ICN Romance and Intimacy Center

They’ve been together for years and his wife now has IC. He so wants to love her, but he’s afraid to try. The last time made love, it hurt her for days afterwards. And so, he turns away with regret in his eyes because he’d rather do anything then hurt her. And she looks to him with sadness in hers wondering why he doesn’t try anymore.
He is a young man with pain from a pelvic injury. He wants to love his wife so badly.. but arousal hurts.. and he doesn’t know what to do next. He doesn’t feel like he’s a good husband. He doesn’t feel like he’s a man anymore.
She is in her twenties and lost her last boyfriend due to her IC. He couldn’t wait for her to get better. She feels like no one will ever want her again.

15 Rules For Successful, Intimate Relationship

There isn’t a single couple that hasn’t, at one point in time, struggled with sexuality due to disability or illness. It’s all about the timing, the trust between partners and your ability to talk with each other. What do you like?? What feels good?? What turns you on?? No more guilt! With a little planning, it’s time to reconnect and play, especially when you have pelvic pain!

Rule #1: Leave guilt and rejection behind you

In our wedding vows, we promise to love and support each other through sickness and health. If a partner is in a car accident or develops cancer, their spouse doesn’t stop loving them or caring for them. We’ll happily fix them meals, bring glasses of water to the bedside, stream videos, do the laundry, run errands and, as always, care for someone in need. Then why are we, the pelvic pain patient, so hard on ourselves? For some reason, some of us feel that we’re not worth love anymore or, worse, that were not good spouses. Some of us even stop trying. You are no different than someone who has been in an accident. Let your partner help you.

Rule #2: Put your fears in context!

Some IC and/or pelvic pain patients begin to fear sexual activity. This can apply not only to the patient, but to the spouse who does not want to be the cause of pain. Both partners need to talk about their fears and then develop a realistic plan. You don’t have to give up romance, but you will create new rules and new styles. Who knows? Your new and improved sex life might be better than you ever dreamed intimacy can be.

Rule #3: Take slow steps as you try again!

Just like anyone recovering from an accident, sexual activity may come slowly.. very slowly.. at first. We can’t expect to be able to dive right in, the first night afterwards, and have wild, glorious, athletic sex that lasts for hours. We may not be able to handle intercourse first, but we can try other forms of cuddling, tenderness and arousal. The key is to any recovery is to go slowly, in small steps and be prepared to try something new if pain occurs. You’ll never know what you’ll discover next!

Rule #4: Don’t doubt the presence of pain!

Several studies on sexuality and IC revealed that many IC patients experience pain or discomfort at various stages of sexual intimacy. Men often feel their worst discomfort at the moment of orgasm when their pelvic floor muscles spasm, with pain so intense that it feels as if a knife is being pushed into their urethra. Women with a long history of tight pelvic floor muscles (aka vaginismus) may find penetration impossible, with many reporting that they’ve never had pain free intimacy. Many other women struggle with flares hours after they have sex. Thankfully, these flares can be reduced with the application of heat (to relax muscles) and, if necessary, muscle relaxants.

Rule #5: Have faith in your love for each other

The presence of pain and chronic illness casts uncertainty on various portions of our lives but it does not change the love and caring we feel in our hearts. When we say “No, I can’t do this tonight,” we’re not saying that we don’t love our partners. We are saying that right now, just at this very moment, our body isn’t strong enough. Always have faith and trust in your love for each other.

Rule #6: Your sex life before may determine your sex life after the onset of IC and/or pelvic pain

Can we blame IC and/or pelvic pain on the collapse of a relationship?? Can we blame it on our inability to enjoy intimacy? If you are a good communicator about sex and if you were willing to explore a variety of sexual experiences, then you have a much better chance of having a good sexual life after IC/BPS. If not, take a moment to learn the from the successes of other couples! Communication, experimentation and optimism are the common factors of sexual success!

Rule #7: Intimacy doesn’t always mean intercourse

One of our best guest speakers was a physician who taught sex education to medical school students. One of his patients had a very satisfying sexual relationship, so much so that he envied their intimacy. But, there was a hidden challenge. The male partner was wounded in battle and had lost most of his penis. How could a man without a penis have sex life that other men envied? He and his partner practiced tantric sex (aka outercourse).

Rule #8: Develop an appreciation for “outercourse.” It’s wonderful too!

Tantric sex (aka outercourse) is a viable, reliable and fulfilling addition to normal intercourse and includes more stroking and caressing. Rather than seeking orgasm quickly, tantric sex focuses on bringing your partner to the point just before orgasm and then extending that point for longer periods of time. If orgasm happens, that’s fine. If it doesn’t happen, that’s okay too. In tantric sex, the gentlest of movements can become thoroughly arousing and it is a viable option during those moments when pelvic pain and muscle tension makes penetration difficult. The best part is that both are so aroused, intercourse (if used at all) is often very quick and not traumatic.

