A recent report in The Journal of Sexual Medicine caught my eye. “Vibrators and Other Sex Toys Are Commonly Recommended to Patients, but Does Size Matter? Dimensions of Commonly Sold Products” is the title. First, I was happy to see that the authors are furthering the discussion about health care providers telling patients about “vibrators and other sex toys” (and, full disclosure, my article in OBG Management is footnoted as among the voices encouraging physicians to consider what they offer women through their practices).
Beyond that encouragement, the researchers compiled dimensions of vibrators and dildos, noting that not every source provides accurate or complete information. The conclusions they reached were that while the size of products varied, the dimensions, overall, “approximated mean penile dimensions.” They further suggested that further familiarity with the product category among clinicians, which is never a bad idea.
Since I’ve been recommending vibrators to women (and men) for some time, I’ve got some practical observations to share, for both patients and clinicians.
First, don’t do anything that hurts. Really.
The corollary to that is that you get to decide what hurts and what feels good. There are no “shoulds.” That’s true even if someone has a chart of dimensions and predictions.
I find that women like vibrators that can be inserted into the vagina for three reasons:
Their favorite toys are as varied as the women themselves, and dimensions are only one part of that equation. Materials, pulse patterns, and vibration strength also count. Sexual partners and history can have an influence, as can progression of menopause, which can mean narrowing and shortening of the vagina. Over time, women may want a shorter, narrower vibrator, quite possibly with a stronger motor for more intense sensations.
But, again: Using a vibrator should feel good. If a vibrator is too large to comfortably insert, don’t insert it—or wait until you’re more fully aroused before you try again. And regardless of “insertable length,” don’t feel like there’s anyone but you who decides how deep to go.
And if insertion doesn’t sound good or feel good, remember there are a number of vibrators designed to stimulate the clitoris, which is where the nerve endings are concentrated that 70 percent of us need for orgasm.
So if your health care provider is still studying up, don’t be discouraged. Women have more than 100 years of experience using their own judgment with vibrators and pleasure, and you can do the same.
Sex is all about the senses. That’s why “sex” is the fraternal twin of “sensual,” which broadly refers to “voluptuous gratification of the senses.”
Now, I ask you, what is more voluptuously gratifying to the senses than sex?
Trouble is, sometimes our senses get a little dull. They need a tune-up. They need variety and stimulation. They need us to pay attention.
We can pay attention to our senses, for example, by noticing the glint of sun on water, the smell of coffee in the morning, a warm breeze on the skin, a meadowlark singing on the fencepost.
But sex is where the senses can have a field day. We tend to rely on touch when we make love—and that’s a lovely place to start. As we mentioned before, the skin is our largest sex organ, so it makes sense to cultivate that sensory garden.
We do, however, have four other delicious sensory organs to awaken. And since our menopausal bodies need more stimulation and a longer runway these days, sexually speaking, why not incorporate other types of sensory delights into our lovemaking? This can serve several purposes—becoming more attuned to the senses we don’t rely on as much; introducing playfulness and novelty into our lovemaking; and creating the more erotic and stimulating environment that helps get us airborn, so to speak.
Here are a few suggestions for cultivating the garden of your senses during sex. If you come up with other suggestions, please share!
Smell. Most of us rarely think about engaging the sense of smell when we make love. Sure, it’s nice to have, but doesn’t seem critical to performance in the bedroom.
Smell may be subtle indeed, but that doesn’t mean it’s not powerful. For one thing, it’s closely linked to memory. The part of the brain that registers scents nestles right next to the limbic system that controls emotion and memory. That’s why a certain smell is often linked to an experience or a person. And that’s the basis of aromatherapy—using certain scents to trigger certain emotion.
We can use this to our advantage in our love life. Is there a scent that you associate with particularly happy or romantic times? I love the smell of jasmine because it reminds me of a wonderful visit to the city of Oaxaca in Mexico. A whiff of jasmine, and I’m transported right back to the Zócalo in the middle of town.
