Category: Male Sex & Vaginismus

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Male Sex & Vaginismus

Why do we need testosterone?

What is testosterone?

Testosterone is the key male sex hormone that regulates fertility, muscle mass, fat distribution, and red blood cell production.

When levels of testosterone drop below levels that are healthy, they can lead to conditions like hypogonadism or infertility. There are, however, sources from which people with low testosterone can boost their levels.

Low testosterone is becoming more and more common. The number of prescriptions for testosterone supplements has increased fivefold since 2012.

This article will explore what testosterone does and whether men should worry about decreasing levels of the hormone as they grow older.

What is testosterone?

Testosterone is the hormone responsible for the development of male sexual characteristics. Hormones are chemical messengers that trigger necessary changes in the body. Females also produce testosterone, usually in smaller amounts.

It is a type of androgen produced primarily by the testicles in cells called the Leydig cells.

In men, testosterone is thought to regulate a number of functions alongside sperm production. These include:

  • sex drive
  • bone mass
  • fat distribution
  • muscle size and strength
  • red blood cell production

Without adequate amounts of testosterone, men become infertile. This is because testosterone assists the development of mature sperm.

Despite being a male sex hormone, testosterone also contributes to sex drive, bone density, and muscle strength in women. However, an excess of testosterone can also cause women to experience male pattern baldness and infertility.

The brain and pituitary gland control testosterone levels. Once produced, the hormone moves through the blood to carry out its various important functions.

Testosterone imbalances

Testosterone imbalances

High or low levels of testosterone can lead to dysfunction in the parts of the body normally regulated by the hormone.

When a man has low testosterone or hypogonadism, he may experience:

  • reduced sex drive
  • erectile dysfunction
  • low sperm count
  • enlarged or swollen breast tissue

Over time, these symptoms may develop in the following ways:

  • loss of body hair
  • loss of muscle bulk
  • loss of strength
  • increased body fat

Chronic, or ongoing, low testosterone may lead to osteoporosis, mood swings, reduced energy, and testicular shrinkage.

Causes can include:

  • testicular injury, such as castration
  • infection of the testicles
  • medications, such as opiate analgesics
  • disorders that affect the hormones, such as pituitary tumors or high prolactin levels
  • chronic diseases, including type 2 diabetes, kidney and liver disease, obesity, and HIV/AIDS
  • genetic diseases, such as Klinefelter syndrome, Prader-Willi syndrome, hemochromatosis, Kallman syndrome, and myotonic dystrophy

Too much testosterone, on the other hand, can lead to the triggering of puberty before the age of 9 years. This condition would mainly affect younger men and is much rarer.

In women, however, high testosterone levels can lead to male pattern baldness, a deep voice, and menstrual irregularities, as well as:

  • growth and swelling of the clitoris
  • changes in body shape
  • reduction in breast size
  • oily skin
  • acne
  • facial hair growth around the body, lips, and chin

Recent studies have also linked high testosterone levels in women to the risk of uterine fibroids.

Testosterone imbalances can be detected with a blood test and treated accordingly.

Testosterone levels and aging

Testosterone levels naturally decrease as a man ages.

The effects of gradually lowering testosterone levels as men age have received increasing attention in recent years. It is known as late-onset hypogonadism.

After the age of 40, the concentration of circulating testosterone falls by about 1.6 percent every year for most men. By the age of 60, the low levels of testosterone would lead to a diagnosis of hypogonadism in younger men.

About 4 in 10 men have hypogonadism by the time they reach 45 years old. The number of cases in which older men have been diagnosed as having low testosterone increased 170 percent since 2012.

Low testosterone has been associated with increased mortality in male veterans. Late-onset hypogonadism has become a recognized medical condition, although many of the symptoms are associated with normal aging.

The following are symptoms of late-onset hypogonadism:

  • diminished erectile quality, particularly at night
  • decreased libido
  • mood changes
  • reduced cognitive function
  • fatigue, depression, and anger
  • a decrease in muscle mass and strength
  • decreased body hair
  • skin changes
  • decreased bone mass and bone mineral density
  • increase in abdominal fat mass

As well as sexual dysfunction, late-onset hypogonadism has also been associated with metabolic disease and cardiovascular disease.