Rule #9: Cleanliness counts

It is a well known fact that sexual intercourse increases the risk of urinary infection in women. Why? Because a womans urethra is relatively short, intercourse can push bacteria from her rectum or her partners penis into her bladder. Before intimacy, rinse the perineum with cool WATER in a water bottle, on toilet tissue or kleenex. Dr. Jennifer Gunter, in her book The Menopause Manifesto, says that no cleaning product should be placed between the labia manora other than water. However, a cleanser can be used at the groin, labia major, mons and around the anus. Patients who are very sensitive can clean with simply water. Dr. Gunter urges caution with traditional soaps, stating that they can remove too much of the natural oils and bacteria that maintain and defend your skin. (I had one of the worst flares of my life with Irish Spring Body Wash.) In contrast, a cleanser protects the integrity of the skin. Dove for Sensitive Skin (fragrance free, hypoallergenic) is quite popular for its gentle cleansing effect. Dr. Gunter also suggests avoid all products with: fragrance, tea tree oil, lanolin, formaldehyde, methylisothiazolinone and methylchloroisothiazolinone.

Rule #10: Think LUBRICATION!

Did you know that vaginal skin is ten times more sensitive than any other skin on your body? The friction from any type of sexual activity can inflame these sensitive tissues if arousal isn’t complete. Using lubricants can reduce irritation, burning and actual tears in tissue, especially in women struggling with estrogen atrophy. Don’t be afraid to use a lot of lubricant, if necessary. There are three types of lubricants:

Silicon Based: Condom safe, not irritating, scent and flavor free. Not for use with silicon toys
Water-based: Condom safe, easy to wash off
Oil-based: Can’t be used with most condoms

YWe suggest trying Intimate Rose Velvet Rose Lubricant, Pjur Med Premium Glide, Sliqued Sea, K-Y Jelly or Astroglide.

Rule #11: Trying various sexual positions

Sexual positions can also provoke more or less pain, particularly during penetration. Experiment with different positions, particularly those which take pressure off the urethra and/or do not strain muscles and/or rub on your sensitive skin. Try using a wedged cushion or pillow to reduce muscle strain and/or find just the right angle so that tender spots aren’t compressed. We suggest trying the NaEnsen Pillow or the Liberator Wedge.

Dr. Ruth recommends the spoon position as an ideal option for women who are pregnant. Other positions can include: the woman on top, the woman astride the man in a chair, or from behind. Remember, penetration is always easiest when the woman is fully aroused.

Rule #12: Use contraception when appropriate

In the era of human papilloma viruses (HPV) and their very strong association with cancer, using a barrier is key to protect each partner from sexually transmitted diseases. Unfortunately some condoms (latex) can be irritating. Look for condoms made of polyurethane (Trojan Supra & oil compatible) and polyisoprene (Lifestyles Skyn – not oil compatible). The Female Condom can work with all lubricants and can reduce friction. Some spermicides, particularly those with preservatives, can also be irritating to the vagina, urethra and tip of the penis. If you develop strange aches and pains coincidentally, check it out and if it hurts, try something else.

Rule #13: Establish an “after sex” routine!

Some believe that the first fifteen minutes after sex are when you can do the most good to prevent infection and reduce inflammation. Most women have been told that they should urinate after sex to expel any possible bacteria that may have been introduced into the urethra and bladder during sex. This makes total sense, but it hasn’t been proven to completely eliminate possible infection and/or inflammation.

Given the fact that women often swell, and tissues feel hot and tender, it is also helpful to rinse the area with cool or cold water (no irritative soaps, please!). This can soothe the tissues and reduce possible infectious organisms. Some find cold or heat packs helpful. If possible, let those tissues rest and cool down. Lay in bed without underwear and, if you have to get up, choose to wear long skirts and no underwear at all.

Some patients may use a muscle relaxant (i.e. Baclofen, Flexeril, Valium) and/or heating pads to reduce muscle spasms. The BodiHeat heating pad can be worn all day but should be worn on the lower abdomen and/or front of the your underwear. Do NOT apply heat or cold directly to the vulva. Vaginal valium suppositories can be very helpful along with, if needed, some pain medication.

Rule #14: It begins with clear communication

During sex, each partner should listen to the cues of the other. If someone says “ouch”, pulls back, slows, falters or says “no” to something happening during sex, respect them. If it hurts, try something else. Be creative. Don’t take pain personally. It says nothing about your love for each other. If either partner is unfit for sexual activity, kiss them, give them a hug and remind them that your love is steadfast.

Rule #15: Focus on increasing arousal and pleasure

From offering a full body massage to playing with feathers or fingernails, the joy of intimacy are moments when you can simply play and provide some pleasure (and laughter) to your partner. There are plenty of ways that you can enhance your experience together, including: erotic massage, using fun massage potions, playing with the sense of touch with fabric, feathers and fingers. Explore your partners entire body, such as the hands, feet, neck, hips, back and thighs. Finger vibes can be fun, as well as larger vibrators.