Here are a couple ways to incorporate smell into your love life:
Taste. This is probably another sense that we don’t incorporate well into sex. One way to develop our taste for sex might be to try some foods that are considered aphrodisiacs.
Some foods simply look suggestive, like fresh figs or asparagus, while other foods actually increase blood flow to the genitals. Some, like avocado and asparagus, do both.
The idea isn’t to eat until you’re stuffed. (Romantic candle-light dinners are bad for that.) The idea is to use the sight and taste of food to stimulate your senses and your passions. So maybe create a lush tray of aphrodisiacs to sample in bed. Or to feed each other. Or to slowly undress while you sample and feed each others.
Here are the top aphrodisiacs:
First of all, know you're not alone. By some estimates, as many as one in ten of us has never experienced orgasm, and among those of us who have, it happens in only about half of our sexual encounters. I'm not suggesting that makes it okay that you're struggling; knowing the facts, though, can lessen your stress about what's happening—or not happening.
In spite of what you see in the movies, most women—up to 80 percent—cannot have an orgasm with intercourse alone. Most women need direct stimulation of the clitoris, and the mechanics of intercourse just don't provide that. Oral or manual stimulation of the clitoris tends to lead to orgasm, and vibrators give the kind of stimulation needed—as variety or because it's easier. Especially as we grow older, many women need the extra stimulation a vibrator provides.
Vibrators can be for external or internal use. External vibrators (Fin, and Kiri) work extremely well for women who respond to direct clitoral stimulation. Other women like the internal stimulation of the vagina and G spot, too, for which some vibrators (Gigi, Raya, Celesse) are designed for insertion. Those vibrators can also be used externally on the clitoris. If you want the extra stimulation during intercourse, the external type will work best.
There are additional features you might think about, too; I've written whole blog posts on the topic. Whatever you might choose, I often recommend to women that they try self-stimulation to see what kind of touch where feels best. That, too, lessens the pressure when you're with your partner.
Enjoy the exploration! It's never too late to learn even more about your body.
If you're experiencing some irritation with clitoral stimulation, you might start with a hybrid (Sliquid Organics) or a silicone lubricant (Pink or Pjur). They provide more slipperiness for longer than their water-based counterparts.
And I would recommend that you try a vibrator. You can vary the intensity of the vibration, the pattern of vibration (continuous or pulsed, for example), and the pressure you (or your partner) apply--all helpful to finding what you need *now* for arousal. I'd recommend the Fin as an external options that is versatile, have nice soft surfaces, and can be recharged. The Kiri is a battery-operated, waterproof option with similar features.
Finally, if you're using a localized hormone like Premarin internally, with an applicator, there may be no added benefit from using a vaginal moisturizer. There's no harm in trying it, though, and I encourage moisturizer use among women who are not using localized hormones. If you choose to, Yes is the preferred product for many women who come to MiddlesexMD.
As a medical doctor, I try to provide a place where uncomfortable or unfamiliar topics can be discussed in an open, honest way, without inhibitions or worries about “what people might think.” For lots of people, both men and women, self-stimulation or masturbation falls into that “uncomfortable” category. Some of the myths surrounding masturbation—like it causing blindness or hair to grow on the practitioner’s hands—have faded, thank heavens! But there’s still a lingering perception, I find, that self-stimulation is somehow less acceptable for women than for men.
For post-menopausal women, self-stimulation is especially helpful, whether or not they have partners. It can solve problems with vaginal dryness or tightness: Stimulation causes your clitoris to swell, helping to maintain healthy blood flow to the walls of the vagina, which in turn can help keep your vagina open, strong and responsive. (It’s the old “use or it lose it” rule.)
If vaginal dryness or tightness is a problem, self-stimulation can also be a way to temporarily feel sexually satiated if intercourse is too painful. I say “temporarily” because I don’t recommend that you think of it as the solution to painful intercourse. Always seek medical attention if you’re experiencing any kind of vaginal pain, because there are lots of remedies.
