Sex Made Easy (5 page)

As such, here is how I like to think of the G Spot: Based on the scientific evidence that we do have, I believe that many, but not all, women have an area on the front wall of the vagina that, when stimulated, feels good to them. All women who have vaginas have this area, but not all women enjoy being stimulated there (this is true of any body part: women have a clitoris
and breasts too, but not all women find clitoral stimulation or breast stimulation to be pleasurable or orgasmic). The G Spot can be stimulated through intercourse positions (missionary with one's hips tilted upward is a popular position for G Spot stimulation, as is woman on top). It can also be explored through finger play (two fingers using gentle but firm stimulation is often recommended) or through sex toy play (again, a G Spot–specific toy is not necessary). As for whether “G Spot orgasms” (orgasms that result from stimulation of the G Spot) feel different from other orgasms, it seems to depend on the woman. Some women prefer G Spot stimulation over other types of stimulation, such as clitoral stimulation. Others prefer clitoral stimulation over G Spot stimulation. My advice is to explore your body and find what feels good to you.

In most women, one labium (the singular term for labia; a woman's vaginal lip) is bigger than the other. This is very common and nothing to
feel embarrassed about. Not only is one labium often a different size and shape from its pair (even the coloration can vary) but women's labia can look more or less symmetrical depending on how a woman sits or how she or her partner hold her labia. Think of how your face looks in a photograph depending on the angle the picture is taken from. The vulva is similar in this regard. So if you're not thrilled by how your labia stack up, remember that they probably look completely different from another angle. If you don't believe me, grab a mirror and see for yourself.

Most of the time, differently shaped labia are just that—differently shaped. They're not better or worse than labia of the same size. With few exceptions, labia size typically doesn't affect how a woman pees, has babies, or enjoys sex. In very rare cases, one or both labia may be large enough to cause pain or discomfort for a woman when she has sex, rides a bike, takes long walks, wears certain clothing, or performs other daily activities. In such cases, health care providers sometimes recommend a procedure called a labiaplasty, which is a resizing and reshaping of one or both labia.

Labiaplasty has become a controversial procedure as some women, health care providers, and women's health advocates worry that in recent years the procedure has been unnecessarily, and sometimes unethically, marketed toward women. Because any surgery carries risks, if you are considering labiaplasty, I would recommend checking in with a health care provider who specializes in vaginal and vulvar health issues and who has the best interests of you and your body in mind. You can find such a provider through the International Society for the Study of Vulvovaginal Disease (
www.issvd.org
). This isn't to say that all labiaplasty is bad; some women feel better about their bodies and are more easily able to participate in sex (or exercise) after labiaplasty. Rather, I simply encourage you to seek out quality information before having surgery done on any body part, including the vulva.

You might also find it of interest to know about a study published in 2011 in the
Journal of Sexual Medicine:
in a recent survey of medical doctors, male doctors and plastic surgeons were significantly more likely to describe normal labia as “unnatural” and say they would recommend labiaplasty for women with normal-looking labia than were female doctors, gynecologists, and general practitioners.
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In other words, if you have questions
about your labia, you might be better off asking a female gynecologist or a general practitioner—or at least including one such doctor as a second or third opinion—before going under the knife. It also sounds like medical schools might want to do a better job of educating future doctors about the wide range of normal, beautiful, healthy vulvas and their labia. You might find it helpful to ask yourself why (or if) it matters that one labium is longer or bigger than the other: our bodies aren't symmetrical in any other place; why would this place be symmetrical? Are there things about your life that you think might be different if your labia were the same size? How might that work? And what if that's not the case?

Many women are susceptible to razor bumps or ingrown hairs on their body, including on their pubic area. Some women who are tired of dealing with repeated ingrown hairs choose to stop removing their pubic hair and instead opt for trimming it. Others choose laser hair reduction, as it is more permanent, though there's no guarantee of complete removal. In other words, if your goal is to go completely bare down there, repeated laser hair reduction may be able to help you permanently remove many of your pubic hairs, but you may never be completely pubic hair–free. An advantage of laser treatment, however, is that it destroys the hair follicle; this can lead to fewer bumps and ingrown hairs. If you prefer to keep shaving, you may be able to lower the risk of razor bumps and ingrown hairs by taking a hot shower or bath before shaving to soften your pubic hairs and help open the pores in your skin. Try shaving in the same direction of hair growth too, which is the opposite of how many women shave their legs.

