This week I wrote for Role/Reboot about the discrepancy between the type of therapy offered to men who are at risk for losing sexual functioning because of medical procedures and what is offered to women in similar situations. If you haven’t read it, you might want to go here and give it a quick scan.
In the R/R article, I omitted the details of my personal experience—what worked and did not work for recovering sexual functioning after a surgery that compromised it. After all, that kind of information is pretty private. But since there is almost nothing out there on the subject, I think it is important to share this part of the story as well.
I had surgery to repair a rectocele, entrocele, remove my uterus, clean up adhesions and do additional biopsies. So, what is a rectocele or an entrocele? Basically, it is when the connective tissue around the vagina is damaged in a way that allows other body parts to bulge into the vagina. In a rectocele, the wall between the vagina and rectum is compromised. So when poop comes down the chute, it doesn’t go out, but builds up in the rectum, which expands like a balloon. It makes pooping without some form of assistance impossible. With an entrocele, the bladder never fully empties, and you pee yourself every time you sneeze.
I went into surgery with every hope of being able to poop when I wanted and pee only when I wanted, but without any idea if I would ever enjoy sex again. It was terrifying.
Recovery was painful and pockmarked with complications—but I knew immediately that I wouldn’t be peeing myself and that my body didn’t seem inclined to make a poop balloon. What I didn’t know was if my sexuality had been amputated along with my uterus. During the eight weeks of bed rest that followed, when there was nothing to distract me, I could not stop wondering if I had lost an important part of myself.
The only instructions that I was given were: 1) “Try not to orgasm for 6 weeks after surgery” 2) “You may resume all normal sexual activity 12-16 weeks after surgery.”
That leaves a lot of questions. Should I avoid becoming aroused or just orgasming? What if I orgasmed in my sleep? And what kind of sexual activity is considered “normal?”
The kind of surgery that I had involved (among other things) pleating the back wall of my vagina (folding the wall over on itself and sewing it that way) and reinforcing the front wall with steel mesh. This not only sounded alarming to a woman who is a self-professed penetration junky, it created literal, physical boundaries to any form of penetration.
When I first worked up the nerve to insert my pinky finger it felt like I was trying to slide between a chain link fence and brick wall. I was fairly sure I would never welcome a penis in there ever again.
Perhaps most troubling is the fact that it did not feel like my vagina anymore. I handled my anxiety by making jokes, by calling my yoni a Frankengina.
From other surgeries, I know that muscles atrophy and scars can harden. So my instinct was to employ the same philosophy of rehabilitation that is applied to men: Use It or Lose It. But my doctor had barred activities like horseback riding, jumping rope and riding a bike for life. So obviously, there were going to be some limits, and I wasn’t sure how and when to begin.
Eventually I found, deep within the internet, one physician’s recommendations for women recovering from extensive pelvic surgery. He recommended starting with daily masturbation at 6 weeks after surgery, beginning penetration at 12 weeks, and attempting intercourse at 16 weeks. From that point on, he recommended intercourse and masturbation five times a week, and warned against going below three times a week. In other words, he believed in giving time for healing, but after that he was a big fan of the “use it or lose” it philosophy.
I had my first orgasm four weeks after surgery. I came in my sleep, right in the middle of a dream about white-water rafting, of all things. I called my doctor’s office and spoke with the nurse, asking her if it was a problem. She laughed, and said that the the instructions should have been: “Don’t try to orgasm in the first six weeks” rather than “Try not to orgasm” That is a big difference.
At six weeks, I began masturbating. The first couple of times it ended badly. Stroking my clitoris in the way that I had before felt uncomfortable, since it pulled on my perineum. The use of a vibrator was simply out of the question. It didn’t help that I felt so disconnected from my Frankengina that I was squeamish. I developed an aversion to touching myself.
Fortunately, right before the surgery, my husband and I had read about Orgasmic Meditation. The touch prescribed by OM is a very light and small stroke entirely focused on the tip of the clitoris. It was not painful, and it allowed my husband and I to re-establish sexual touching
More importantly, it was a non-threatening way for both my partner and I to start thinking of me as a sexual person again. He saw me, and especially my vagina, as being incredibly fragile. OM with its very light touch allowed him to feel good about touching me again. The downside was that it did nothing to lessen my aversion to touching myself.
At 8 weeks, my doctor said that I could start doing Kegels again. (Before, it had been strictly off-limits) At first, it felt like I was squeezing crushed glass. It only added to the anxiety that I already felt about how stiff the walls of my vagina had become. I could not imagine ever fitting anything in me again.