Another benefit of stimulating yourself is the way it helps you to get to know your own body and what satisfies you best. As hormone levels decrease and effect other changes in your body, what’s worked in the past may not be as satisfying now. It’s great to be able to experiment with your partner to find your new best experience, but that’s not always possible, for all kinds of complicated reasons. Old habits die hard, and either you or your partner may feel tense or intimidated about changing things up. You can experiment to see what works for you and then share that knowledge with your partner to make your sex lives more mutually satisfying.
If you don’t currently have a sex partner, self-stimulation is a great way to enjoy the side benefits of sex, like tension and stress release and the feeling of calm and relaxation that immediately follows a sexual session. Fantasy can be a fun part of it; picture yourself with a former lover—or George Clooney (or Dean Martin… or… you tell us!). And taking care of yourself in this way keeps open the possibilities in case you do find yourself in a relationship again. In my decades of practice, I’ve learned never to say never!
If your sex life is suffering from other issues—a rough time in your relationship or it seems to hard to get your love life back on the right track—I caution patients against replacing intimacy with a partner with self-stimulation. It may be the “easy” thing to do, but it can compound problems if you turn to self-stimulation instead of your partner for satisfaction.
Self-stimulation is a normal part of a healthy sex life. At this point in our lives, the last person we need to be shy with is ourselves. Who knows what we’ll learn?
Orgasm. Such a complicated topic; so many questions, so few answers. But let’s focus on the most important point, which is, that for women, the biggest obstacle to experiencing orgasm is anxiety. How can anyone relax while having sex if she’s thinking, “Will it happen this time or won’t it?”
As you can imagine, research on this topic is somewhat limited. But the renowned sex researchers William Masters and Virginia Johnson, who were the first to describe the four-step process of experiencing orgasm (during intercourse) many decades ago, said there are four steps involved:
1) Excitement. During foreplay, blood begins to engorge the clitoris, vagina, and nipples, and creates a full body sexual blush. Heart rate and blood pressure increase.
2) Plateau. Sexual tension builds as a precursor to orgasm. The outer one-third of the vagina becomes particularly engorged with blood, creating what’s called "the orgasmic platform." Heart rate, blood pressure, and respiration continue to increase.
3) Orgasm. A series of rhythmic contractions occur in the uterus, vagina, and the pelvic floor muscles. Sexual tension releases, and muscles throughout the body may contract. A feeling of warmth usually emanates from the pelvis and spreads throughout the entire body.
4) Resolution. The body relaxes, with blood flowing away from the engorged sexual organs. Heart rate, blood pressure, and respiration return to normal.
(For another model of sexual arousal, remember Rosemary Basson's, which takes into account women's more complicated reality.)
Another good thing to know is that experiencing orgasm during intercourse takes time. In one study of 1,000 women, the “mean duration” was about 13 minutes. So trying to hurry it along or time it to coincide with your partner’s is probably not going to help.
It all gets back to the whole idea of relaxing—of letting go and focusing on the moment, enjoying the closeness and intimacy itself without worrying about what the outcome will be every time you have sex.
And, too, most women—two thirds of us—never experience orgasm at all during intercourse; some say the only way they ever get there it is through hand stimulation (their own or their partner’s) or with a vibrator, which often is the quickest route.
If you’re having trouble experiencing orgasm, try some things on your own to see what works and what doesn’t, not just physically, but mentally. Some women, for example, find that fantasizing puts them in a “zone” where they can escape the distractions of life. (Imagine yourself on a desert island with the one you love!)
This is one of those things that can only get better with honest, open communication. Talk with your partner about your feelings, your reactions—everything—so that you both have a good understanding of what’s going on and why.
Let us know your questions about experiencing orgasm; we’ll do our best to answer them (if you’d rather not post them here, use the “Ask Dr. Barb” button on our site). And in the meantime, relax and enjoy the journey.