Savage Love: Floored

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Q: I’m a 40-year-old married straight woman. I gave birth to our first kid in 2015 and our second earlier this year. My perineum tore and was stitched both times. I have not been able to have sex with penetration since having our second child. My OB/GYN said I’m “a little tighter now” due to the way the stitching was performed. My husband is very well endowed and I can’t imagine how on earth I’m ever going to get that thing back in me, let alone enjoy it. We have a history of pretty hot sex and I really miss it. I’ve been searching online for some sex toys to help me. I’ve never used sex toys before. I’ve always been able to have thrilling orgasms easily without any devices. I still can with manual stimulation. But I want to have sex with my husband. I’m confused and I just don’t know what I need to help me open back up and get through the pain. Please help!
– Thanks In Advance

“Unfortunately, this situation is very common – but luckily there are options to help her get her groove back,” said Dr. Rachel Gelman, a pelvic floor physical therapist at the Pelvic Health and Rehabilitation Center (pelvicpainrehab.com).

Also sadly common: OB/GYNs shrugging off concerns like yours, TIA.

“I see that all the time,” said Dr. Gelman. “Part of the problem is that the pelvic floor/muscles aren’t on most doctor’s radar. That’s due to many factors – cough, cough, insurance companies, cough, our dysfunctional health care system, cough – but to water it down, it’s the OB/GYN’s job to get someone through pregnancy and deliver a healthy baby. And when that’s accomplished, the feeling is their job is done.”

But so long as you’re not able to have and enjoy PIV sex with your hung husband, TIA, there’s still work to do.



“TIA needs to see a pelvic floor physical therapist,” said Dr. Gelman. “A good PT would be able to assess and treat any pelvic floor dysfunction, which is often the primary cause or a contributing factor for anyone experiencing pain with sex, especially after childbirth.”

At this point Dr. Gelman began to explain that pushing a living, breathing, screaming human being out of your body is an intense experience and I explained to Dr. Gelman that I’ve had to push a few living, breathing, screaming human beings out of my body, thank you very much. Dr. Gelman clarified that she was talking about “the trauma of labor and delivery,” something with which I have no experience.

“Labor and delivery can have a significant impact on the pelvic floor muscles which can cause a myriad of symptoms,” said Dr. Gelman. Pain during PIV sex sits high on the list of those symptoms.

“The fact that TIA had tearing with the deliveries means she most likely has scar tissue, and a PT would again be able to treat the scar to help decrease any hypomobility and hypersensitivity,” said Dr. Gelman. “A pelvic floor specialist can also instruct her in a home program which may include stretches, relaxation techniques, and dilators – dilators are graduated cylinders that are inserted vaginally to help stretch the vaginal opening and promote relaxation of the pelvic floor.”

A set of “graduated cylinders” is essentially “a bouquet of dildos,” TIA. You start with the smallest dilator/dildo, inserting it every day until you can insert it without any pain or discomfort, and then you “graduate” (nudge, nudge) to the next “cylinder” (wink, wink). You can order a set of dilators online, TIA, but Dr. Gelman wants you to find a doc that specializes in sexual medicine first.

“There are some good medical associations that she can check out for resources and to help locate a provider in her area,” said Dr. Gelman. “The websites of the International Society for the Study of Women’s Sexual Health (ISSWSH), the International Society for Sexual Medicine (ISSM) and the International Pelvic Pain Society (IPPS) are where she should start.”

Follow Dr. Gelman on Instagram, @pelvichealthsf.