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Dear Dr. Myrtle,
I have not been sexually intimate with anyone for several months, and I'm worried about having pain when I am penetrated again. Is there anything I can do?
 A woman's vulva and vagina are especially sensitive areas of the body. Before women are ever sexually intimate, or when some times passes between periods of intimacy, the vulva and vagina can lose flexibility and tissue strength. This can lead to uncomfortable or even downright painful sexual experiences. This brochure describes a healing program to help tone the vulva and help sexual intimacy be more pleasurable.
Our goal is threefold:
- To increase flexibility and elasticity of the vulvar skin and suppleness of the underlying structures.
- To increase blood flow and circulation to nurture the skin, clitoris, support tissues, and vaginal canal.
- To allow sensation to be pleasurable, not irritating.
When you read through this article, pay special attention to areas of the program that seem most helpful for you and your unique situation.
Moisturizing and Massage
One way to help increase the suppleness of your skin (on the vulva as well as in the vagina) is to perform a vulvar/vaginal massage with a moisturizing sexual lubricant. We suggest Liquid Silk, because it:
- Is a moisturizing, water-based, genital-safe lotion;
- Will soak in and not get sticky as you use it; and
- Will help you massage with very little friction.
Before you begin, make a plan for yourself. We suggest placing a bottle of Liquid Silk next to your toothbrush to remind you to do your massage when you brush your teeth: morning and night.
Let's take a look! Find some comfy clothing, privacy, a mirror, and a lamp. You may want to recline on your bed with a pillow behind your back and a pillow to prop your mirror on. Spread your knees apart a comfortable distance (use pillows for your legs, too, if you'd like) and gaze upon your lovely vulva.
See how much it looks like a blooming flower? The labia are the petals, and you can peer down to the opening of your vagina as toward the center of a flower. Try to find a skin flap at "12 o'clock" that covers the tip of your clitoris. This is called the clitoral hood, and some women can pull it back to view the clitoris. Your clitoris may be several different colors -- from tan to pink to deep purple -- and any or all of these colors are normal. The clitoral legs are drawn here, but in reality they cannot be seen because they lie under the surface of the skin and circle around the vagina. Look for your urethra (where urine comes out) and your anal opening. The skin between the vaginal opening and the anal opening is called the perineum, and can be a sensitive sexual spot for some people.
It is normal for every woman's vulva to look asymmetrical (some parts bigger or smaller than others) and for every woman's vulva to be different. In this way, we are all truly unique. If you'd like to see some photos of the vast range of beautiful vulvas in the world, we recommend the book Femalia by Joni Blank.
Vulva Massage
Many women report that the skin on the vulva is tight and uncomfortable to touch after they are not sexually intimate for a time, such that vaginal penetration isn't even a possibility. Even if this does not describe your situation, massaging the vulva can help your inner body tissues by increasing the amount of blood circulating to the area and allowing the area to become accustomed to touch.
Most women find that they can accomplish this massage in about five to 10 minutes, so you don't need to feel as though you'll be spending the rest of your life doing vulva massage. Other women find that this massage gives them permission to slow down and connect with sensations of touch on their genitals, and prefer to spend more time on the massage. Remember that this does not need to be self-sexual in any way, but if that is comfortable for you, by all means explore these sensations.
Begin with the skin of your outer labia. Put a quarter-sized dab of Liquid Silk on your fingertips and massage it into your labia, using small, circular strokes. You don't need to feel "wet," but do use enough lubricant to make your massage feel somewhat slick, so that you know you are using enough to effectively moisturize. Push lightly into the skin with the pads of your fingers in order to massage and strengthen the tissues underneath. Rather than brushing across the skin, pick up your fingers when you move to a new spot to avoid pulling or tearing. Your goal is to bring fresh blood to your skin with these circular strokes, pushing congested fluid and old blood out. You are not trying to stretch out your skin; rather, you are working to increase your skin's flexibility.
Now, extend your massage to include the inner labia, clitoral hood, clitoral tip, and perineum. An effective technique for perineal massage is to slip your thumb into your vaginal opening and squeeze or massage the skin between the lower vaginal wall and anal opening. Perineal massage is especially beneficial if your vagina feels uncomfortably tight, since this massage helps increase flexibility of the skin that stretches during penetration.
To complete your external massage, massage around the vaginal opening, using gentle, circular strokes.
Internal Vaginal Massage
It is also important to massage the inside of your vaginal canal, but it's necessary to do this with something that will prevent friction and tearing in the process. You can choose to use a well-lubricated finger or two; or, if you'd like to increase your reach and/or are concerned about tearing, we recommend using a smooth-surfaced, hard plastic vibrator to perform this massage.
A Woman's Touch has several different vibrators that you may want to consider. We generally recommend the Waterlily (one finger wide), Slimvibe 1 (two fingers wide) or Slimvibe 2 (2.5 to 3 fingers wide). It's best to choose the vibrator size based on how many fingers you can comfortably insert into the opening of your vagina when you are not aroused.
After a session of external vulva massage, apply the same massage to the innter surfaces of your vagina by coating your vibrator with Liquid Silk, inserting it into your vagina, and letting it run for about five minutes. Most women find it comfortable to have lubricant on both the skin and the vibrator. This internal massage isn't about pushing something in and out of your vagina, but rather letting the vibrations massage lubricant into your vaginal tissues.
When you feel comfortable with this internal vaginal massage, gradually lengthen the amount of time you spend on it. If you have a partner, you may want to ask him/her for assistance, or you may want to continue doing this on your own -- it's completely your choice.
Remember to focus on pushing gently into your skin and massaging the tissue beneath with small, circular strokes. You're not "too tight," and there's no need to attempt to stretch your vagina. This massage will help you increase skin flexibility so that your body can adjust to sexual penetration if you choose.
More than penetration ...
The next step is to evaluate yourself with regard to your orgasmic potential. Are you able to bring yourself to orgasm? Could you before, or could you ever? Time can have a negative effect on the function of blood vessels and the clitoris. For women who once had orgasms but have stopped, the blood vessels can literally "get out of shape" such that you may not be able to have orgasms that are as intense in the future. If you are able to bring yourself to orgasm, you have my prescription to bring yourself to orgasm at least once a week (for the rest of your life -- seriously!). This is actually preventive maintenance for your body. If you are not able to orgasm now, or have never been able to orgasm, please see our Orgasms article and brochure. The pelvic floor exercises described in our Kegels article and brochure may also be of assistance.
Where do you go from here?
The road from here depends on you. This is much more of a process than an endpoint. The path you travel from here may be one of continued daily massages and intermittent orgasms. Or you may find that the path you travel involves taking vacations from the massage/orgasm schedule and restarting the program when you feel like you need to. Continue this program at whatever frequency you are comfortable with.
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