What a pain



Dear Readers:

In the process of starting to crawl out of my "I just had two babies! Leave me alone!" cocoon, I've been teaching some new workshops, one on what it's really like to have twins, and one that I'm calling "Is There Sex after Motherhood?" — hoping the idea comes across even though motherhood is, technically, a lifelong venture ending in death, after which, one assumes, not so much sex. I debuted the sex one recently at the original "clean, well-lighted place for buying things to stick up your hoo-ha," Good Vibrations. There was a decent crowd, and everybody seemed to have a good time; and when we got to the Q&A, I was gratified by the number of questions. (That's how you can tell if people were interested in your presentation, right? Not so interested = polite thanks and drifting away; interested = hang around asking questions until the management kicks you out.) There's some serious sadness haunting the new and newish mothers though, so while it's all good and fun to talk about how a simple blow job between child care tasks can save your marriage (ask me how!), some of the questions stayed with me after we'd cleared away the cookies and juice (yes, mothers are served toddler snacks, don't ask me why) and gone home.

It's surely true that during the first few years after having kids, your sex life tends to be ... well, "lackluster" is a nice word, but I think "laughable" might be more accurate in a lot of cases. Some of the women at these events are really beating themselves up over it though, which I guess is expected and is why I'm talking about this stuff in the first place, but one of them really saddened me when she said, quite matter-of-factly, that intercourse was still quite uncomfortable for her several years later and she hadn't mentioned this to her husband. "I think you need to communicate with your husband," the other speaker, a therapist, offered. "I think you should find out what hurts and make it stop hurting," I countered.

How many women, mothers or not, are having painful sex and just not mentioning it? The most common cause of uncomfortable insertive sex is nothing more complicated than a case of "not ready–itis" or lack of lubrication, but a Harvard study cited by the National Vulvodynia Association (see www.nva.org/media_corner/fact_sheet.html) estimates that 16 percent of women in the United States suffer from the chronic vulvar pain called vulvodynia or its subtype, vulvar vestibulitis, affecting just the opening to the vagina. That's a lot of women! Most are young when it starts, and most can locate no particular event or infection that set it off, but the pain can be paralyzing (many describe it as feeling like acid was poured onto sensitive tissues, or "like knives"). So we have a mysterious etiology; a location in the parts that many women simply don't mention in public, even if that public comprises their doctor, themselves, and nobody else; and an exclusively female population of sufferers; and what do we get? Predictably, silence, confusion, and shame. And while I have never been a big fan of men-versus-women jokes and somehow doubt that if men got pregnant, ma- or paternity leave really would be two years long with full pay (come on!), if men often had agonizing, unexplained pain in their manly man parts, surely they wouldn't have been subjected to generations of doctors pronouncing it "all in your head."

The good news — there has to be some — is that vulvodynia is finally getting the research money and attention it deserves.

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