Q: Can I experience vaginal orgasm?

I’ve got good news and bad news for you. The good news is that you’re just like 75 to 80 percent of women! The majority of women are not able to experience orgasm only with vaginal penetration or stimulation. Most of us need direct clitoral stimulation to orgasm, whether that stimulation is oral, digital, or with a vibrator.

You asked. Dr. Barb answered.A recent journal article on this topic described one factor of influence was the distance between the clitoris and the vaginal opening (read more in this blog post). A few millimeters can make a difference to how orgasm is experienced--and that’s an unmodifiable factor! Since each of us is individually made, the bad news is that if you haven’t experienced vaginal orgasm by now, you’re likely not going to.

There’s one option for you to try: Some vibrators, like the Gigi2 and the Celesse, are shaped specifically to put pressure on the “G spot.” If you’re one of the people for whom orgasm can happen through G-spot stimulation, one of those vibrators can help!

September 06, 2016

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vibrators ›   women's sexual health ›  


Q: What vibrator do you recommend for a first-time user?

You say you don't currently have a partner, and were diagnosed with premature menopause before your last relationship ended. I’m with you on hoping for another romance in your future!

You asked. Dr. Barb answered.In the situation you describe, the best vibrator is one you can use internally (place inside the vagina). This will improve blood supply to the vagina and surrounding tissues and keep the vagina patent (medical term for open) and more elastic, until you have a partner. Probably the best designed vibrator for this would be the Liv2 or the Raya. The Liv2 is rechargeable and has a bit more intensity in its vibration (important for post-menopausal women), but either could work well. These vibrators can also be used externally, in direct contact with the clitoris, as well as internally.

Along with these you’ll want to use a water based lubricant. Any of these could work well for you; our most popular are Yes WB and Almost Naked.  

You mentioned that you’re also using Vagifem as a localized estrogen. It’s a good idea to continue that for vaginal tissue health. And I’m so glad you’re putting the effort into maintaining and regaining sexual health! 

That Vibrator: Choosing and Using with Your Partner

We’ve been talking about vibrators for a few posts now, spinning riffs off the MiddlesexMD survey in which some of our readers participated. This will be the last post on using a vibrator with your partner, so I want to delve into the details of how to choose a vibrator and then use it together.

When it comes to sex toys, the human imagination runs wild. You can find every permutation of color, size, and shape for every conceivable purpose. This is certainly true for vibrators. For our shop we’ve tried to narrow the field to a few high-quality devices that are uniquely suited to the needs of “mature” women (think long-lasting, powerful, straight-forward to use, and safe). But there are also vibrating devices just for men (penis rings and prostate massagers, among others), and some more specifically for partnered use.

A few additional pointers before we begin:

  • Decide whether you’d like to get used to a new vibe alone or to share the initial awkward play with your partner. There are pros and cons to each approach. Doing it together can be a funny, fumbly foray into a new level of intimacy that has its own quirky, erotic quality. Acclimating to a new vibe alone allows you to really concentrate on what you like and what works without the distraction of another person. Probably, you’ll want both to practice together and alone at some point.
  • A vibe is a very personal gadget. You’ll discover a lot about yourselves and each other, sensually speaking, that might surprise you both. That’s the beauty and the challenge of using a vibe. Be patient and persistent. If something doesn’t feel good, try another approach or a different type of vibrator. Some moves may be nice together; others feel better alone. Be sure to share what works with your partner.

Writes one blogger: “The thing about couples’ vibrators (and the thing about couples) is that each individual will have a wildly different experience, and the success of the device (or the relationship) is your ability to make it work for you.”

  • New partner? Don’t forget the risk of STDs. During sex, the vibrator may travel from him to her and back again, carrying whatever fluids are present, including sperm. Be sure to clean it thoroughly with soap and hot water or put a condom on it. Never go from rectum to vagina without cleaning. Hard materials, like silicone, plastic, and glass, are easiest to clean.
  • Do not put a small vibrator in the rectum. The most common vibrator mishaps are those that occur when the device gets “lost” in the vagina (it’s not really lost), or more frequently, in the rectum.
  • You can’t use too much lube, but you can use too little. Buy a good quality lubricant, and use it Use only water-based lubes with silicone toys.

 With that in mind, I’d suggest starting simple, small, and uncomplicated. You can program some vibes for different series of pulses, to vibrate to music, to use with your Smartphone or a remote. I’ll bet some vibes change color with your mood. But why make things more complicated than they need to be at first?