The degree to which testosterone levels decline varies between men, but a growing number of men experience the effects of reduced testosterone levels. Life expectancy has increased, and many men now live beyond the age of 60 years.

As a result, a higher number of men see the effects of age-related testosterone depletion.

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Male Sex & Vaginismus

Low Testosterone Affects Your Body

Low Testosterone

Low testosterone

Testosterone is a hormone produced by the human body. It’s mainly produced in men by the testicles. Testosterone affects a man’s appearance and sexual development. It stimulates sperm production as well as a man’s sex drive. It also helps build muscle and bone mass.

Testosterone production typically decreases with age. According to the American Urological Association, about 2 out of 10 men older than 60 years have low testosterone. That increases slightly to 3 out of 10 men in their 70s and 80s.

Men can experience a range of symptoms if testosterone decreases more than it should. Low testosterone, or low T, is diagnosed when levels fall below 300 nanograms per deciliter (ng/dL).

A normal range is typically 300 to 1,000 ng/dL, according to the Food and Drug Administration. A blood test called a serum testosterone test is used to determine your level of circulating testosterone.

A range of symptoms can occur if testosterone production drastically drops below normal. Signs of low T are often subtle. Here are 12 signs of low T in men.

1. Low sex drive

Testosterone plays a key role in libido (sex drive) in men. Some men may experience a decline in sex drive as they age. However, someone with low T will likely experience a more drastic drop in their desire to have sex.

2. Difficulty with erection

While testosterone stimulates a man’s sex drive, it also aids in achieving and maintaining an erection. Testosterone alone doesn’t cause an erection, but it stimulates receptors in the brain to produce nitric oxide.

Nitric oxide is a molecule that helps trigger a series of chemical reactions necessary for an erection to occur. When testosterone levels are too low, a man may have difficulty achieving an erection prior to sex or having spontaneous erections (for example, during sleep).

However, testosterone is only one of many factors that aid in adequate erections. Research is inconclusive regarding the role of testosterone replacement in the treatment of erectile dysfunction.

In a review of studies that looked at the benefit of testosterone in men with erection difficulties, nearly half showed no improvement with testosterone treatment. Many times, other health problems play a role in erectile difficulties. These can include:

  • diabetes
  • thyroid problems
  • high blood pressure
  • high cholesterol
  • smoking
  • alcohol use
  • depression
  • stress
  • anxiety

3. Low semen volume

Testosterone plays a role in the production of semen, which is the milky fluid that aids in the motility of sperm. Men with low T will often notice a decrease in the volume of their semen during ejaculation.

4. Hair loss

Testosterone plays a role in several body functions, including hair production. Balding is a natural part of aging for many men. While there is an inherited component to balding, men with low T may experience a loss of body and facial hair, as well.

5. Fatigue

Men with low T have reported extreme fatigue and decrease in energy levels. You might have low T if you’re tired all of the time despite getting plenty of sleep or if you’re finding it harder to get motivated to exercise.

6. Loss of muscle mass

Because testosterone plays a role in building muscle, men with low T might notice a decrease in muscle mass. Studies have shown testosterone affects muscle mass, but not necessarily strength or function.

7. Increased body fat

Men with low T may also experience increases in body fat. In particular, they sometimes develop gynecomastia or enlarged breast tissue. This effect is believed to occur due to an imbalance between testosterone and estrogen in men.

8. Decreased bone mass

Osteoporosis, or the thinning of bone mass, is a condition often associated with women. However, men with low T can also experience bone loss. Testosterone helps produce and strengthen the bone. So men with low T, especially older men, have lower bone volume and are more susceptible to bone fractures.

9. Mood changes

Men with low T can experience changes in mood. Because testosterone influences many physical processes in the body, it can also influence mood and mental capacity. Research suggests that men with low T are more likely to face depression, irritability, or a lack of focus.

10. Affected memory

Both testosterone levels and cognitive functions — particularly memory — decline with age. As a result, doctors have theorized that lower testosterone levels could contribute to affected memory.

