Dating the One You Married, Part 14A

Overcoming Sexual Pain and Fear

Willard F. Harley, Jr.

 

I encourage married couples to try to meet all four of each other’s intimate emotional needs when they go on a date: Affection, Intimate Conversation, Recreational Companionship, and Sexual Fulfillment. They should blend together. But when Roseanne and Ted first came to my office, they were not meeting any of those needs for each other. They were not in love and they had never been in love.

So, preparing them for dating was quite a challenge.

First, I helped them eliminate demands, disrespect, and anger from their conversation, and replace them with the four friends of Intimate Conversation (to inform, investigate and understand each other; to develop an interest in each other’s favorite topics of conversation; to balance the conversation; and to give each other undivided attention when conversing). With practice, that enabled them to engage in Intimate Conversation, which helped them make Love Bank deposits and avoid withdrawals when they talked with each other.

Then, I helped Ted learn to be affectionate with Roseanne and she returned the affection to him whenever he expressed it. It not only helped them make Love Bank deposits, but it also helped create an attitude of goodwill, wanting to help each other resolve conflicts instead of stubbornly wanting their way at all costs.

The next emotional need that I helped them meet for each other was Recreational Companionship. Since I’ve already explained how I helped Sherry and Todd become each other’s favorite recreational companions in Part 9 of this series, I won’t repeat a description of that procedure that I used for Roseanne and Ted. After several weeks of discovery, they found recreational activities that they both enjoyed and spent part of each week engaged in those activities together.

To get to this point, I had spent almost six months with them, holding them accountable to follow each assignment. While there was always some resistance, especially from Ted, they both completed the assignments and discovered a relationship that they had never experienced before. They were actually getting along with each other. While unresolved conflicts still existed, they didn’t argue about them, knowing that I would eventually address them to their mutual satisfaction.

But they were not ready to date yet because they were not meeting one intimate emotional need that would be more difficult for them to meet than any of the others: Sexual Fulfillment. What made it so difficult was that Roseanne had developed an aversion to sex due to the pain that she had experienced whenever she had made love to Ted. She had been willing to go through it early in marriage because she wanted children, but once she was satisfied with three, there was no reason for her to endure the pain again.

Off to a Very Bad Start

Rosanne and Ted began their marriage ignorant about how to create a mutually enjoyable sexual experience. They both didn’t believe in having premarital sex, so their first sexual experience was on their honeymoon. And it was a disaster for Roseanne.

Ted's image of a marital sexual relationship was based on his experience with pornography, so he made no effort to help her enjoy the experience. Instead, he used her body as his sex toy, doing some of the things he had seen on pornographic videos. Roseanne's image of sex was to submit to her husband, so she tried to go along with it, assuming that it’s what all married couples do.

It was not only very degrading to her but, because she was not at all aroused and her vagina was not lubricated, intercourse was painful to her. Over time, it became increasingly painful whenever she had intercourse. She eventually developed the reflex, vaginismus, which gave her the most intense pain she had ever experienced whenever her vagina was penetrated.

Roseanne’s mother had never enjoyed having sex with her husband and had given her the impression that she should expect it to be unpleasant. It was seen as one of many sacrifices women make in life. But as intercourse became increasingly painful over time, she had come to a point where even the thought of sex made her feel physically ill.

So, when I introduced the topic for the first time, she would not talk to me about it.

Instead of talking, I asked her to read in private the Q&A column that I had written, "How to Overcome Pain During Intercourse" (see below, after this article). In that column, I begin with the premise that intercourse should be completely avoided if it is accompanied by pain or even discomfort. In other words, Roseanne’s assumption that sex is a painful sacrifice for women is terribly misguided. Instead, I wrote that it should be very enjoyable and sexually arousing for women. If a woman does not have that experience, there are lessons to be learned.

From that premise, I went on in that column to describe the primary and secondary causes of vaginal pain. A dry vagina or bacterial infections are the most common primary causes. But if the primary problem is not solved, and intercourse continues, a secondary problem, vaginismus, is a common result. It is a very painful reflex that can persist long after the primary cause of pain is eliminated.

