Vibrators and Vaginismus


Besides starting with a V, most people would probably say that vibrators and vaginismus really have nothing to do with each other. But I’m here to tell you otherwise.


Let’s start with a quick review

vaginismus is a condition where a woman can’t get anything into her vagina without pain. Sometimes she can’t get anything in at all, even a finger, a tampon. Sometimes she can get smaller things in, but not a penis without having significant pain. Vaginismus is often due to tight muscles but also had some psychological factor, because the brain starts to connect the idea of penetration with pain and that creates a cycle.

Often, when we think of vibrators, we think of the models that go inside a vagina and, as a result, we don’t usually think of them as something women who are suffering with vaginismus would be interested in using. Think again.

First of all

While most women with vaginismus primarily work with dilators (cylindrical shaped sticks that gradually  increase in size as the vaginal muscles stretch) , as they move through the small sizes, the truth is that dilators can get boring, and even irritating in their clinical sterility. And the right size internal vibrator can be a great change of pace.

Interesting colors, different shapes, and materials and the buzz or vibration can be fun too for a woman who’s dilating nightly. Also, as you get more comfortable with having something inside the vaginal canal, the vibrations can get the vagina back into working order faster by stimulating the muscles and the blood flow.

In general, blood flow makes everything “work better” and the vagina is no exception!


Now what about good ol’ external vibrators?

Here’s where you need to think outside the box. Just because you are not having intercourse does not mean you shouldn’t be having sex, either by yourself (sex for one) or with your partner! And you know I always say that an external vibrator is one of the best tools available to make sex (for everyone) easier, more fun and accessible.


So here’s the most important thing to remember

Just because you have vaginismus,- or maybe you don’t have vaginismus but you have other pain- that doesn’t mean you can’t enjoy vibrators. Au Contraire my friends! Go out and get thee a vibrator.



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

The Project of keeping Your Sex Life Alive - Part 2





Because it’s the room I’m least likely to show guests, I tend to treat my bedroom like extra storage space. It’s also the room in my house least likely to get vacuumed. But prioritizing your sex life means treating the bedroom like the crown jewel of your home. Founder of the design company AumHome, Nidhi Huba recently spoke to SheKnows about how to feng shui your room for sex. Huba suggests clearing unsexy things like dead plants, dirt, and dust first.



Huba also emphasizes adding two of anything: lamps, candles, night tables, and working with the five senses. Choose colors based on what you want in your sex life. Reds increase energy. Blues calm. Greens encourage heart-centeredness and prosperity. “Go beyond just colors,” Huba adds. “Really try to use every sense. I love encouraging my clients to switch to soft sheets, cozy blankets and soft rugs. Work with room sprays and spritz a mix of sandalwood, cedar, rose and vetiver over the bed.”


“People get sucked into social media and work emails and before you know it, an hour has slipped away and it’s too late to get amorous,” says Bat Sheva Marcus, LCSW, MPH, PHD, and clinical director of Maze Women’s Sexual Health.

Smartphones aren’t the only distraction you may need to clear out of your bedroom, but they are a common distraction. I can think of a million excuses to bring my smartphone to bed, from reading myself to sleep to waking myself up, but none of those activities are any good for my sex life.

“I know it’s hard, but try to keep the smart phones out of the bedroom,” Marcus suggests. “Invest in an old fashioned alarm clock, if you need to be woken up. But if you keep the phones out of the room, you’ll be amazed to find you have freed up so much time for talking and snuggling, not just sex. And if that seems like too big a barrier, then at least use the rule on weekends.”

Where you have sex matters, and it’s possible you used to think about it more than you do now. If you have your own home and you’ve got no kids or grown kids, the tension about where to have sex may be gone. That doesn’t mean you should stop thinking about where you have sex. On the contrary, this is an ideal time to think about making your bedroom a great place to have sex.”