Maybe start with a small, clitoral vibe that looks unintimidating (is smaller than he is) and that is easy to use. Try the Kiri or the Mia2, both by Lelo, a manufacturer of high-quality sex toys. 

Consider the type of power you’d prefer: rechargeable (no batteries to buy; most powerful), lithium ion batteries (more power), regular alkaline batteries (typically less power). Some vibes are waterproof (consider the possibilities…).

When your vibrator arrives, check it out either alone or with your partner; charge it up; read the manual; test-drive the features. To start, use it on your extremities at the lowest setting, even with your clothes on, to get used to the feeling. How does it feel on your leg? Arms? Move to the back of the knee. Inner thigh. Circle the nipple—his and yours if you’re test-driving together.

Take it slow. Continue to explore what works for you. Use it on the labia, around the vagina. Or let him do it. Don’t go for a direct hit on the clitoris; too abrupt just hurts. Oblique works better. Vary the speed, the intensity, the angle.

Take turns. Let him hold the vibe and guide his hand. Then switch and let him guide you. Once you’ve both figured out what feels good, you can communicate with, or show, your partner.

Turn up the speed and run it up one side of his shaft and down the other. Then use your mouth on his penis with the vibe held against your cheek to continue the vibration but with a change in temperature and texture. Circle the head of his penis with it. With the vibration set very low, use it on his scrotum and finally, his perineum (the space between his scrotum and anus). This region can be very sensitive and indirectly stimulates his prostate. If you’re on top, you can easily reach down with the vibe and gently buzz this area.

Take your cues from him. Experiment, and let him tell you what he likes. You might also try a vibrating penis ring—you get clitoral vibrations while he gets a buzz to his shaft. Good vibrations all around.

The whole process may feel strange at first. But as this blogger puts it, “And that’s kind of the point: adding a little bit of fun and awkward and weird to sex.”

Eventually, you should learn a lot about pleasuring yourself and your partner. Maybe you’ll like the vibe just for foreplay or maybe it will become an integral part of your sex play. Maybe you’ll just decide to use it alone or not at all. As sex and relationship counselor, Kate McCombs writes, “…if a toy doesn’t do it for you, it doesn’t mean you’re broken.”

That Vibrator: Honey, Meet the Vibrator

In the last post, I made the case (persuasively, I hope) for why you might want to introduce your partner to sex with a vibrator. Now, let’s look at some non-threatening, sensitive ways to do that.

First, let me remind you that he might not be as threatened as you fear. Vibrators are everywhere—he’s probably seen them in the drugstore, on TV, or on social media. Maybe he’s curious, too. He may also be aware that your libido and sexual responses have been changing. You need more stimulation, more time, and maybe a change of pace to keep the flame alive. Maybe he needs something different as well.  

Create a sense of mutual exploration and play.A good beginning is with a conversation. Something like, Hey, I’ve been thinking…or, I read an article on… What do you think about…? Or, Maybe you’ve noticed I’m not as responsive as I used to be… Sex and relationship educator Kate McCombs suggests that “people really underestimate the sexy power of talking about what you’re going to do to each other later. For example: ‘…Should we try it? Hey. Why don’t we check it out online? Ooh. Let’s do it, and let’s get the expedited shipping.’ Then, by the time it arrives, you’ve basically been engaged in this four-day foreplay. I think that can be powerful for people.”

Shopping for your vibe together not only builds anticipation, but it feels like you’re sharing this new adventure—you’re on the same team, rather than either one of you being in charge or leading the charge.

You may need to reassure him early on that a vibrator never replaces sex with the living, breathing person you love. It’s a tool and a toy; it adds a new dimension; it can feel good; and you can learn a lot about what you both like. But it isn’t a replacement; you won’t become dependent on the vibrator; you won’t prefer it to him. In fact, studies show that women (and men) who use vibrators usually perform better and feel more positively about sex with their partners.

(There’s a physiological reason for this. Orgasm begets orgasm, because the muscle contractions, genital stimulation, and increased circulation makes it easier to orgasm next time. That’s why you never need to worry about the myth that a vibrator will make climaxing with your partner impossible; in fact, it’s just the opposite.)

A more oblique approach might be to introduce something new but less threatening, like massage or shower sex to your routine. Buy a new lube or massage oil. Expand your repertoire of sexy smells and touch. If you’re getting green lights, maybe you can, in time, gift him a “Happy Wednesday” vibrator.

Create a sense of mutual exploration and play while being sensitive to your partner’s comfort level as you go along. If he’s reticent, slow down and explore why. Fear is usually the underlying cause of anxiety or resistance. Bottom line: It’s worth trying something new, but if you both can’t play, it won’t be fun.  