Razor bumps frustrate some people when it comes to sex because the bumps may make them feel less sexy. Dimming the light or using candlelight to illuminate the bedroom can minimize the appearance of razor bumps and ingrowns. Or, you can remind yourself that we're all human, we all have skin issues from time to time, and your partner is lucky to be with you just as you are with them, razor bumps or not. That said, if your bumps truly are from shaving or ingrown hairs, you may want to bring the issue
up and reassure your partner about what caused them, lest they wonder whether you have a sexually transmitted infection (STI) or some other infection. (And if you do have an STI, I hope you will find a way to share this with your partner, as it's the kind thing to do.)

If sex hurts for you, mention this to a health care provider. A gynecologist, in particular, is a good place to start, as he or she can examine your vagina, cervix, and vulva (the outside parts) to look for an identifiable reason. Often if sex hurts only when penetration begins but then gets better, a lack of lubrication and time spent in foreplay is to blame. It can take several minutes after a woman feels sexually aroused—even as long as ten to twenty minutes—for her to produce enough vaginal lubrication for comfortable penetration. It can also take this long for a woman's body to become sufficiently aroused so that her vagina grows longer and wider (vaginal tenting), thus making more room inside for comfortable penetration with a partner's fingers, a sex toy, or a partner's penis.

One strategy, then, is to spend longer in foreplay doing whatever it is that makes you feel tingly, sexy, and excited before starting vaginal penetration or intercourse. A sex therapist I know told me that she would advise women to wait to begin intercourse until the vagina felt like it was practically throbbing for sex. That level of sexual excitement is often a good indication that a woman is sufficiently aroused and her vaginal lubrication is in good supply.

If you'd rather not wait to start sex for whatever reason (quickies can be fun too), you might try applying a dab of water-based lubricant to your vaginal entrance as well as to the fingers, penis, or sex toy that's about to enter you. That might make for more comfortable sex. If extra foreplay and added lubricant don't ease your pain, circle back with your doctor and ask what else might be causing it. If your doctor can't figure it out, get a second opinion from a doctor who specializes in vaginal and vulvar health.

As I've said before, any time sex hurts, you should mention this to a health care provider, such as a gynecologist. If your gynecologist isn't able to determine what's at the bottom of your pain, consider getting a second opinion from a vulvovaginal specialist or a dermatologist. That's right—a dermatologist, a doctor who specializes in skin health and disease. Dermatologists and gynecologists have different specialized kinds of training and one type of doctor sometimes picks up on certain health conditions that the other type misses. In the case of genital pain, some cases of painful sex are caused by skin disorders that affect women's genitals. Some skin disorders can cause women's genital skin to become very thin and easy to tear during sex. A dermatologist can help rule out skin conditions that might be contributing to genital pain.

As I mentioned before, spending more time in foreplay and adding water-based lubricant may be helpful. And if you're approaching menopause, are postmenopausal, if you've had your ovaries removed (perhaps as part of a hysterectomy or for other reasons), or if you've undergone cancer treatments that have affected how your ovaries function, then you might benefit from using a vaginal moisturizer; ask your health care provider if this is a good choice for you. Some vaginal moisturizers contain estrogens but not all do. Vaginal moisturizers are different from lubricants in that they help the vagina maintain a level of wetness for days on end and aren't just used during sex. Vaginal moisturizers are typically used two or three times a week and may be inserted into the vagina at night before bed, where they are left to do their work while you sleep. If you are recently sexually active after a long absence of sex, or after having had some type of vaginal surgery, ask your health care provider whether vaginal dilator therapy is right for you.

Although it's uncommon, some women experience sexual arousal for hours, days, or months without relief, even after masturbating or having sex with one or more orgasms. Some women enjoy this experience of ongoing sexual arousal; others do not. They may find it uncomfortable or distracting, especially if it's not part of a bigger experience of feeling sexually aroused or desirous.

First described in 2001, this was initially called Persistent Sexual Arousal Syndrome and was more recently renamed Persistent Genital Arousal Disorder (PGAD), as women with PGAD are more likely to say that their genitals are feeling “aroused” (rather than that they feel sexually aroused themselves).
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It's unclear what causes PGAD. Some women report that their symptoms started either while taking certain antidepressants or after they stopped taking antidepressants. One study reported on a woman who started experiencing PGAD about a month after she started on a diet that was very, very high in soy (her genital arousal was so unrelenting that she would masturbate upwards of fifteen times in a day to try to relieve the tension).
¹³
Other research suggests that women with PGAD are more likely to be anxious or depressed and to monitor their physical sensations (how their body feels), suggesting that perhaps these psychological characteristics are linked to PGAD.
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This doesn't mean that PGAD is “all in your head”; rather, women who pay more attention to how their body feels may be more prone to anxiety as well as to PGAD.