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

The Project of keeping Your Sex Life Alive - Part I


The woman who edited my dissertation Kristy Lin Belluni once told me the following:

“When I was a teenager, I used to babysit my cousins so my aunt and uncle could go out and have sex in the back of their minivan. I remember hanging out with my aunt while she prepared for one such outing. She lined the van’s backend with blankets and spritzed it with Calvin Klein’s Obsession. She raised one eyebrow at me and said, “Don’t tell your mom this is what we do when you babysit.” Because of my aunt, I learned early on that keeping a sexual relationship alive meant putting effort into having sex, making a place for it, even in the busiest of times.


When I was a teenager and a twenty-something, my biggest sexual problem was space. For me, “not supposed to have sex” meant I had sex in cars, campers, dark rooms, dugouts, and broom closets.


I remember that place-focused sex fondly. For a lot of people, the tension around sex you’re not supposed to be having, the tension that causes you to have sex in crazy places, makes sex exciting. Maybe that’s why there’s a juicy cocktail called Sex on the Beach and why people like to boast membership in “the mile-high club.” 


Tension can make sex more exciting, but the effort to create space for sex makes it pretty awesome too.

You don’t have to be hiding your sex life from your kids or your parents or anyone to put some thought and effort into where you have sex.


In my next blog post, I’ll talk about ways to actually make Space for Sex. Stay Tuned.




Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Let’s Rethink Our Birth Control


Alrighty then, let's dive into everyone’s favorite topic: the wild world of birth control pills!

Back in 1961, the FDA gave the green light to those little magic pills, a.k.a. birth control pills, and boy, did they change the game! Nowadays, you can find over 60 different types on the market, and believe it or not, a whopping 12 million women in the U.S. are rockin' them to prevent unwanted pregnancies. For most women, these pills are like superheroes - affordable, efficient, and super effective. No more freaking out about surprise pregnancies, hooray!


But hey, hold up - not all women are best buds with these oral birth control pills.

Some just don't get along with 'em, and some literally hate them. And the side effects? Oh, they're real! Unfortunately, these side effects often get swept under the rug, or worse, women don't even realize that their birth control is causing the problem.


So, what are these pesky side effects, you ask?

Turns out, hormonal birth control pills can mess with your mojo.. They can mess with your desire, arousal, and even cause dryness and pain. Lots of my patients have shared their frustration, wondering if their pills were behind their sexual woes. But here's the kicker - since their doctors didn't warn them about these potential side effects, they just assumed it was all in their heads. And that makes them pretty mad, and rightfully so "Why didn't anyone tell me this could happen?" they wonder. Some have been dealing with these issues for years before finally connecting the dots.


Ironically - those tiny pills that were supposed to spice up your sex life might just be the culprits for killing your desire!

You see, birth control pills work their magic by suppressing hormones to stop you from ovulating and prevent baby-making. But in the process, they also mess with your natural androgen production, like testosterone. And you know what? Testosterone is a critical hormone for driving a woman's libido. So, when these pills tamper with your testosterone levels, it's no wonder your desire can take a nosedive. Bummer, right? (On the bright side, at least they help with skin issues!)


Here's another twist

More and more women start taking birth control pills at younger ages, and they end up staying on them for 10 to 15 years or even longer. While it's generally safe, we're not exactly sure what long-term use does to your libido. Some studies suggest that even after stopping the pills, some women still struggle to get their groove back.

But here’s the good news

If you're on the hunt for non-hormonal birth control options, there are some good options to explore:

    •  Condoms and diaphragms are classic options that still do the trick.
    • Some IUDs are hormone-free or only have "local" hormones that shouldn't mess with your whole system.
    • Oh, and as of September 2020, we've got a new player in town - the FDA-approved vaginal gel contraceptive called Phexxi! It's more effective than old-school spermicides. This little cream, made of lactic acid (you know, that stuff found in yogurt and kefir) and potassium bitartrate (a cooking ingredient known as cream of tartar), gets inserted into the vagina about an hour before the fun begins. It keeps your vaginal pH levels steady and acidic, killing any rogue sperm that dare to enter!