According to a research study published in the Journal of the American Medical Association, some smaller research studies have linked testosterone supplementation with improved memory in men with low levels. However, the study’s authors did not observe memory improvements in their study of 493 men with low testosterone levels who took testosterone or a placebo.

11. Smaller testicle size

Low testosterone levels in the body can contribute to smaller-than-average sized testicles. Because the body requires testosterone to develop the penis and testicles, low levels could contribute to a disproportionately smaller penis or testicles compared to a man with normal testosterone levels.

However, there are other causes of smaller-than-normal testicles in addition to low testosterone levels, so this isn’t always just a low testosterone symptom.

12. Low blood counts

Doctors have linked low testosterone with an increased risk for anemia, according to a research article in the Journal of the American Medical Association.

When the researchers administered testosterone gel to anemic men who also had low testosterone, they saw improvements in blood counts compared to men who used a placebo gel. Some of the symptoms anemia can cause include problems concentrating, dizziness, leg cramping, problems sleeping, and an abnormally rapid heart rate.

Outlook

Unlike women, who experience a rapid drop in hormone levels at menopause, men experience a more gradual decrease of testosterone levels over time. The older the man, the more likely he is to experience below-normal testosterone levels.

Men with testosterone levels below 300 ng/dL may experience some degree of low T symptoms.


testosterone

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Male Sex & Vaginismus

Want to Have Wild and Loud Sex?

Worried that you can’t have wild and loud sex because your stamina dropping? 

Building stamina takes time. Unfortunately, losing it happens a lot faster than you might think. If your health and fitness habits are less than optimal, your body — and your energy — might be suffering as a result. If you find yourself tiring a lot faster than you used to, you might need to work on building your stamina.

Stamina is your body’s ability to sustain extended periods of physical activity. Extended periods can refer to several days of low-intensity exercise or minutes of high intensity exertion. Unhealthy lifestyle choices decrease your endurance and resilience, making it more difficult to sustain intense activities.

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Male Sex & Vaginismus

How Does Taking Testosterone Can Help You – Outside the Bedroom

How Does Taking Testosterone Can Help You

How Does Taking Testosterone Can Help You

Your sex life might not be the only thing lifted

Low testosterone can cause a bunch of unpleasant effects. Everything from your mood to your sex life can plummet if your levels of that important hormone aren’t up to snuff.

That’s where testosterone replacement therapy comes in. If you are clinically low in testosterone – usually levels that test below 300 nanograms per deciliter (ng/dL) – supplementing with T can boost your mood, your sex drive, and even your muscle growth.

And now, there might be one more benefit to add to the list: heart protection. At least, that’s what researchers from the Boston University School of Medicine are suggesting after they studied 656 men with low testosterone for about 7 years.

Testosterone is a male hormone which can be found in both men and women. But it is more of the male characteristics. Usually at age 30, blood levels of testosterone starts to decline slowly. If testosterone declines in a man’s body, his muscles, energy, and libido begin to decrease. Men who smoke and drink alcohol excessively lose testosterone faster than those who don’t.

Male hormones or testosterone stimulates metabolism, promote fat burning, increase red blood cells and muscle growth.

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Male Sex & Vaginismus

Sexual Trauma History

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

The following history exemplifies onset of vaginismus subsequent to episodes of psychosexual trauma. There have been three women referred to therapy so physically and emotionally traumatized by unwelcome sexual attack that vaginismus developed subsequent to their traumatic experiences.

Couple C
When first seen, couple C had been married for 18 months, with repeated attempts to consummate the marriage reported as unsuccessful. The husband, age 31, reported effective sexual function with several other women prior to marriage. The wife, age 28, described successful sexual connection with four men over a five-year period before the specific episode of sexual trauma.

One of these relationships included coitus two or three times a week over a 10-month time span. She had been readily orgasmic in this association. The traumatic episode in her history was a well authenticated episode of gang rape with resultant physical trauma to the victim requiring two weeks’ hospitalization.

Extensive surgical reconstruction of the vaginal canal was necessary for basic physical rehabilitation. No psycho-therapeutic support was sought by or suggested for the girl following this experience.