My fear that my vagina had been irreparably damaged just got worse and worse. One night about ten weeks after surgery, the anxiety overwhelmed me. I needed to know how bad off I was. I hadn’t been able to relax enough to insert a finger inside of myself since that first time. So I begged my husband to try. I just needed to know that my vagina had not been replaced by a brick wall. He started by using the same touch that he used in OM. And by the time he had penetrated me with his finger, I had forgotten the object of the exercise. It was completely painless, and it felt pretty damned good.
At about 12 weeks, we hit a wall. The program that I had found suggested working up to intercourse by using fingers during masturbation. I think whoever had that idea must not have ever had the kind of surgery that I did. BAD idea. The problem was that no matter how relaxed I was when I started, as I got aroused, my vagina tightened down on whatever was inside of me. Fingers have bones and nails. My Frankengina did not like either one.
Another huge problem was that neither of us knew our way around my vagina anymore. That wonderful spot way up high—gone. The pleasure from press and release on the back wall—gone. Everything was equally exquisitely sensitive. Toys were no better than fingers. Molded toys have seams, which I never would have noticed before, but I do now. Silicone type toys were better, but they had a drag to them that became uncomfortable pretty quickly.
So we skipped that step. Actually, it wasn’t that we made the conscious choice. We just sort of gave up. It was too emotionally loaded to keep trying.
There was another complication. My first adult sexual experience had been exceptionally violent. If you feel a burning need to write about it, you can do so here. My partner had torn a hole through my vagina and had actually done damage that set in motion the need for all of the surgery.
In that way that only survivors’ brains can do, I had found a way to blame myself. I had gotten hurt, I reckoned, because I had been so tense he had to use that much force and that is how everything went horribly wrong. Yes, I know how fucked up that line of reasoning is. But even though I know it is not true, and that such thoughts are not helpful, they still sneak back in.
So, I was frightened that I would do something that would injure me badly. And my husband was just as worried, if not more. In fact, he was so concerned about not hurting me that he did not even want to help with the rehab some days. I worried that my efforts to get his cooperation could, at some point, be a violation of his consent.
But then something utterly unexpected happened. One night, we started kissing and making out like a couple of high school kids. It was hot and amazing. So we did it again the next day, and the next.
On the third day, we were doing the full grind against each other. It didn’t hurt to have pressure on my pelvis. In fact, it felt pretty damned good. I reassured my husband that I didn’t want sex, but I did want to feel my body next to his. So we took off our clothes, buried ourselves under the covers and slid into each other’s arms. His skin against mine and the way our bodies fit together felt like home. But the longer we kissed and made out, the more I wanted to just feel him between my legs. So we ended up doing a form of what I suppose you could call frottage. His naked pelvis gently ground against mine. It was AMAZING. Finally, my husband, who has always been more sane than I am, stopped it. And in a burst of genius, he brought ice for my pelvis and ibuprofen.
We didn’t plan to do that again. It just kept happening, often after OM. We were not doing it as a part of the recovery program, but just because it felt good to us. And after every session, my husband would bring me the ice and ibuprofen.
I think that the ice and ibuprofen was genius. It stopped inflammation from leaving a bad aftertaste. And it also sent all the blood away from the area. Without it, the vascular congestion would have continued and it would have made me tender and overly frustrated. Don’t get me wrong, I was frustrated, but it was just enough frustration that I was eager to keep trying. And some days the fear that I would never merrily fuck again was overwhelming. But somehow, I kept muddling through.
One day as we were doing our naked frottage, he was a little too stiff and he just accidentally popped in. We both froze. And he began apologizing profusely. But it wasn’t his fault. I knew he was hard and I had moved my hips the wrong way. And, more importantly, it didn’t hurt. It didn’t exactly feel great, but it wasn’t uncomfortable either. We disengaged and we did the whole ice and ibuprofen routine.
After the accidental one-stroke-intercourse, we went back to fingers, and I discovered I could tolerate them better than I had been able to a couple of weeks before. As long as I was relaxed and had clitoral stimulation I thoroughly enjoyed it—to a point.
When I got seriously aroused, just as my body was preparing to orgasm, my Frankengina would tense against the fingers, and everything would become very uncomfortable. By that time, I had orgasmed twice in my sleep, so I knew that I had not lost the ability. I just had no idea how to get there when I was awake.
My solution was to just jump to intercourse. But Pete was having none of it. For starters, he wanted to be absolutely sure that my body was ready for it. But in addition, he thought that skipping to intercourse would be a waste of a great opportunity. He saw this as a do-over for me—a second shot at being a physical virgin. He wanted to be sure that when my Frankengina lost its virginity, it would be wonderful. He did not want to have intercourse if there was little to no chance that I would orgasm. So he asked that we hold off until I was able to orgasm again.