After she read the article, she was willing to talk with me about it. Everything I wrote made sense to her, and she could see how her misconceptions about sex, and her husband’s insensitivity, helped create the excruciating pain that she now associates with sex.

I then encouraged her to follow the instructions I recommended in the Q&A column to help her overcome the vaginismus reflex. Her husband was not to be present when she followed the plan. It involved penetration of the vaginal opening that was slow and gentle enough to avoid the pain reflex. She was training neural pathways in her spinal cord to extinguish the painful tightening reflex of her vaginal opening, and replace it with a relaxed opening when stimulated.

Within a week, she noticed a significant improvement and continued the recommended procedure every day for the rest of the month until she could quickly insert a candle with a one-inch diameter into her vagina without experiencing any pain.

Challenging Her Sexual Aversion

Her next assignment was to read my Q&A Column, "How to Overcome Sexual Aversion" (see Dating After Marriage, Part 14B). In spite of the fact that she had overcome vaginismus, the thought of having intercourse, or any other sexual experience with her husband, was repulsive to her. She had developed a sexual aversion.

If you have had bad experiences doing something, you will come to associate them with what you have been doing. Even if the task, by itself, had nothing to do with your bad experiences, the very thought of it will eventually create anxiety and unhappiness, and doing it will make matters even worse. Psychologists call this an aversive reaction.

While it’s true that vaginismus played an important role in creating Roseanne’s aversion to sex, Ted could not be let off the hook. Knowing that she was in pain, he continued to have intercourse with her until she finally put a stop to it.

I explained to Roseanne that her aversion to sex could be overcome and that the insensitive husband who had put her through many painful sexual experiences could change. She had already seen how affectionate he had become, and how their conversation had become enjoyable for her. So, she took my word for it that she could actually enjoy having sex with Ted someday.

She followed the method I recommended in my Q&A column.

First, she practiced relaxing while thinking about sex.

Then, she practiced relaxing while thinking about having sex with Ted.

That was a very tough assignment for her because thinking about sex with Ted brought horrible memories to mind. Even before she had experienced any pain with intercourse, he had forced her to engage in degrading and disgusting sex acts. How could she forget about all of that and learn to think of him as a caring and sensitive lover?

But over time, relaxation helped her change her thoughts from his past sexual abuse to what could become lovemaking. She started to imagine how sex could communicate care, just as affection communicates care. Ted had already demonstrated his care for her as never before, and let her know that he would never again try to force her to have sex that was unpleasant for her. They wouldn’t be having sex: They would be making love.

The third step she followed was to think about making love with Ted while he sat in the room with her.

When she was able to completely relax with him present, she went on the fourth step by talking with him about making love. She began by talking about romantic scenes that she read about in novels, and then went on to forms of sex that she found offensive, relaxing as she talked. Finally, she was able to talk about making love with him, and how she would like it to happen. She found that she could talk freely about making love without feeling anxious or nauseous. She had become almost free of her sexual aversion.

The fifth step was her final test: Having intercourse with her husband, Ted. It had to be done very carefully, with her in charge of every aspect of the experience. She wanted the lights to be turned off, so I encouraged Ted to take her advice.

Roseanne was in complete control of the first experience. First, she put a lubricating fluid into her vagina to be sure that it wasn’t dry. Then, she very slowly inserted his penis into her vagina. He was instructed by me not to move at all, and let her do everything. She had already been using candles to help her overcome vaginismus and could be somewhat rough with them without any pain. But the reflex can sometimes briefly return under different conditions, so she was careful to go slow. With his penis completely inserted with absolutely no pain or discomfort, she began slowly to thrust, which convinced her that all pain was gone and her aversion to sex was gone along with it.

Up to this point in her recovery, I had not discussed the five stages of the sexual response with her. My goal was to simply demonstrate to her that her vaginal pain and sexual aversion could be overcome. And they were definitely overcome.