Mr. and Mrs. C met one year after the rape episode and were married a year after their introduction. Prior to the marriage the husband-to-be was in full possession of the factual history of the gang raping and of the resultant physical distress.

During the latter stages of their engagement period, several attempts at intercourse proved unsuccessful in that despite full erection, penetration could not be accomplished. It was mutually agreed that in all probability the security of the marital state would release her presumed hysterical inhibitions. This did not happen.

After the marriage ceremony, attempts at consummation continued unsuccessful despite an unusually high degree of finesse, kindness, and discretion in the husband’s sexual approaches to his traumatized partner. Severe vaginismus was demonstrated during physical examination of the wife after referral to the Foundation.

The remaining two rape experiences were family-oriented and almost identical in history. In both instances young girls were physically forced by male members of their immediate family to provide sexual release, on numerous occasions, for men they did not know.

In one instance:
A father, and in another, an older brother, forced sexual partners upon teenage girls, 15 and 17 years of age and repeatedly stood by to insure the girls’ physical cooperation. Sexually exploited, emotionally traumatized, and occasionally physically punished, these girls became conditioned to the concept that all men were like that.

When released from family sexual servitude each girl avoided any possibility of sexual contact during the late teens and well into the twenties, until married at 25 and 29 years of age. Even then, they could not make themselves physically available to consummate their marriages, regardless of how strongly they willed sexual cooperation. Severe vaginismus was present in both eases.

The husbands’ physical and psychosexual examinations were within expected limits of normal variability. Neither husband had been made aware of the family-oriented episodes of controlled rape that had occurred years before their association with their wives-to-be.

Once apprised of the etiology of their wives’ psychosomatic illness, both men offered limitless cooperation in the therapeutic program. There are various etiological orientations to vaginismus. As evidenced previously, trauma initiating involuntary vaginal spasm can be either physiological or psychological, or both, in origin.

Of course there are factors of psychosomatic influence that predispose to vaginismus other than those frequently noted categories of channelized religious orthodoxy, male sexual dysfunction, and episodes of sexual trauma.

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Male Sex & Vaginismus

Sex with Lesbian

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

Two case histories illustrate the occasional effect of homosexual orientation upon the female partner. Couple G was composed of a 26-year-old woman married to a man 37 years old. The wife had been actively homosexual since seduction by an elder sister when she was 12 years old.

There had been no history of heterosexual function before meeting her husband. He was a successful professional man and offered the woman much in the form of social status and financial security. He had been previously married and divorced.

Sexual exposure during the short engagement had been restricted, by female edict, to multiple manipulative approaches. There was total inability to penetrate on the wedding night or to consummate the marriage thereafter. When the unit was seen after 18 months of marriage, the wife’s hymen was not intact but there was evidence of severe vaginismus.

Once all of her pertinent history was obtained and shared with her marital partner, there was little further resistance to penile penetration. She was orgasmic with intercourse within two weeks after termination of the acute phase of therapy. Couple H had been married for 7 years. There were two children.

The husband became an alcoholic, lost his job, and left his family without warning. He was out of the home for 3 years before he could be persuaded to seek professional help. There was another year spent in treatment before he could return to family and social position.

Fortunately, there was sufficient financial resource, so no great financial hardship was suffered by his family. The wife, distraught at first, sought support from her best friend, also married and living in the neighborhood.

Marrying A Lesbian

Within a year an overt homosexual relationship developed. Mrs. H had no prior history of homophile orientation. Two years after her husband left the home, Mrs. H attempted sexual intercourse on several different occasions with two different men, but neither man could penetrate.

There was no further heterosexual exposure after these failures until her husband was released from institutional control to return to normal activity. When attempting intercourse, Mr. H could not penetrate, nor was he able to during the subsequent two years before the couple was seen in therapy.

The vaginismus was obvious at physical examination. The probable cause of her involuntary rejection of coitus was explained and accepted by both partners. Dilators were used effectively and coital functioning was reestablished quickly.

