Thursday, April 26, 2012

Naughty Nurse Kimpy - 04/25/2012


Ask Naughty Nurse Kimpy is an advice column that addresses reader’s most burning questions on sexual health/relationships. STIs, birth control, is it real or is it fic, sexual positions--you name it. There are no stupid questions, only ones that are too embarrassing to asks someone you know. If Naughty Nurse Kimpy doesn’t know the answer, she’ll find an expert who does!


The information and advice from Ask Naughty Nurse Kimpy is for entertainment/educational purposes only and is not intended to be used as expert medical advice. It is not meant to replace the advice of your physician. All medical advice and information should be considered to be incomplete without a physical exam, which is not possible without a visit to your doctor.

Today’s post focuses on the times when sex isn’t fun, because it’s painful. It’s a more common phenomenon than you might think, and Naughty Nurse Kimpy will give her very best effort to demystify the topic. Next week’s post will focus on a few specific examples of when a sexual position is painful and how to problem solve.

Hi! I have a question about birth control; I don't want to mess with hormones and stuff, and I am only 21 so no IUD, but I wanted to ask you what you think about lady-comp for the times when I don't want something like a condom or a dental dam in the way (of course if both my partner and I are STD-free)?

Dear reader, Nurse Kimpy is very sorry to admit that she isn’t quite sure what you’re referring to when you use the term “lady-comp.” Would you do her a huge favor and submit your question again, with a few more details? She really wants to be able to help you find the right birth control choice, she just needs some more information. Thank you!

Dear Nurse Kimpy, I was wondering if you could talk about something called "Vaginismus" on here? General symptoms and explain what it is? I'm pretty sure I've got it, but I'm too lazy/scared (mixture of both) to actually go to a doctor and rule out other things. Talked to my mum about it tho (she's a nurse too) and she told me that she thought that's what it is. During/after/right before masturbation (with toys going inside) I can get these horrible cramps. They start inside, and around the pelvis area and spread through my body till I can't stand up or barely move from the pain, and I just "lock" like that till it passes again. I'm a virgin for the time being, my boyfriend is currently overseas. He seems to agree that it could be vaginismus as well... This is a bit rambling, I'm sorry about that. But yeah, was wondering if you could help me understand a bit more about it? Best, wishes from M.

Naughty Nurse Kimpy wants to help you out with this problem--sex shouldn’t have to hurt, even when there’s only one of you involved! We’ll go through a quick tutorial on just what vaginismus is, and things that can be done for it. Our goal is to figure out what can be done so you get back to fun, pain-free loving.

Vaginismus is a condition that affects the pubococcygeus (PC) muscles--a group of powerful muscles located on your pelvic floor that control your your uterus, bladder, and bowels. This group of muscles is never fully relaxed, so they easily constrict when they’re needed. In vaginismus, they involuntarily spasm, causing the entrance to your vagina to be impassable. The spasms are painful, because they are so strong. Once you’ve experienced these spasms, your body can become conditioned to trigger a tightening/spasm response in advance of inserting something into your vagina. Your body tightens up in order to avoid the pain of insertion, but paradoxically, it’s the tightening of the PC muscles that is causing the pain.

PC muscle contractions can occur before, during, or after insertion of an object into your vagina. While the object is usually a penis, that doesn’t have to be the case. In your situation, toys appear to cause the same reaction as a penis might. For some women, they can’t even insert a tampon or have a gynecological exam. As with anything, there is a range of severity in vaginismus; for example, some women can use tampons, but they can’t have sex.

Below, you’ll find a graphic about the cycle of pain that affects most women with vaginismus. Nurse Kimpy found it on a great website--Vaginismus--and it does a really good job of illustrating the mind/body connection that is prevalent with women who experience vaginismus.

Nurse Kimpy wants to point out--emphatically!--that vaginismus isn’t your fault. The muscle spasms are completely involuntary. Anyone who tells you that all you need to do is relax so it will stop is just trying to sell you a big old line of hooey. Now, you mentioned that you were too scared/lazy to talk to your doctor about it, but Nurse Kimpy is sorry to tell you that you truly do need to have that conversation with your doctor. It could be that there is a medical reason underlying your spasms, and you should get that assessed before you do any more problem solving.
The good news for you is that if you truly do suffer from vaginismus, it can be treated effectively. It usually requires a series of treatment steps that a woman can use to retrain her PC muscles. It would be perfect if you could start to address this now, so that you can work on it before your boyfriend returns home.

Naughty Nurse Kimpy wishes you the best of luck as you troubleshoot what you’re experiencing. If you have any follow up questions, you know what to do.

Do you have a question for Naughty Nurse Kimpy? Click the banner below, fill out the form, and get your answer in the next installment of Ask Naughty Nurse Kimpy.