Roseanne and Ted had already learned how to be affectionate toward each other. Every morning and evening when they were in bed they hugged and kissed each other. But without my prodding, they began being affectionate while naked. Nature took its course and the rest is history.

Within a week, Roseanne was wanting Ted to make love to her every morning and every evening. She had discovered enjoyable sex for the first time in her life. At first, Ted thought he had died and gone to heaven, but he discovered that he couldn’t keep up with her. It wasn’t long before they both decided on a more moderate schedule of lovemaking.

Ready to Date

You’d think that dating, at this point in their marital development would be irrelevant. They were already making massive Love Bank deposits without it. They were being affectionate throughout every day, they enjoyed intimate conversation with each other, they had discovered recreational activities that they both enjoyed, and they made love often.

But just because they knew how to meet each other’s intimate emotional needs didn’t mean that they would schedule time to do it after they stopped seeing me. When they were eventually on their own, and with the demands of their three children, they would be tempted to prioritize spending their free time with them instead of giving each other undivided attention.

I had not yet addressed the topic of conflict resolution to them, and they had planned to continue having counseling sessions with me until they had mastered it. But I wanted them to learn how to date first.

Dating simply guarantees romantic love. By scheduling time each week to meet the needs of affection, intimate conversation, recreational companionship, and sexual fulfillment, a couple avoids letting objectives of lesser importance prevent them from staying in love.

So, I introduced a dating schedule of 15 hours a week to them.

Up to this point, Roseanne and Ted had met each other’s intimate emotional needs in an unscheduled way, whenever an opportunity presented itself. But I wanted them to make it a part of their weekly schedule so that they would never find themselves drifting away from their romantic relationship.

Meeting intimate emotional needs in an unscheduled and impromptu way can also be part of a romantic relationship. But there’s something about unscheduled events in busy parents’ lives that don’t get done. And the meeting of intimate emotional needs is too important to be left to chance.

Unfortunately, the schedules of Rosanne and Ted were packed with their children’s activities. The reason that they were doing such a good job meeting each other’s intimate emotional needs was that it was assigned to them, so they made the time to do it a priority. But it was easy to see how that priority could take a back seat to care for their children after they stopped counseling with me.

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How to Overcome Pain During Intercourse


Introduction: The first three letters are a sampling of experiences of women who suffer from painful intercourse, and my answer covers all three of their situations. The fourth letter posted describes a woman who has overcome the pain, but has not made a good sexual adjustment after the symptoms ended. My answer to that letter explains how to overcome the effect of having tried to have sex under conditions of extreme pain.

LETTERS #1-3

Dear Dr. Harley:

In reading your August 26th Q&A, Preparing for Marriage, you tell E.C. that failing to meet your spouse's needs opens the door for an affair. I hate to hear you say that! I have been having problems for several months now and my doctor believes I may have endometriosis. One of the problems I have been having is very, very painful intercourse. Therefore, my husband's needs are very hard for me to meet. We have tried other outlets other than intercourse, but it doesn't seem to be enough for him. How can I get him to understand that intercourse really does hurt a lot!!! He thinks I am faking or that I am having an affair because I don't want sex with him. It just plain hurts and I don't want to do it very often. Our marriage is deteriorating fast because of this and also a few other factors. He's making it very hard for me to love him! Any suggestions?

R.D.

Dear Dr. Harley,

My husband and I have been married for almost two years. We are very much in love, we enjoy each other's company, and we have a solid commitment to our marriage. The problem has been our sex life. Both of us were virgins when we got married. Although my husband has been an extremely patient lover, from the very first night of our honeymoon, sex has been an ordeal for us. Sometimes it works and other times it doesn't. Almost every time we attempt to make love, I get very nervous and it is painful for me. A few times in the last two years, we have had wonderful, spontaneous sex. I have switched birth-control pills and tried relaxing before sex, but it seems that arousal is difficult because I anticipate the pain. I have no history of abuse (of any kind), and I very much want to have sex that will drive my husband wild! What can I do?

A.P.

