Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions at EMandLO.com. To ask her your own question, click here.
Dear Dr. Vanessa,
I am a 34-year-old female virgin. There were times with one ex when I thought I was ready, but it would start to hurt, I'd get scared and then wouldn't go through with it. I was wondering if I should see gynecologist and have my hymen broken ahead of time to save me from some discomfort. Everything I've read has said first intercourse sex is never "magical." Could this help?
It is possible that stretching the hymen open might help. The hymen is the thin, skin-like tissue that stretches over part of the vaginal opening. Some women are born with more hymenal tissue than others. Many are born with so little that they may seem they have none. Often, women stretch their hymens open during activities that have nothing to do with sex. These activities include working out, gymnastics, horseback riding, and other sports. Penetrative masturbation - with or without sex toys, such as vibrators or dildos - may also stretch the hymen open.
Women with a lot of hymenal tissue can stretch it open slowly over time. A gynecologist can tell you how to obtain vaginal dilators. They are a series of increasingly thick rods that can be used to stretch open the hymen. Or you or your partner can use fingers in the same way. Start with the smallest finger that causes no discomfort. Then increase to two to three fingers over time. This type of dilation usually takes weeks. It is best done as a form of foreplay when you are aroused. Don't attempt penile-vaginal intercourse until you have been comfortably dilated to about the size of a penis a few times.
The hymen, however, is not the only cause of painful intercourse - also called dyspareunia. There are two very common causes. One is insufficient sexual arousal before intercourse. This leads to a lack of vaginal lubrication, which leaves the vagina too dry to comfortably enclose a finger, penis or dildo. This may be resolved with more foreplay and/or the use of artificial lubricants such as K-Y or Astroglide.
The other very common cause is called vaginismus. It is painful intercourse that happens when a woman's fear and anxiety about vaginal intercourse cause the muscles around her vagina to go into spasm when her partner tries to insert a finger, penis or dildo. Gynecologists, accredited sex therapists, and very patient partners can help a woman resolve vaginismus by using the dilation techniques described above.
There are several other possible causes of painful intercourse, including malformations of the vulva and vagina, infections of the reproductive tract, endometriosis, allergies to foreign substances like latex or spermicides, and scarring from vaginal tears resulting from childbirth, episiotomy, hysterectomy, rape, or female genital mutilation. Hormone imbalances can also lead to painful intercourse by causing thinning and drying of vaginal tissue. These are common among women after menopause, but they may occur among younger women as well.
The place to start sorting through all these possibilities is with your gynecologist. Please talk with her or him about this. That conversation and a pelvic exam may begin to make all the difference in the world for you.
Best wishes for your good sexual health,