I was tempted to fake an orgasm. But in addition to being a relationship sin, faking it was a highly impractical idea. I had been ejaculating with my orgasms for a long while. And I have no idea how to fake that.
After a lot of frustration and tears, I realized that I was going to need to learn to orgasm differently. I needed to open and relax instead of clench and bear down in response to arousal. I wasn’t even sure if it was possible. But I had seen a Betty Dodson clip in which she said it was how some women come. She doesn’t seem to think it is a good idea since it is hard to do. But she acknowledges that it is a possibility.
Mastering the technique was hard. It was so counter-intuitive. We all tense when we are aroused, don’t we? But I figured that if women who are in the pain of labor can learn to relax those muscles, I could do the same in arousal. I remembered that my childbirth educator had said that if you drop your jaw, it helps open your birth canal. So I tried it and the birth breathing as well. I even used the visualization technique, only instead of visualizing a baby descending, I imagined those stupid flower-opening sequences that they used in old movies as a metaphor for sex.
And then one day, it just happened. It was different from any orgasm I had ever had before and there was none of the delicious lead-up. It was just BAM, then yawn. But it was progress.
Pete and I finally agreed it was time for intercourse. We decided to try it in a scissors position, since this would give us a lot of control. We used a ton of lube, and we took our sweet time—a very sweet time—getting to the point of full insertion. At some point, I thought that I might kill him if he didn’t just do it already. When he finally slid himself all the way in, it was nothing but incredible pleasure—pleasure like I had never felt before with intercourse.
It lasted exactly one thrust longer than the previous (accidental) intercourse. I was so tight that it flooded Pete with stimulus. He came after two gentle thrusts. Again, he was apologetic. But he needn’t have been. I understood exactly why.
In the weeks and months that followed, we discovered something really important about my new vagina: It felt amazing—for both of us. Neither of us had ever experienced intercourse that was so intensely pleasurable.
That brings me to something that is something of an aside, but it seems like an important one: We have to stop making judgments about the kinds of surgery women have. If women want to have their vaginas tightened surgically, we should not scoff. It has the potential for many women to make a world of difference.
I know that a lot of sexual educators will tell you that the size of a vagina does not impact the sexual pleasure of the vagina’s owner or her partners. And I think they are probably right as long as the structure of the vagina is intact. But when that structure has been compromised, as can happen in childbirth or even from bouts of very severe constipation, surgical intervention can make a HUGE difference.
For both of us, intercourse is a very different experience than it was before the surgery. It can be a sensory joy, or a painful mess. For example, we had the bright idea of a midnight romp several weeks ago. Neither of us could find the lube, so we improvised. That is a very bad idea considered how tight I am these days. I was unbelievably sore for a week, and my husband got a micro-tear on the skin of his penis. He described it as feeling a lot like a big paper cut. He called it his pee-pee-boo-boo, and it was funny right up to the time that it got infected. Then it became really painful. He had to treat it with antibiotics, and we couldn’t have sex while it healed.
Even given our positive outcome, I wish we had had guidance on sexual rehabilitation. I think that it could have done a lot of good. For starters, it would have greatly lessened my anxiety. For another thing, it might not have left me feeling separated from my body. I love my Frankengina, but it still feels like a Frankengina, not my own body.
I think that ongoing squeamish separation from my body has taken a toll. My sexual desire is a tiny fraction of what it once was. Now there are many reasons for that. I have undergone two other surgeries since the one that created the Frankengina. The second one was fairly major: a knee replacement. During the two and half years I have spent convalescing, I have gained a lot of weight and lost a lot of fitness. But I think that my reduced sexual desire is related to how disconnected I still feel from my body. Yes, I love intercourse, but I can count on one hand how many times I have masturbated in the last two years. So my sexuality has gone from being a part of myself that I mostly expressed in a relationship to being a relationship-facet rarely expressed or experienced outside of it.
However, I am not sure that anyone could have answered some of the questions that I had before the surgery. I wanted to know if I would ever ejaculate again. The answer is probably not. I can’t come in a way that promotes that. I wanted to know if anal sex would be off the menu forever. My answer is YES! I want nothing to do it with it. I wanted to know if I would ever enjoy sex again, and the answer is absolutely. But not in the same ways. I used to enjoy long extended sessions of sex. Now I cannot handle anything that goes past a half hour. But that half hour packs a hell of a lot of pleasure.
I am not sure if this article, which wanders very far into TMI Territory, will help anyone. My hope is that it does. But at the very least, I believe that I have made the case that women need sexual rehabilitation, or at least guidance, following surgeries or illnesses that are likely to impact their sexual functioning. No one should have to stumble around in the dark like I did.