Dear Dr. Harley,

I have a problem. Whenever I have sex, it hurts. Sometimes, after we are finished, blood shows up in my underwear. Do you have any idea what could be causing the problem? I am going to get to a doctor, but I would like to prepare myself before I get there.

C.D.

Dear R.D., A.P., and C.D.,

A good sexual rule of thumb is, Don't have intercourse if it's painful. If you ever experience pain during intercourse, stop. Then see a doctor to help you determine the cause of the pain and help you overcome the problem. When the physical cause of the pain is eliminated, go back to having intercourse painlessly and enjoyably. To do otherwise invites disaster.

It's true that when important emotional needs, such as sexual fulfillment, are unmet, there is a risk for an affair. But having sex at all costs is not the solution. In fact, if you follow my Policy of Joint Agreement (never do anything without an enthusiastic agreement between you and your spouse) you would never have sex in a way that's painful to you. Instead, you would pursue painless sexual options until you have resolved the problem.

Most women throughout most of their lives experience no pain whatsoever when they have intercourse. But, once in a while, most women do experience pain during intercourse. When they do, they should identify and treat the problem before having intercourse again.

There are primary and secondary causes of vaginal pain during intercourse. The primary causes are those that are responsible for the initial pain or discomfort. Secondary causes are those that are created by the pain itself if intercourse continues. These can trigger vaginal pain long after the primary causes have been overcome.

Primary Causes of Vaginal Pain

One of the most common primary causes of vaginal pain during intercourse is a dry vagina. Usually, when a woman is sexually aroused, fluids are secreted in the vagina that keep the lining well lubricated. But if a woman is not sexually aroused, or if fluids are not secreted for some other reason, intercourse can cause very painful damage to the vaginal lining. And in some cases, the lining of the vagina can actually tear, resulting in post-intercourse bleeding.

There are two ways to avoid a dry vagina during intercourse. The first is to avoid intercourse until you are sexually aroused. The second way is to use an artificial water-based vaginal lubricant, such as K-Y jelly, Vagisil Intimate Moisturizer, or Replens Vaginal Moisturizer, as a substitute or backup for natural lubricant.

Since vaginal secretion is usually an indication of a woman's sexual interest, I usually recommend that intercourse wait until she experiences sexual arousal and natural lubrication. I want couples to avoid getting into the habit of sex that's passionless for her. But if natural secretion is an unreliable indicator of your sexual arousal, I would certainly recommend an artificial lubricant.

If you're not sure if a dry vagina is the cause of your pain, use an artificial lubricant once. If there is no pain under those conditions, then you have proof that it's the cause of your distress.

Another common cause of vaginal discomfort during intercourse is a bacterial infection. This occurs frequently in women, and an antibiotic will generally cure the problem within a week or so. A related problem is bladder infections. While the problem may be in the bladder or urethra, not in the vagina, it often causes discomfort during intercourse.

A visit to your doctor will identify and treat a bacterial infection so that you will have a minimal interruption in your sexual fulfillment. But be sure to make the appointment as soon as intercourse is uncomfortable. Otherwise, it can develop into a secondary cause of vaginal pain that I will explain later.

There are other diseases that can cause pain or discomfort during intercourse. Vaginal endometriosis is one of them. When your doctor examines you for possible bacterial infection, be sure to ask him or her about endometriosis, because it is often overlooked during an examination. Your doctor examination will also be able to check for any vaginal tumors or venereal diseases that may be causing your discomfort. These problems may take longer to treat than bacterial infections, but whatever the problem turns out to be, don't have intercourse until it has been overcome.

If you have experienced vaginal bleeding after intercourse, your doctor should also be able to identify its source and treat it for you. Sometimes a scratch or tear in the lining caused by something other than intercourse can be the cause of your problem.

It is very important for you to be comfortable with regular pelvic examinations. Otherwise, you may let a medical problem become so far advanced that it causes you permanent injury. If you are embarrassed to see a male doctor, find a female doctor. But whatever you do, don't let your inhibitions prevent you from experiencing painless intercourse.