Bottom line #2: If you get a complete shutdown with no wiggle room? Completely fine. You don’t need toys for a loving sex life. Maybe you can shelve the conversation for another time. I believe, however, that you are free to use a vibrator by yourself. Using a personal vibrator will keep your tissues healthy and your interest in sex alive. That’s a good thing for you and your partner.

If you’re still with me, in the next post we’ll dig into vibes for beginners (and beyond) and how to use them with your partner.

 

 

That Vibrator: Built for two. The rationale.

I may be taking off the training wheels, but I want to forge right ahead with the topic from the last post about using vibrators with your partner.

I know. I should probably take things slow and discuss why and how you should be using a vibrator. But we’ve done that a few times. HereHere (this one is a series). And here

So without further ado, let’s talk about partner sex with a vibrator. First, we’ll lay some groundwork; then we’ll get into the nitty-gritty.

One thing I often hear from women is, “I don’t think my partner would like it.” In fact, that was the reason of 15 percent of respondents in our MiddlesexMD survey who don’t use a vibrator. Another 4 percent said “my partner disapproves.”

In the gentlest possible way, I’d like to ask if this response is based on assumption or actual conversation. Have you discussed introducing a vibrator into your sex play? Because in my experience and that of other sex therapists, most men aren’t threatened by vibrators, and some find them kind of hot.

My anecdotal evidence is backed by science. In the study of vibrator use by Dr. Debby Herbenick, of the 1,000 men who were asked, 45 percent reported having used a vibrator, usually during sex with a woman.

Boredom is a huge disincentive to sex.Another barrier mentioned by Kate McCombs, MPH, is the notion that an orgasm with a vibrator is a cheat, which harkens back to that misbegotten standard of our youth in which the only real orgasm was a vaginal orgasm. Well, now we know that 70 percent of women don’t orgasm with vaginal penetration alone. And at this stage of life, I’d like to suggest that all orgasms count. To paraphrase Woody Allen, “I’ve never had an orgasm that wasn’t right on the money.”

If one or both of you are shy about taking this particular plunge, here are some good reasons to nudge the boundaries of your comfort zone.

  • Oh, those elbow, hips, and knees. Sex can be acrobatic, requiring pressure on joints that don’t work so well and repetitive motions that can be hard to sustain. A vibrator is a little comfort measure that allows things to happen quickly (or not) and reliably without so much work or pressure on the joints.
  • Make it last or make it happen at all. Maybe it takes longer for you. Maybe you need more stimulation. Maybe he can’t quite last as long or get it up. A vibrator makes things more reliable and less frustrating for both of you. One respondent to our survey was surprised to find her libido flagging after menopause…“when necessary, the vibrator assures a pleasurable experience for both my husband and me.” Says another, “It removes any anxiety about how long it’s taking, or is it working…” It’s going to work, and it can take as long as you want.
  • Break the monotony. You know the moves by heart. You could (and maybe you have) done them in your sleep. Boredom, especially after decades with the same partner, is a huge disincentive to sex. That’s where a vibrator (and other sex toys) can spice things up and introduce some creativity and play into your ho-hum routine. In our survey, over 20 percent of you agreed that you use a vibrator “to supplement intimacy and playfulness with a partner.” That is a very loving and wonderful use for this gizmo.
  • Know thyself (and thy partner). How can you let your partner know what you like if you don’t know what you like? A vibrator is a great tool for self-discovery, for finding out where the nerve endings are and what pressure and speed works best. You can also experiment on him. You may discover some new sweet spots.

In the end, while vibrators can be a fun toy and a helpful assist for flagging libido and waning sensation in the nether regions, whether or not you incorporate them into either personal or couple use is totally up to you.

In the realm of sexual intimacy, while I think it’s good to explore boundaries and maintain an open, questing spirit, if an experiment becomes too uncomfortable or anxiety-provoking, then a loving partner will back away. A vibrator for personal use is your decision (“It’s your orgasm,” writes one blogger), but introducing it into sex with your partner is a tango that requires a little more sensitivity.

More about that in a future post.

 

That Vibrator: A Him and Her Thing

In the first post about our survey of MiddlesexMD readers regarding their vibrator use, we examined the topic by age. Turns out, you guys are way ahead of the curve—or at least of the commonly cited 52 percent of women under 60 who have used a vibrator, according to a study by Dr. Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University.

