muscles individually with his finger I will put the largest dilator or my largest vibrating dildo in for a few minutes, just to prepare my vagina for the penis.  This also involves a healthy lathering of coconut oil.

After a few minutes I take out the dilator, do some contract/releases, and we insert the penis.  We have tried a number of different positions in an effort to minimize hitting a certain spot that is painful for me (top of pelvic clock kind of near urethra).  We've tried me on top, spooning on our sides with him behind me, doggy style (why be PC about it - we all know what doggy style is), and what my PT calls the fork position, which is really hard to describe.  The fork is him laying on his side facing me while I lay on my back perpendicular to him with my legs draped over his pelvic area.  Honestly, it's hard to tell which position is best at this point.  It all feels very stretchy.  I can definitely tell that some are less painful on that spot than others, but it's not as much about the position as it is about how I position myself in the position (if that makes sense).

We stay still for several minutes and then we'll do a slow moving in and out.  Movement is what causes me the most pain, so when I say slow I mean SLOW movement.  We figured out yesterday that if we do a full in and out motion (meaning the penis goes all the way in and almost all the way out) the penis rubs across that sensitive spot of mine, and that if we don't pull the penis out quite as far it helps a lot.  As for movement, the easiest position is me on top because I have total control.

I have found myself very sore after these encounters.  I have two different kinds of pain: The first pain is more of a stretching type pain.  My husband penis is large so it feels very stretchy when it's in my vagina.  The second pain is the one spot inside that does not like to be touched.  I'm going to try and see if Lidocaine can help with the spot - it has never helped in the past, but maybe that's because my problems were too huge and too numerous to be fixed by Lidocaine.  But now that I can pinpoint a specific area of pain, perhaps I can put Lidocaine there and it might help.  As for the stretchy pain, I'm hoping that the more we do it, the less it will hurt, just like with dilating.  I'm also going to try putting in a Vitamin E suppository after these episodes to try and soothe my sore vagina.

Most importantly we have to make sure that we do this frequently to retrain my vagina (and my head) and I have to not get discouraged when I feel sore.  It's part of the process and I have hope that it will get better.

My biggest fear is still that my libido will never come back.  This post has been very technical and that's what everything is right now: technical.  I understand that at this point I cannot expect to feel desire or pleasure when it still hurts and feels sore, but I am terrified that once the pain goes away I still won't actually want to have sex.  I'm trying not to let that fear take over me.  I'm trying to focus on the great strides that we have made.  I am very encouraged by our progress, but that fear is there, so I'm acknowledging it.

The Sword Has Found Its Sheath

After more than two years of no penis/vagina contact, we have finally taken the first step to getting back to intercourse.  My husband and I have a plan to loosely follow the steps outlined in the book Completely Overcome Vaginismus.  We decided to start with partial insertion of the penis.  First I took a bath to relax my muscles (and some Valium to relax my mind).  Then we did some dilating first using my husband's finger, just to make sure that all the muscles were nice and loose.  The next step was to put in the largest dilator for a few seconds, then I pulled out the dilator and directly put the penis in.  I was on top so that I had all the control.  Of course we used lots of lube during this whole process.

It felt tight, but okay.  My husband's penis is large (and sadly that is not something I want to brag about) so it definitely felt like it was stretching, but it wasn't necessarily a painful stretch.  The partial insertion really felt so easy that I decided to just go all the way down and have his whole penis inside.  It was easy enough to get there, but it was definitely stretchy.  We hung out there for a few minutes and I tried moving my body around to see which positions were the most or least comfortable.  The most comfortable position with me on top was to have my torso sort curved in a C position, kind of like a hunch-back.  I'm not sure I could actually have sex this way because it would hurt my back if I was like that for too long, but at this point we're just experimenting to see what's the least painful on my vagina (specifically the urethra/G-spot that is the most painful spot for me).  After a few minutes we separated and layed down for a bit, then we decided to try it again just for extra stretching.

Overall I think it was a big success.  We agreed from the beginning that there would be no expectation of pleasure - that this was more of a step in the process of getting to the point of real intercourse.  There was no moving in and out - that will come later.  But it's been two years and I finally got that phallus back in my chalice!   :)

We will do this a few more times and then move on to the next step.

Yay for us!

Extended Dilations, Hormones and More

It's been a couple weeks since I got the Botox injections in my Pubococcygeus and my Puborectalis muscles.  It is really hard to tell what's happening down there, but I think that it has made my muscles more relaxed.  It's easiest to feel this when either the PT is working down there or my husband is helping me dilate.  When I do it myself it's harder to tell any difference, but when they do it, I (and they) can tell that the muscles aren't as resistant.  So that's good news and hopefully a good sign for things to come.

My therapist recently went to a seminar for sexual pain and among the doctors there were Dr. Goldstein and also Dr. Pacik.  She spoke to both of them about me.  I have never seen Dr. Pacik, but she wanted his opinion on what to do after getting botoxed.  His procedure is very different from Dr. G's.  Dr. Pacik puts the patient to sleep to administer the Botox and when she wakes up she has a dilator in her vagina.  Now this is usually for cases that are much more extreme than mine - I can get a dilator in my vagina with no problem and  no anesthesia.  However, Dr. Pacik feels strongly that women with any level of pelvic pain should have a dilator inside for many hours each day.  I believe his theory is that having the dilator inside for that long will help to retrain the muscles and get them used to having something in there.  He feels strongly that this is part of the process.  Dr. Goldstein, on the other hand, thinks this is a bunch of malarkey.  But my therapist thought there was no harm in giving it a try so I talked to my PT about it and she said to go ahead and try it (my PT had never heard of doing these extended dilations before).

The longest I've been able to stand having the dilator inside is about 40 minutes.  It's actually harder than I thought it would be.  I thought I could just lay there and keep that dilator in there for a long time with just slight discomfort.  But it actually becomes more and more painful the longer it stays in.  At first I tried it with the largest dilator, but it pushes in the top spot that is very tender for me (12 o'clock on the inside - basically where the G-spot is, where the urethra is as well).  So I tried going a size down.  This helped a little, but it's still painful.  Another problem is that it really hurts to pull it out after having it in there for so long, even though I've lubed it up like crazy.  It's like my body absorbs the lube and by the time I pull it out there's really none left.  Yesterday I tried relubing every 5 minutes or so, but it still felt painful every time I pulled it out.  I guess I'll try the extended dilation a few more times, but as of right now I feel like it's causing more pain than actually helping.

My hormones were retested a couple weeks ago and my testosterone is finally within the normal range.  However I have to keep using the Androgel - 1/2 gram rubbed on thigh each day - indefinitely.  Dr. G's nurse said that some people have to keep using it forever to maintain the right levels, while others are able to wean off of it eventually.  I didn't realize this, and although it's not a huge deal, I really don't like the idea of having to put T gel on my legs every day for the rest of my life.  It makes me hairy and pimply.  If it actually gave me a sex drive I might say that it's a fair trade, but it doesn't so I'm not feeling the motivation to do this forever.  Hopefully it won't be forever.