If your doctor can identify the source of your vaginal discomfort, don't have intercourse until the problem is treated and overcome to his or her satisfaction. Some problems can be treated in a week or less, while others, like endometriosis, may take months to overcome.

If you are unable to have intercourse during treatment for a vaginal disease, that doesn't mean you'll be forcing your husband to rush off to have sex with someone else. I suggest that your husband be informed by your doctor of what it is you are going through, and how you will be treated. A major problem you may face is your husband's failure to see your sexual reluctance for what it is: vaginal pain brought on by a physical cause. If he doesn't believe you when you explain that it's the pain that makes you reluctant, his ignorance puts your sexual relationship, and probably your marriage, at risk. But once he understands the nature of the problem, and knows that it isn't an affair or some other emotional cause, he will be happier with alternatives to intercourse while you wait for your treatment to take effect.

In some cases, a husband's thoughtlessness is remembered long after the painful symptoms are gone. If your husband tries to force you to have painful intercourse with him and threatens you if you do not cooperate, your memories of his insensitivity will be a far greater barrier to your future sexual relationship than your disease ever could have been. Don't let him create those barriers to your future together. Insist that there be no sex unless you enjoy the experience with him. It's not only in your best interest but in his best interest too. If you go ahead and try to make love when it's painful for you, you may have a very difficult time making love to him in the future.

A Secondary Cause of Vaginal Pain

What should you do if you eliminate the primary causes, and you still experience vaginal pain? What if your doctor finds no physical cause for your discomfort during intercourse? That can be very discouraging to most women, who begin to think that it's all in their heads. If the pain is not physically caused, then it must be psychological, right?

Not necessarily. In fact, most cases of persistent vaginal discomfort are not due to primary causes at all, but rather to a reflex called vaginismus. It's not psychological or emotional, it's very physical. Vaginismus is a painful reflex that is created in association with a primary cause of vaginal pain. In other words, if you experience vaginal pain from any one of the primary causes I've mentioned, vaginismus can develop secondarily. Long after the primary cause is ended, the vaginismus can persist.

This reflex responds to stimulation of the vaginal opening. If you suffer from vaginismus, you will notice it most when you first try to insert something into your vagina. The opening involuntarily contracts and pain is immediately felt. In extreme cases, the contraction is so tight that nothing can penetrate it.

From this description, you can see how it would interfere with intercourse. Regardless of how sexually aroused you might be, or how lubricated your vagina might be, as soon as you try to insert your husband's penis, you would experience excruciating pain. It may be difficult to insert his penis because the vaginal opening becomes constricted. In some cases, it is impossible to insert a penis.

Naive couples often don't know what to make of vaginismus. Some of my clients believed it was God's punishment for their having sex before marriage. Others have blamed it on the sins of their parents. But whatever its cause, it certainly feels like punishment for something. Only after I am able to explain the cause of the reflex and help them eliminate it, do they realize that sin has nothing to do with it.

There is a tried and proven way to overcome the vaginismus reflex. If you follow this procedure, I guarantee your success. I recommend that you follow the exercises I recommend in the privacy of your bathroom, or when you are alone in the house. Your husband should not be included until the later sessions.

First, determine how strong the reflex is and what triggers it. The way to determine its strength is to insert your finger into the vaginal opening to see what happens. If there is no reaction to your finger, insert something increasingly wider, like candles, until you can trigger the reflex. It will be an involuntary contraction of the opening as you try to insert the object, and it will be painful.

Notice how large the object must be before the reflex is triggered, and how tight the opening gets. The smaller the triggering object, and the tighter the opening, the more difficult it will be to extinguish the reflex. If you can't get your finger into the opening without extreme pain, you have a very well-developed case of vaginismus. But regardless of its intensity, it can be eliminated.

The way to eliminate this reflex is to set aside a few minutes each day, preferably several times a day, to expose the opening of your vagina to penetration without triggering the reflex. If you can associate vaginal penetration with no pain or discomfort, the reflex will be extinguished. But remember, even an occasional triggering of the reflex can strengthen it.

