Ask Dr. Annie K.: Pain

I’m 22 years old and haven’t had sex yet. I’ve had close encounters, but every time I try I experience a lot of pain. Actually any sort of penetration brings severe pain and discomfort (tampons, fingers etc). i’ve had a basic exam from my gynecologist who reports everything is healthy and normal down there. What can I do to finally have an enjoyable sex life?

Over 75% of women experience pain from vaginal penetration at some point in their lives. You are not alone. 12% have severe pain the first time having intercourse. Many women will benefit from you asking about this very important (and painful) topic. Thank you for not being afraid to ask – Dr. Annie K is here for you.

What you are describing is called primary dyspareunia, a.k.a. painful penetration. From your gynecologic exam (which I bet was painful) it sounds like there was nothing visible externally that would indicate an infection or some kind of skin problem.

So what could it be and what to do? When it comes to painful sex, it is never “all in your head.” There is always a cause.

When I hear women talk about pain from inserting a tampon or finger as you describe, my first thought is vaginismus. Vaginismus is is considered a vagina in panic. There is an involuntary tightening of the muscles around the vagina, usually in response to penetration, or even from expecting penetration. Some women describe it as a ripping feeling or a sharp burning pressure that can last for hours or days. Anxiety is common along with frustration.

Although it may sound unusual, the first treatment recommendation is physical therapy. There are therapists specifically trained in pelvic floor anatomy. The entrance to the vagina is through pelvic floor muscles – there is no way around them! The treatment has a very high success rate in women like you who are highly motivated.

When talking sex let’s not forget the basics.

When the time comes, be sure you are with a partner you feel close to. Communication with your partner can be a game changer when a women has pain. This is a medical problem – you are working on it and sex is a priority. This may even bring you closer as a couple.

Technique is important. Allow for adequate foreplay – that part is fun! Most women achieve orgasm by stimulation of the clitoris, not penetration. No medical therapy can make up for a sexual partner who doesn’t like to play.

Lubrication can help many women who have pain with sex. Inadequate lubrication happens. It is ok to use K-Y jelly or go natural and use organic coconut oil or saliva.

Women who have experienced trauma may have painful sex as it may trigger PTSD. Work with a therapist is crucial in solving those issues and being able to move on to have a fulfilling sex life.

Whatever your age, when you have sexual pain, it can affect your self-esteem. Know that it is treatable but may take time. Start with finding the right physical therapist.

Unfortunately the first time is rarely like it looks in the movies. But it gets better! You are on your way to a healthy sex life.

FRIDAY THE 13th

You don’t have to be superstitious to at least give a passing thought to the fact that it is Friday the 13th and a full harvest moon. While Love and Medicine raises a skeptical eyebrow to such folklore, I like to use these cosmic events as a diving board for reflection and change.

Together with the change in seasons, we are in transition. Our bodies and minds are recalibrating. The cool dark fall nights are upon us. It’s time to get sassy and creative.

This week, for no reason at all, based on nothing, I thought I would discover the job of my dreams. One that would tap into my intellectual and creative skills, pay well and be spiritually satisfying, while allowing me to travel the world. That did not happen…yet.

At least I’m not feeling stuck. I am optimistic that I will be discovered. It’s not like I want to be a model or an astronaut – I’m being realistic, not grandiose.

Thinking we’re too old to make changes is what gets us stuck. I hear the too old excuse every day. But being older we have opportunities we didn’t have before. As a doctor with 25 years experience I’ve seen just about every complication at least once. We are wiser, we know the pitfalls. We know what we want. We also know our past does not define us.

Allow the power of the full moon to move you as it moves oceans. And don’t be afraid.

The Lifeguard

In honor of the end of summer, here is a little short story about summer love.

The Mediterranean sea is unusually rough. The waves vigorously clap the sand, sending a salty mist into the ocean breeze. The white sand, like sifted flour, surrenders to the harsh waves, and is enslaved by the powerful water. Sailboats in the distance struggle their way toward the horizon. Topless women casually soak up the sun’s rays. Conversations and reading are light, as the scenery takes precedence.