One marriage had existed in a sexual successful state for almost 10 years when the husband was detected in an extramarital affair. There was a 4-month period of continence while marital fences were mended with help from clergy. Although verbally forgiving his transgressions, the wife evidenced vaginal spasm during subsequent attempts at coital connection.

The marital unit’s inability to reestablish a successful coital pattern continued for almost 18 months until, consumed with fears for performance, feelings of guilt, and finally of personal rejection, the husband became secondarily impotent. When seen in therapy, both vaginismus and impotence were presenting systems.

There have been 7 more instances of vaginismus treated by Foundation personnel. Onset of symptoms has ranged from evidence of involuntary vaginal spasm with a first coital opportunity to dysfunction secondary to physiological or psychological trauma. There seems little need for further illustration of the onset of the syndrome.

Regardless of onset, an effective therapeutic approach is to establish the etiological influences by careful history-taking, and then to approach treatment confidently. With adequate dissemination of information so that full appreciation of onset of the sexual dysfunction is acquired by couple involved, and the sexual partners’ mutual cooperation in therapy, reversal of the syndrome of vaginismus is accomplished with relative ease.

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Male Sex & Vaginismus

Marital Sex Solution

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

The initial and most important step in the treatment of vaginismus is physical demonstration of the existence of the involuntary vaginal spasm conducted to the clinical satisfaction of both marital partners.

Anatomical illustrations of the involuntary constriction in the outer third of the vagina is made available to the marital partners and the specific anatomical involvement explained in detail. Then the basic aspect of clinical therapy is accomplished in a medical treatment room with the female partner draped and placed in the gynecological examining position.

Vaginal Insertion

The obvious presence of involuntary vaginal spasm, demonstrated by any attempt at vaginal insertion of an examining finger, frequently is more of a surprise to the female partner than it is to her husband. She may be completely unaware of the existence, much less the severity, of the involuntary spastic constriction of her vaginal outlet.

The chaperoned pelvic examination is not terminated before the husband also has been gloved and encouraged to demonstrate to his’ and to his wife’s satisfaction the Severity of the involuntary constriction ring in the outer third of the vagina.

Once the clinical existence of vaginismus has been demonstrated to the satisfaction of both marital partners, resolution of this form of sexual inadequacy becomes relatively easy. Hegar dilators in graduated sizes are employed in the privacy of the marital bedroom.

The actual dilatation of the vaginal outlet is initiated and conducted by the husband with the wife’s physical cooperation, at first with her manual control and then verbal direction. Again, the rationale behind the Foundation’s demand for availability and cooperation of both marital partners.

Increase Sex

When attempting to alleviate varying forms of human sexual inadequacy, is underscored. After the larger-sized dilators can be introduced successfully, it is good policy to encourage intravaginal retention of the larger dilators for a matter of several hours each night. Usually a major degree of the involuntary spasm can be eliminated in a matter of 3 to 5 days, presuming daily renewal of dilating procedures.

To date there has not been a failed attempt to relieve the involuntary spasm of vaginismus, once the clinical existence of the outlet contraction has been demonstrated to both husband and wife and the cooperation of both partners in the dilatation therapy has been elicited.

When coitus is attempted during the first month or six weeks after initial relief of the involuntary vaginal spasm, preliminary dilatation of the vaginal outlet occasionally may be indicated.

In many instances, however, the simple clinical demonstration of the existence of the vaginal constriction and the subsequent controlled usage of the dilators for a few days is quite sufficient to remove permanently this involuntary obstruction to vaginal penetration.

While physical relief of the spastic constriction of the vaginal outlet is usually accomplished without incident, the psychosocial trauma that contributed to the involuntary constriction must not be ignored. When physical symptoms of sexual dysfunction are relieved or removed, the tensions that have led to onset of the symptoms usually become much more vulnerable to treatment.

For a couple contending with vaginismus, an explanation of the psychophysiology of the distress, what it is, how it developed, and assurance that relief is possible are all important factors in the therapeutic program. As stated previously, the first and most important step in symptomatic relief is to demonstrate to both husband and wife the clinical existence of the dysfunction. Thereafter, the therapist is dealing with a receptive, if somewhat surprised, audience.