Begin each session by covering your finger with water-based lubrication (such as K-Y jelly, Vagisil Intimate Moisturizer, or Replens Vaginal Moisturizer). Very slowly, lubricate the opening of the vagina with your finger, then slowly insert your finger about an inch. Even in the worst cases of vaginismus, a finger can be inserted so slowly into a lubricated vaginal opening that the reflex is not triggered. In a slow circular motion, gently rub the vaginal opening with your finger in ever-increasing circles. Remember to go slowly enough not to trigger the reflex or experience any discomfort. After you have rubbed the opening for about a minute without any pain or discomfort, slowly insert your finger into the vagina, and in a circular motion gently rub the inside of the vagina as far as your finger will go. Then remove your finger, and do the same thing all over again. Do it about five times before you end the session.

You will notice that after the first insertion of your finger, the opening is much less sensitive, and you will be able to penetrate much more quickly without triggering a reflex. Move your finger slowly enough so that you avoid any discomfort. But after a while, you will find that you can move it very freely without pain.

You may end the first session thinking that you have overcome the reflex, only to discover at the beginning of the next session that it is back. So start the next session very slowly and carefully, doing again what you did during the first session. When you think you are ready, use a larger object than your finger, such as a candle, and increase the diameter of the object until it is about the size of a penis. Be sure to re-lubricate whatever you choose to insert, and go slowly to avoid the reflex.

The number of sessions to completely eliminate the reflex will depend on the severity of the vaginismus. But when it is eliminated, you should be able to insert an object the size of a penis, with lubrication, fairly rapidly without any pain or discomfort.

There are some women who are not comfortable touching themselves and would prefer having their husbands carry out these exercises. While it can work, the problem with anyone else doing it is that no one but you knows precisely how much pressure to use, and your husband would inadvertently trigger the reflex far more often than you would. That means that it would take much longer for you to overcome vaginismus with his help.

His turn should come after you are convinced that the reflex is extinguished. Up to this point, obviously, you should have avoided intercourse, because it would have brought the reflex back. But when you think the reflex is gone, it's time to start having intercourse again. Unfortunately, you will find that after you have learned to insert a penis-sized object into your vagina without incident, the reflex may suddenly reappear the first time your husband tries to insert his penis.

To prepare for that common outcome, the first time you have intercourse you should insert his penis yourself. Use plenty of lubricating fluid, and lay on top of him when you do it so you can control the penetration. He should lay motionless so that the penetration and thrusting are done only by you so you can stop whenever you experience the least amount of discomfort. Eventually, you will be able to insert his penis without any pain, thrust as fast and deep as you want, and experience no discomfort whatsoever. The vaginismus reflex will have been eliminated.

If it ever comes back, it will be in a much milder form, and you will be able to eliminate it in a day or so by going back to inserting his penis yourself and controlling the thrusting motion during intercourse.

To repeat what I have already said numerous times, whenever you experience any pain during intercourse, stop immediately. Then solve the problem before resuming intercourse. 

LETTER #4

Dear Dr. Harley,

My wife and I have been married for about 2 1/2 years. Before our marriage, and for a short time afterward, our sexual relationship was fantastic. 2-3 months after we got married, she was diagnosed with endometriosis and went into the hospital for a laparoscopy to remove the endometriosis. She was still having quite a bit of pain a couple of months after the surgery and the doctor put her on Zoladex (a drug that makes the women go through "temporary" menopause while she is on it). She was on the Zoladex for about 5 months, and our sex life has never been the same. We rarely had sex while she was on the Zoladex, and it has continued on since then.

She has spoken to her doctor who put her on the medication, he says it's all in her head (which of course did not hit home very well at all). She has told me that she is still very attracted to me, but she just can't raise those emotions anymore.

So here lies the problem, it has now gone on for well over 2 years and I am really getting frustrated about not being able to resolve this. My greatest desire is to get our sexual relationship to the point it was when we got married. She wanted me as bad as I wanted her. I am willing to do whatever it takes to get us back to where our relationship was and build on that, but her response is "If I don't have any desire, how can I fix the problem?"

