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.