Relieve Sex Tensions

The easiest way to relieve the sexual tensions, the sexual misconceptions, even the established sexual taboos, is through direct dissemination of information. Women handicapped sexually by the influence of religious orthodoxy, married to men with sexual dysfunction, victimized by rape, contending with unexplained dyspareunia, frustrated by aging constriction of the vaginal barrel, or confused by homosexual and heterosexual conflict all have one thing in common.

They all exhibit almost complete lack of authoritative information from which to gain some degree of objectivity when facing the psychosocial problem evidenced by the symptoms of their sexual dysfunction.

With no knowledge of what to expect sexually, no concept of natural levels of sexual responsivity, and even real distrust for authority, theirs is a desperate need for definitive information. Education to understand the psycho physiological aspects of the problem is a point of departure for these traumatized women.

Confidence comes slowly from a gradually increasing degree of objectivity that develops from their psychosocial acceptance of the basic concepts of the naturalness of human sexual functioning.

With pertinent sexual information absorbed, with the physical dysfunction illustrated, explained, and relieved, women with resolution of involuntary vaginal spasm have been reoriented to lives of effective sexual functioning.

Of the 29 women referred for relief of their sexual dysfunction, all have recovered from the vaginismus, and 16 were orgasmic for the first time in their lives during the two-week attendance at the Foundation.

Four more women have reported orgasmic return during the follow-up period after termination of the acute phase of their treatment. Six women were previously orgasmic before onset of the secondarily acquired symptoms of vaginismus.

Their orgasmic responsivity returned spontaneously after treatment. Three women remained non-orgasmic, despite clinical relief from their involuntary vaginal spasm.

Vaginismus, once diagnosed, can be treated effectively from both psychological and physiological points of view, presuming full cooperation from both members of the sexually dysfunctional.

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Male Sex & Vaginismus

Male sex and Vaginismus

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

Male sex and vaginismus is a psycho physiological syndrome affecting women freedom of sexual response by severely, if not totally, impeding coital function. Anatomically this clinical entity involves all components of the pelvic musculature investing the perineum and outer third of the vagina.

Physiologically, these muscle groups contract spastically as opposed to their rhythmic contractual response to orgasmic experience. This spastic contraction of the vaginal outlet is a completely involuntary reflex stimulated by imagined, anticipated, or real attempts at vaginal penetration.

Vaginismus is a classic example of a psychosomatic illness.

Vaginismus is one of the few elements in the wide pattern of female sexual dysfunctions that cannot be unreservedly diagnosed by any established interrogative technique.

Regardless of the psychotherapist’s high level of clinical suspicion, a secure diagnosis of vaginismus cannot be established without the specific clinical support that only direct pelvic examination can provide. Without confirmatory pelvic examination, women have been treated for vaginismus when the syndrome has not been present.

Conversely, there have been cases of vaginismus diagnosed by pelvic examination when the clinical existence of the syndrome had not been anticipated by therapists. The clinical existence of vaginismus is delineated when vaginal examination constitutes a routine part of the required complete physical examination.

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Male Sex & Vaginismus

Male Painful Sex

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

Vaginismus occasionally develops in women with clinical symptoms of severe dyspareunia (painful intercourse). When dyspareunia has firm basis in pelvic pathology, the existence of which escapes examining physicians, and over the months or years coition becomes increasing painful, vaginismus may result.

The patient is not reassured by console that “it’s all in your head” or equally unsupportive pronouncements, when she knows that it is always severely painful for her when her husband thrusts deeply into the vagina during coital connection.

As examples of this situation, vaginismus has been demonstrated as a secondary complication in two cases, of severe laceration of the broad ligaments. Also recorded are two classic examples of onset of vaginismus, the first in a young woman with pelvic endometriosis, the second in a 62 year old postmenopausal widow (without sex-steroid replacement therapy) who through remarriage sought return to sexual functioning after seven years of abstinence.

The two women developing a syndrome of vaginismus subsequent to childbirth laceration of the broad ligaments supporting the uterus (universal-joint syndrome) have similar histories. A composite history will suffice to demonstrate the pathology involved.