At this stage of the endometriosis, she does not have pain during intercourse (though at the beginning of this fiasco she did). We are now at a point where we are fighting a battle over desire. She is very willing to do what it takes to solve the problem, so if I can find any possible solutions, she is willing to try them. She thinks it's a hormonal problem, but she's already asked her doctor and he doesn't agree with her.

What started from a small outpatient surgical routine, has turned into a full-blown problem which has led to some very stressful evenings and conversations (mostly on my part). I am more than willing to do anything you might suggest to get to the bottom of this, I would love to have the girl I married back.

She has this fear that everyone we talk to about this is going to tell her she has a mental problem, and that bothers her. This may be a reason why she hasn't pursued a solution to this herself. She wants this to be a physical thing, such as a low estrogen level, but her doctor assures her it's something else. Is there anything I can do, or anyone I can talk to who would have more knowledge about circumstances such as these? I am almost at my wit's end, I love my wife very much, but I want us to be happy and enthusiastic as we once were.

M.H.

Dear M.H.,

From what you have told me, I would agree with your wife's doctor that the problem is not physical, but rather emotional. She is probably now as physically capable of passionate sex as she ever was. Her loss of desire can be explained by the experiences she had with you while she endured the symptoms of endometriosis. Those experiences not only included painful intercourse but could have also included insensitivity on your part to her predicament. Since then, you apparently have been arguing with her about it, perhaps being disrespectful and demanding. Those Love Busters really do a number on sexual desire!

Sexual desire for most women is considerably more fragile than for most men. For men, physiological factors (testosterone) tend to dominate, while for women, emotional attachment and past sexual encounters have more influence.

I would imagine that her endometriosis turned her terrific sexual experience with you into a nightmare; she came to view lovemaking as a very unpleasant necessity. For a while, she would have endured the pain just to please you, but eventually, she could not bear it any longer. She may have even been brought to tears while making love to you.

To compound the problem, your sex drive may have made you insensitive to her pain. Knowing that she was suffering, you may have charged ahead to meet your need. She would have seen you in an entirely new light, a man who cared more about sex than about her. Then, when the endometriosis was discovered and treated, your months of celibacy may have made you less affectionate and thoughtful.

In the beginning of your marriage, you were meeting your wife's emotional needs and avoiding Love Busters. She wanted to make love to the man who loved and cared for her, and each sexual experience was a treat. She was emotionally connected to you and she had memories of many enjoyable sexual experiences. That's why she had sexual desire -- she expected each sexual experience with you to be terrific because every past experience had been that way.

When your wife developed endometriosis, it may have marked the beginning of a downward slide in your relationship. Perhaps a few Love Busters were unleashed, and perhaps you were not as thoughtful or affectionate as you had been in the past. By the time the disease was under control, she couldn't even remember what it had been like to enjoy sex, and she was no longer emotionally connected to you. The result was no sexual desire.

You and your wife are at a point in your marriage where you can recreate the enjoyable experience you once had. But to do it, you will need to begin at the beginning.

First, I recommend that you make sure that your wife re-connects with you emotionally. Have you eliminated Love Busters that may have been created during her months of endometriosis? Are you meeting the emotional needs you once met? You may want to encourage her to complete my Love Busters Questionnaire and Emotional Needs Questionnaire to help identify the obstacles to your relationship.

Then, if she still gets a knot in her stomach whenever she thinks about having sex, I suggest that she follow the advice I offer in my Q&A column, "How to Overcome a Sexual Aversion" (see Dating After Marriage, Part 14B). These procedures may seem to be long and technical, but they work. Once you have a willing sex partner again, you will appreciate what you have even more than before, and you will know how to protect it so that you don't lose your passion for each other again.

Your wife went through sexual hell when she had endometriosis, so it's no surprise that she just doesn't feel the same about sex. If you treat her with the love and thoughtfulness she deserves, and she learns to overcome the aversive reactions she has developed, those bad experiences will be replaced with good experiences, and sexual desire will return to her.

 

Part 14 continues with 14B, "How to Overcome Sexual Aversion."