Every relationship has its dry spells. Yet for some, challenges in the bedroom isn't just a phase — it's the permanent result of an unfortunate medical condition.
Recently, Buzzfeed author Lara Parker shared her experience living with vaginismus, a condition that causes spasmodic contractions that can make vaginal penetration and intercourse (often referred to as PIV sex) painful and often impossible. Exact numbers are difficult to come by, due to embarrassment that may lead to some women not seeking treatment, but it's estimated that two out of 1000 women have the condition. The condition can have both physical and emotional causes, from UTIs to anxiety or sexual trauma.
"I have had some women who had vaginismus where they don't find it painful, it just doesn't work. It's [caused by] physical combined with emotional reasons," sex therapist Dr. Madeleine Castellanos, author of Wanting to Want: What Kills Your Sex Life and How to Keep It Alive, told Mic. And it's not just women who can't have sex due to a medical condition. As Dr. Castellanos pointed out, the male equivalent would be erectile dysfunction, a condition that is surprisingly common among younger men.
As Parker details in her article, sexual dysfunction in young adulthood can be humiliating and depressing. It also can be a struggle for the romantic partners of those suffering from such conditions.
Living without intercourse: For most of us, sex is a crucial part of an adult relationship, so not having sex for an extended period of time can be a source of tremendous frustration. "In the beginning, it affected me a lot," said Ross, 28, who has been with his girlfriend for three-and-a-half years. His girlfriend's unwillingness to address the issue also made it seem like they had reached a dead end in their relationship.
Now, after months of undergoing physical therapy, his girlfriend's condition has improved. "We can now enjoy a regular non-intercourse sex life," Ross said.
Patrick*, 35, has been in a relationship with a woman with vaginismus for a decade. "It affected our relationship greatly and nearly ruined it on several occasions,"he said. "For years after we were together she would break down in tears for no apparent reason, because she was as frustrated as I was that things were not working and she felt that she could not fulfill me in the way I wanted."
Ramona*, 29, dated a man for four years who had chronic erectile dysfunction during the second half of their relationship. "He told me before the first time we had sex that sex had been the reason his other two substantial relationships had ended, which at the time seemed really crazy to me, because at the beginning our relationship was pretty sexual — for at least the first year or two," she said.
After losing both a parent and his job, Ramona's boyfriend started having more trouble achieving and sustaining erections, even though he was only in his mid-twenties. "It was such a source of shame and anxiety and feelings of failure on both our parts — he felt all those things because his junk didn't work, I felt them because I felt like I wasn't sexy enough to make my boyfriend's junk work," said Ramona.
Sex therapist Vanessa Marin told Mic that this isn't uncommon — in fact, a "majority" of her male clients are in their early 20s to late 30s.
"A lot of people hear ED and think the picture of the nice salt-and-peppered gentlemen in the Viagra ad, but it's much much younger than a lot of people think," she said. In fact, experts estimate 5% of men between ages 20 and 39 experience some form of erectile dysfunction.
Erectile dysfunction or vaginismus is not something anyone puts on their wish list, and it can lead to insecurity not only for the sufferer, but for the partner as well. "A lot of people really take it personally [when their partners have erectile dysfunction], like 'I'm not sexy enough, he's not attracted to me, I'm not pretty enough.' You can go into some awful places in your head," Marin said.
Learning other ways to have sex: The good news for couples dealing with a condition like vaginismus, is that the condition is often treatable. Current treatments range from Botox, to antidepressants, to use of dilators (medical devices that increase in size inserted into the vagina) combined with talk therapy. For many men with ED, both therapy and pharmaceutical options such as Viagra can help.
Not all conditions preventing penetrative sex can be treated. Yet, as the couples in these situations who put in the hard work have discovered, sex, pleasure and orgasm don't have to equal penetration.
"I've [treated] guys who have had a radical prostatectomy [an operation that removes the prostate gland and can result in loss of erection] who now can not get an erection and don't want to get surgery to have a penile implant," Castellanos said. "They start having the best sex that they've ever had because they're paying attention to pleasuring their women, they're engaging in oral sex, they're using their hands, they're using their entire body. They're learning to understand that they're not completely defined by their penises."
Even women who don't suffer from conditions such as vaginismus will tell you that PIV sex isn't the best way to get off. Being forced to step outside the boundaries of PIV sex — and to step outside the bedroom — can help the relationship evolve in unexpected ways.
"Prior relationships for me had been very sex driven and only lasted briefly because of that. We found ourselves seeing plays, going to museums, art shows, doing things we both liked, just being in the presence of one another. It was with that I found a degree of satisfaction no sexual experience had been able to provide before," said Fred*, a 23-year-old whose college girlfriend had vaginismus.
With love, patience, and dedication, not having penetrative sex doesn't have to mean the end of a relationship – or even the end of sexual pleasure. "I think if you dedicate yourself to it you can really begin to understand that PIV isn't the end all be all. Skill and knowing your partner proved to me that any sexual act can be just as satisfying," said Fred.