She never tires of watching him as he scans the crowded beach. His eyes alert as he concentrates, to discern any hint of danger amid the playful sounds resonating from the water. Her eyes follow his large footprints sinking in and molding the sand. She marvels at his bronzed muscular calves laboring under his broad, sculpted torso. How gracefully he strolls along the beach, for such a large mountain of a man.

Every few minutes, without a pattern, he breaks his intense focus on the surf and glances back at her. Aware of the stirring she provokes, he fights the distraction and his gaze returns to the water, back to his duty.

A quickening of her breath and a flash of warmth envelop her body each time their eyes meet. Images of previous meetings bring a rosy tinge to her cheeks. Her body is aching, alert, wanting. She lusts for the physical closeness, so different from the touch she is familiar with at home. She craves the full weight of his body on hers, allowing her to feel small and protected.

She is suddenly ashamed. Her actions and their unspoken implications flood her mind, trap her and suffocate her. A revolting taste of guilt fills her mouth and her body grows limp. A glance from him reins her in and she allows herself once again to feel and not to think. She chooses expansion over contraction, upheaval over order, and freedom over settling.

When the crowd thins out and darkness creeps in, she carefully climbs the steep steps to the lifeguard station, clutching her sarong tightly. It feels like a treehouse -secluded and private. It is their sacred space. When the beach is clear he joins her, carrying two small glasses of Arak. Their lovemaking is slow and deliberate. The air swells with the scent of sex, salt, sweat, anise, and desire.

Intercontinental Parenting

My three children are adults now. They live in Australia, Los Angeles and Israel. I can’t picture any of them living in Milwaukee. They are happy where they are.

Here are some of the ways I deal with the distance. It’s not easy.

1.Trust their choices. My eldest daughter moving to Australia was tough. Australia is far – from practically everywhere – but it is where she found love. Israel is more than an abstract dream; for my youngest, it is home. My son ditched neuroscience and a medical technology company in Copenhagen to write, record and produce music in Los Angeles .

2. Blame yourself, a little. You showed them the world. You traveled as a family and never saw geography as an obstacle. As parents you fostered the confidence and independence they need to be away.

3. Visit them. Face the fact that in order to see your kids you may have to sit in a crowded metal cylinder in the sky for a full day traveling to places that you wouldn’t choose for yourself – LA that would be you.
Meeting half-way changes it up. Japan was a perfect halfway meeting point for our Australian and Hawaii a perfect place for her wedding. Europe works for our Israeli.

4. Make them come visit you even if you have to pay their way.

5. Create an active group chat. For us pictures of food and dogs dominate, with some great memes.

6. Coordinate reading the same book or watching the same series.

7. Once in a while send a card. It may take forever to get there but they will have something tangible to hold. Conversely get them gifts in their local shops and they can be delivered to their door.

8. Count your blessings if far away for you is driving distance.

9. Stay involved in each other’s daily lives. Your kids never stop needing you. Make sure they know you are there for them for everything. Don’t be restrained by time differences.

10. Never end a conversation before saying “love you”.

Mercury Retrograde And What Does It Have To Do With You?

 

Mercury in retrograde – the default scapegoat when you’re having a bad day, your computer crashes or if you have to explain doing something really impulsive. Before we start judging it as fact or folly, L+M wants to know what it actually means. It suits me as a once aspiring astronaut who always wondered about astrology.

Mercury Retrograde. Take a deep breath. And don't text your ex.

Mercury is a tiny planet that moves super fast. When Mercury zips around the sun, as it passes Earth it appears to be moving backwards, from Earth’s vantage point. This optical illusion is what is known as Mercury retrograde. This happens about 3-4 times a year and lasts three weeks each time.

Stargazers have always been fascinated by retrograde motion. When Mercury speeds by, it creates a sort of disruption or turbulence that is thought to affect us on earth. In astrology, Mercury is associated with communication, relationships, travel, contracts, and computer codes.

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