Mr. And Mrs. D
was seen with the complaint of increasing difficulty in accomplishing vaginal penetration developing after 6 years of marriage. There were two children in the marriage, with onset of severe dyspareunia oriented specifically to the delivery of the second child. The second child, a post mature baby of 8 pounds 14 ounces, had a precipitous delivery.

There is a positive history of nurses holding, the patient’s legs together to postpone delivery while waiting for the obstetrician. As soon as sexual activity was reconstituted after the delivery the patient experienced severe pain with deep penile thrusting. During the next year the pain became so acute that the wife sought subterfuge to avoid sexual exposure.

The intercourse frequency decreased from two to three times a week to the same level per month. On numerous occasions the patient was assured, during medical consultation, that there was nothing anatomically disoriented in the pelvis and that pain with intercourse was “purely her imagination.”

Supported by these authoritative statements, the husband demanded increased frequency of sexual function. When the wife refused, the unit separated for serveral months. During these month period, the woman assayed intercourse on two separate occasions with two different men, but with each experience the pelvic pain with deep penile thrusting was so severe that her obvious physical distress terminated sexual experimentation.

The couple was reunited with the help of their religious adviser, but with attempted intercourse vaginal penetration was impossible. After 8 months of repeatedly unsuccessful attempts to reestablish coital function, the unit was referred for therapy.

Couple E
married 8 years when seen in the Clinic. They mutually agreed that coital connection had not been possible more than once or twice a month in the first two years of marriage. Each time, the wife had moaned or screamed in pain as her husband was thrusting deeply into her pelvis. After the first two years of marriage, every attempt at vaginal penetration had been unsuccessful.

Both had been under intensive psychotherapy, the husband for three and the wife for four years, when referred to the Foundation. During the routine physical examinations, advanced endometriosis was discovered, and severe vaginismus was demonstrated.

In due course the wife underwent surgery for correction of the pelvic pathology. After recovery from the surgery she returned with her husband for therapeutic relief of the vaginismus which, as would be expected, still existed despite successful surgical correction of the endometriosis.

Couple F
a 66 year old husband and his 62 year old wife, were seen in consultation. When the wife was 54 years old, her first husband died after a three-year illness during which sexual activity was discontinued. She remarried at 61 years of age, having had no overt sexual activity in the interim period.

She had never been given hormone-replacement therapy to counteract the natural involution of pelvic structures. First attempts at coital connection in the present marriage produced a great deal of pain and only partial vaginal penetration.

With reluctance the wife sought medical consultation. Her physician instituted hormone-replacement techniques. After a 6-week respite, further episodes of coital activity also resulted in pain and distress.

Despite the fact that by this time the vaginal walls were well stimulated by effective steroid replacement, the new husband found it impossible to attain vaginal intromission. The wife had developed obvious psychosocial resistance to the concept of sexual activity in the 60 plus age group based on the pain that had been experienced attempting to consummate her new marriage.

And a real sense of embarrassment created by the need for medical consultation and the necessity of admitting that she had been indulging in coital activity at her age.

As a result of the trauma that developed with attempts to renew sexual function subsequent to almost ten years of continence, she developed involuntary spastic contraction of the vaginal outlet. Judicious use of Hegar dilators and a detailed, thorough, and authoritative refutation of the taboo of aging sexual function (based on the belief that sexual activity in the 60, 70, or even 80 year age groups represents some form of perversion) were quite sufficient to relax and relieve the vaginal spasm.

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Male Sex & Vaginismus

Impotence Trauma

sexual, male, impotence, vaginismustrauma, sex, lesbian, vaginismus, marital, sex ,solition

Here is illustrative of an etiological factor frequently encountered in vaginismus, that of the influence of channel visioned religious orthodoxy upon the immature and adolescent girl. When the couple was first seen in consultation, couple A’s marriage had existed unconsummated for 4 1/2 years.

The wife, from a sibling group of four females and one male, was the only one not to take the vows of a religious order. Her environmental and educational backgrounds were of strictest parental, physical, and mental control enforced in a stringent disciplinary format and founded in religious orthodoxy.