In this post, we’ll break down the numbers according to how you use your vibe—alone and/or with a partner (neither being mutually exclusive). Using those little gadgets with a partner opens up a new world of exploration, so we’ll dig into that in future posts.

Vibrators have gone mainstreamFirst, we just want to focus on your reported vibrator habits. In our survey, as opposed to the Herbenick study, respondents mostly cluster around the 50 to 70 age range; 10 percent are under 40 and about the same are over 70. So your responses are a peek into vibe use in the peri- to post-menopausal years. Since you are all MiddlesexMD readers, you’re probably interested in learning about and improving your sex life.

About a quarter of you reported never having used a vibe by yourself. Obviously, that leaves three-quarters of you use a vibe at least “rarely.”

Over half of respondents of all ages (54 percent) have never used a vibrator with their partner. When we broke the numbers down by length of relationship, a couple of interesting points emerged. Of those in a new relationship (less than a year), about 90 percent use a vibrator alone at least “rarely,” yet almost 60 percent “never” use one with a partner. So, this “new relationship” group appears comfortable with solo use but very shy about partnered use.

By comparison, about 65 percent of those in longer-term relationships (over 10 years) have used a vibe alone at least “rarely” and half have used one with their partner at least “rarely.” 

There isn’t a lot of national research on vibrator use with a partner. Of the 52 percent of women who use vibrators in the Herbenick study, 80 percent have used them with a partner. According to this New York Times article, vibrator use is growing fast among menopausal-aged boomers as well as the 35-45 year age group, who use them to inject a little fun into a middle-aged relationship.

So what’s the takeaway for MiddlesexMD readers?

Well, for one thing, you’re in tune with the times when it comes to vibrator use. This is good because using a vibe is linked to positive feelings about sex and also to improved sexual performance and enjoyment.

However, if you’re open to adventure, a little more creativity and experimentation could be in order for using them with a partner. We’ll continue to talk about this because a vibrator could be a terrific aid to the particular issues involved in sex after menopause.

No doubt about it, vibrators have gone mainstream. We may have resistance to using them from the unsavory associations that linger from our youth, but there’s no reason to perpetuate a bad rap, especially when there are a lot of great reasons to use a vibrator at this stage of the game. 

Our New Survey: A Few Stats on Vibrator Use

The times just might be a-changin’. At least that’s what I think we’re seeing with the results of our new MiddlesexMD survey.

The times just might be a-changin'.We asked for readers of our website and newsletter to respond to several questions about whether and how you use a vibrator, and we’ve been compiling and pondering those results for a while now.  Granted, our sample size is small and not exactly random, since it’s comprised of MiddlesexMD readers. Given the nature of
 our mission, it’s skewed toward women in those peri- and post-menopausal middle years between 50 and 70.

That said, there’s a lot to be gleaned from the stats and especially from your comments about how you use vibrators and what you’d like to know about using them. We’ll continue to address those questions in future posts.

An interesting place to begin the discussion might be in what I interpret as a generational and cultural shift in attitudes and comfort level toward using a vibrator. Those are the cracks within which I think the times might be changing.

There’s a lot of anecdotal and scientific evidence that vibrators have gone mainstream in the past decade or so. In a 2011 study co-authored by Debby Herbenick, PhD., director of the Center for Sexual Health Promotion at Indiana University, over half of the 2000 women between the ages of 18 and 60 who were surveyed have used a vibrator and felt positively about both sex and their vibe.

In our survey, about 80 percent of the respondents under 60 have used a vibrator alone at least “rarely” and over half have used one with a partner. Of the respondents over 60, about 68 percent have used a vibrator alone and 37 percent with a partner.

About twice as many women over 60 have never used a vibrator alone compared to women under 60. In our much smaller subset of women under 50, all report using a vibrator at least rarely.

Granted, these numbers may be less revealing since our respondents cluster around the menopausal years and are women who are interested in their sex lives. But I think they do reinforce a sense of the cultural shift that has occurred.

Those of us who came of age during the rollicking 1960s and 70s may have partaken of, um, many things, including the sexual freedom of birth control options and evolving cultural morés. At that time, however, vibrators weren’t really on the radar. Heck, we were still striving for the elusive simultaneous orgasm (vaginally and without help). And what the heck was wrong with us if we couldn’t manage it?

“…by the 1970s, scientific publications stated that vibrators were harmful and never to be used by ‘normal’ women,” writes Lauren Streicher, MD., associate clinical professor at Northwestern University’s medical school in this blog post.

