Improving Libido after Vaginismus: The Importance of Foreplay

Improving libido after vaginismus

Foreplay is a very important aspect of improving libido after vaginismus. Darcy Donahue, a Certified Sex Therapist, writes: “Foreplay is an essential part of being ready emotionally as well as physically for sex. Your dilator may be able to help you relax the vaginal opening, but stimulation to your skin (arms, lips, legs, breasts, thighs, clitoris, behind-the-ear, etc.) help to build anticipation and arousal. It is during the arousal phase of the sexual response cycle that the vagina elongates and the pelvic organs pull up into the belly, making more room for deeper penetration. It is also during this phase that blood flows to the vulva, making the area swell and become protective to the bony areas of your pelvis. The walls of the vagina also stretch and relax, making penetration easier. In addition to the physical changes in our bodies during arousal, our brains begin to release a tremendous amount of hormones and neurochemicals that create feelings of wellbeing. Orgasm is just icing on the cake after that, but can also add to the experience.”

Libido is a highly complex issue. For many of my patients, libido was good in earlier years but diminished with the frustrations of vaginismus. For others, libido was never very strong.

disgust and vaginismusRecently, the topic of improving libido after vaginismus and the importance of foreplay has been discussed on the VaginismusMD Forum:

Patient 1 asks: “I want to have an exciting and fun sex life with my husband but it’s so hard. My question to you girls is do you have any suggestions on how to get the fun back in sex? I know foreplay is key but I try so hard and feel my brain shuts off for us.”

Vaginismus support groupThe VaginismusMD Forum members reply:

Patient 2 suggests: “We would plan date nights. Whether it was going to a romantic dinner or just staying home & watching a movie. I would go out and buy some lingerie and wear under my clothes…it made me feel sexy…I would surprise him with it…on the way home from dinner, etc. One thing we would always say when we would start to be intimate with each other was it’s OK if we don’t have intercourse. We would just spend a lot of time kissing & touching… Sometimes we didn’t even end up trying to have sex. But we needed those moments of intimacy to connect emotionally. We eventually got to a good place where we had those sparks again! I finally started to actually act on my feelings and initiate being intimate without it feeling like a chore.”

I write: “Dressing up and dressing down can be very helpful to avoid the mechanical aspects of dilation. Water is wonderful, take a shower or bath first-together. Use lubes on each other. Be vocal! We all know how music can move our souls. Let’s make some sex noise. Our partner, male or female, vocalizing with soft purring noises or downright screaming can be a big turn on for all involved. Once you dilate easily you do not need to dilate for the recommended one hour prior to intercourse. Actually even 5 minutes can work just fine. Actually a finger works as well.”

In addition to my aforementioned thoughts concerning the importance of foreplay in improving libido after vaginismus, please reference two blogs regarding further helpful tips for improving libido after vaginismus:

Two further areas of thought regarding improving libido after vaginismus

Medications can significantly affect one’s libido. In the recently discussed thread on the VaginismusMD Forum, Dr. Andrew Rynne writes:

“It simply can not be overstated just how bad the SSRI’s are for sexual functioning. They have the propensity to turn off pleasure receptor in your brain and to leave them turned off. Anorgasmia in men and loss of libido in men and women are common but woefully under-reported side effects of all anti-depressants and most anti-anxiety medicines. If you are on any of these medications and are suffering from lack or loss of libido then the first thing you need to consider is weaning yourself off them.”

Another area of diagnosis and treatment relates to Hormone Studies done with blood testing. Some women have naturally low testosterone, and testosterone replacement has been shown to be effective in certain cases of low libido. Dr. Rynne also touches on this, writing on the VaginismusMD Forum: “Consideration may need to be given to [one’s] hormone profile if you are circa menopausal or post. HRT including testosterone may need to be considered.”

As previously stated, libido is a highly complex issue!

Post-Procedure counseling deals with the complex issue of low libido and the importance of foreplay. It is well known that vaginismus is both a physical and an emotional disorder and even though a woman may be making excellent physical progress with her dilators, our patients often say that they need to “catch up emotionally to where they are physically”.

Contact Us

If you have any questions about our vaginismus treatment using Botox and progressive dilation under anesthesia or vaginal dilators, please contact us via our contact us form. More information on vaginismus and the vaginismus treatment using Botox and progressive dilation under anesthesia can be found on our sister website, PlasticSurgeryPA.

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About Dr. Pacik

Peter Pacik, MD, FACS is a recognized pioneer in treating patients with Botox for vaginismus and the author of When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy. He has been in practice for over thirty years and belongs to a small group of prestigious surgeons who are double board certified by both the American Board of Surgery and the American Board of Plastic Surgery. In 2010, Dr. Pacik received FDA approval to continue his study to treat vaginismus using intravaginal injections of Botox together with progressive dilation under anesthesia.
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