She was taught that almost any form of physical expression might be suspect of objectionable sexual connotation.

For example:
She was prohibited when bathing from looking at her own breasts either directly or from reflection in the mirror for fear that unhealthy sexual thoughts might be stimulated by visual examination of her own body. Discussions with a sibling of such subjects as menstruation, conception, contraception, or sexual functioning were taboo.

Pronouncements on the subject were made by the father with the mother’s full agreement. Her engagement period was restricted to a few chaste, well-chaperoned kisses, for at any sign of sexual interest from her fiance, the girl withdrew in confusion.

Couple A
Mrs. A entered marriage without a single word of advice, warning, or even good cheer from her family relative to marital sexual expression. The only direction offered by her religious adviser relative to sexual behavior was that coital connection was only to be endured if conception was desired.

Mrs. A’s only concept of woman’s role in sexual functioning was that it was dirty and depraved without marriage and that the sanctity of marriage really only provided the male partner with an opportunity for sexual expression. For the woman, the only salvation to be gained from sexual congress was pregnancy.

With the emotional trauma associated with wedding activities, and an injudicious, blundering, sexual approach from the uninformed but eager husband, the wedding night was a fiasco quite sufficient to develop or to enhance any preexisting involuntary obstruction of the vaginal outlet to a degree sufficient to deny penetration.

The husband, of the same orthodox background, had survived these traumatic years without developing secondary impotence. His premarital experience had been two occasions of prostitute exposure, and there was no reported extramarital experience.

He masturbated occasionally and was relieved manually by his wife once or twice a week. His wife had no such outlet. Her only source of effective relief was well-controlled psychotherapy.

With an incredible number of thou-shalt-nots dominating Mrs. A’s environmental background, it is little wonder that she was never able to develop a healthy frame of reference for the human male in general and her husband in particular as a sexual entity. Her sexual value system reflected severe negative conditioning.

Couple B
The presenting complaint for couple B upon referral to the Foundation was that of secondary impotence. The husband’s history was one of successful response to coital opportunities with three women over a period of 18 months before meeting his wife.

An eight-month courtship followed without attempted coital connection or, for that matter, any physical approach, as the man was overwhelmed by the multitude of restrictions placed upon courtship procedure by the girl’s religious control. The husband-to-be was of the same faith, but his background was not orthodox.

Following a chaste engagement period, failure to consummate the marriage occurred on the wedding night. Religious orthodoxy, although of major import, was not the only factor involved in this traumatized marriage.

With both husband and wife tired and tense, he unfortunately hurried the procedure. All too cognizant of prior coital success and totally frustrated by lack of sexual exposure to his wife, he attempted penetration as soon as erection developed.

While attempting rapid consummation, his wife, unprepared for the physical onslaught, was hurt. She screamed; he lost his erection and could not regain function. By mutual agreement, further attempts at consummation were reserved for the seclusion of the wedding trip.

Attempts at coition were repeated during the honeymoon and thereafter almost daily for the first five to six months of the marriage and two to three times per week for the next year, but there was no success in vaginal penetration. Eighteen months after the wedding the husband developed marked loss of erective security.

He rarely could achieve or maintain an erection quality sufficient for intromission.

When there was erective success, frantic attempts at vaginal penetration stimulated pain, fear, and physical withdrawal from his female partner.

During the remaining two years before consultation, attempts at coition gradually became less frequent. The husband’s history included a report of eight months of psychotherapeutic support without relief of the symptoms of secondary impotence. No consideration had been given to the possibility of coexistent female pathology.

The involuntary vaginal spasm certainly could have been present before marriage, invalidating the initial attempt at intromission. Also, it is possible that over a few year period, the severe degrees of frustration resultant from multiple unsuccessful attempts to penetrate could initiate involuntary vaginal spasm.

If a moderate degree of spasm were present at marriage, the sexual ineptitude of the husband and the episodes of pain with attempted penetration would tend to magnify the severity of the syndrome well beyond any initially existent level. Secondary impotence resulting from long-denied intromission is not at all uncommon.