Well, guess what? The times have certainly changed since then. By the time Charlotte fell in love with her “rabbit” (a vibrator for both clitoral and vaginal stimulation) on the first season of Sex in the City in 1998, vibrator use had gone mainstream. Now, guys use them; partners use them; same sex couples use them. Far from being stigmatized, vibrators are associated with a whole bunch of good things, including a more robust sex life.  

Some of us older gals may have missed the memo, but we’re catching up. That’s what our survey suggests: younger women use vibrators more, but our over-60 cohort is coming of age, so to speak. That’s a good thing, because vibrators are most critical during those drier, less sensitive, post-menopausal years.

So don’t be surprised if your doctor prescribes a vibrator just to keep your downtown tissues healthy, as Streicher did for one of her 70-year-old patients, who had to adjust her hearing aid to make sure she understood correctly. 

January 15, 2016

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intimacy ›   orgasm ›   relationships ›   vibrators ›  


Q: How can I introduce sex aids to my partner?

First let me say that what you describe doesn't make you at all unusual. You say that you require a feeling of fullness and some G-spot stimulation to experience orgasm. Your partner's health issues make erections "fleeting," and yet you both enjoy intimacy; you'd like to explore adding a dildo or other device to increase your enjoyment.

Most couples find mutual satisfaction an invaluable component of intimacy; a partner's arousal and satisfaction enhances pleasure for most of us! Your partner's situation has changed, and if you're like most women, orgasm may have become less reliable over time, too. Now is the time to have a conversation with your partner—just to acknowledge the changes and that you'd like to try something new. (I wouldn't recommend that you produce a surprise vibrator or dildo during a intimate interlude! At that moment it could be taken as a judgment rather than an enhancement.)

The analogy we often use at MiddlesexMD is to vision. When it becomes more difficult to read the fine print, we get "cheaters" or reading glasses! We don't shelve our books. Why shouldn't we take the same attitude toward sex?

You may find that your partner is relieved to have you start the discussion. You might even look at options together and make the selection as part of extended foreplay.

Have confidence! It sounds like you and your partner have conquered more daunting obstacles together. I'm certain you can navigate this one.

When Size Matters

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:

  • They like the feeling of fullness (and for them a dildo is also effective)
  • They like direct stimulation of the G-spot (which, as we’ve said before, has a mystique all its own)
  • While they don’t specifically think of the G-spot, they like the internal stimulation

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.

Vibrator Myth-Busting

Recently, I joined with two colleagues to produce a “continuing medical education” unit for the American College of Obstetricians and Gynecologists (ACOG). Our topic was “Vibrators and Other Devices in Gynecologic Practices” (if you’re a health care practitioner, you can investigate the CME offer here).

I was joined by Mary Jo Rapini, a sex psychotherapist and long-time friend of MiddlesexMD, and Debra Wickman, a gynecologist who teaches at the Banner Good Samaritan Medical Center in Phoenix. We talked about a 2009 study in the Journal of Sexual Medicine that says that 52.5 percent of women have used a vibrator; that led us to talk about the roughly half who have not.

A number of myths might get in their way, and we hope we made some progress in busting them.

Myth #1: Vibrators are for people whose relationships are in trouble. Based on what the three of us have seen, the opposite is true. As Mary Jo explains, “Vibrators are for couples who want to explore, who want to try new things, who want to play and have fun in their sex life.” Couples who share that desire are typically interested, trusting, and care about each other.

Myth #2: Vibrators make it hard to have an orgasm any other way. I’m happy to debunk this one with a medical reality: As the muscles involved in orgasm grow stronger, orgasm becomes easier and more intense. Vibrators are good at stimulating—and they don’t get tired or fumble, as we sometimes do as we lose a little strength and dexterity. Staying sexually active with a vibrator will increase your responsiveness to manual stimulation—that’s just the way we work.

Myth #3: There’s something sinful about a vibrator. Again, it’s Mary Jo who addresses this most directly. She’s had a number of conversations with faith leaders on her patients’ behalf, when religious concerns weighed on their minds. The ministers she’s talked to are invariably in favor of keeping marriages strong, and maintaining physical intimacy is a natural part of those relationships.

Myth #4: Vibrators are only for self-stimulation. Vibrators are good for self-stimulation, and that’s a good option for women who want to maintain their sexual health when they’re without a partner. But they’re also part of intimacy for couples. They’re especially good for couples who see a need to slow down and spend more time in foreplay. Which, now that I think about it, could be any of us who’ve achieved midlife!

If you’re among those who haven’t tried a vibrator, I support your right to decide for yourself. Here’s hoping, though, that none of these myths is what’s standing in your way.

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