So, here's the lowdown

Birth control pills work like a charm for many women, no side effects and all!


    • But if you're experiencing low desire, arousal issues,  after starting these pills, you're not crazy - it's probably connected!
    • If you decide to ditch the pills, it will probably help, but it could take some extra help to get things back to normal.
    • And guess what? There are some fantastic non-hormonal birth control options out there! Just keep an open mind and explore your choices.


There you have it, my friends. The fabulous world of birth control pills and how they can play with your body and desires. Remember, you've got options, so stay informed and take charge!


(And read more in my book: Satisfaction Guaranteed: How to Have The Sex You’ve Always Wanted.)




Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Want More Sex? Here’s a Tip…


Yesterday yet another woman told me that one of the reasons she doesn’t want to have sex with her husband is because she’s so self conscious.


Sigh. She doesn’t feel great about her body and HE DOESN’T MAKE HER FEEL GREAT ABOUT HER BODY! He makes comments if she gains weight. He makes comments about her belly button, he makes comments about hair on her body. Oh yeah. And then he wants her to feel sexy, be sexy, and make love to him. (Double sigh)


Okay guys…here’s a little secret.

In order to make her feel beautiful — tell her she’s beautiful — tell her what things about her are beautiful — tell her what things about her turn you on — tell her…tell her…tell her…I PROMISE you! You’ll see a new woman. And the converse is true also. STOP telling her what you don’t like about her. It will just make her dive under the covers, wear fuzzy pajamas (you know, I love fuzzy pajamas so maybe that’s not so bad,) and avoid you (that is so bad).


And here’s the funny thing.

My guess is that if you are having more sex…she will look more beautiful to you. Just a hunch. Let me know if it works!



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

What if you Want a Different Kind of Sex: Part 2


If you want a different kind of sex from what you are having, as far as I can tell, you have two options:

  1. Talk to your partner and see if they are open to the change. They may just be waiting for you to say the word. Alternatively, they may be taken aback that you want things that feel non-too- PC and that may take some negotiating. Or, it is possible that they like, or are more comfortable with, calmer, less “rough” sex and it may be difficult to change style. In any event, it’s worth a try.


  1. Or, if your partner really can’t/won’t consider a change in sexual direction, you always have the option to have sex in your head when you’re with them, and that can be a different kind of sex.


Okay, let’s look at the first option.

See if you can talk your partner into getting with the program. This seems like the more obvious of the two approaches and it is the optimal choice. It also might prove to be the more difficult option. Talking to your partner about this means coming clean as to what you really want, even if you are a tad embarrassed to admit it. Women seem to have an awfully hard time admitting to themselves, let alone telling their partners they want them to be dominated or that they want to dominate. It’s so culturally frowned upon that it takes an unusual person to recognize a desire to be thrown on the bed and controlled. Admitting it out loud is twice as difficult. But if you want this to work you have to own that part of yourself, understand it is normal and natural.


And now you have to communicate to your partner concretely, not in generalities. Saying “I’d like you to be rougher or take charge more,” might not get you anywhere. I suspect you’ve probably even tried that already. What you probably need to do is describe, in graphic detail, exactly what you want them to do to you, when and how. And I know, that’s a bummer, because part of the charge of this kind of sex is letting go and letting someone else take charge and here you are feeling like you are back to controlling everything again. Conversely, if you would like to be more aggressive, own that and talk about it. Or, if you want to role play, dress up as an alien or tie your partner up, own it.


It’s also important to accept that you might not get exactly what you want, but you will get a closer version than you might be getting now. And who knows? If you’re really lucky, you may unleash something in your partner that allows them to run with it. Maybe they will find a part of themselves that, until now, they’ve kept wrapped up. You’ll never know until you try.


And unfortunately, “really trying” does not mean one vague, theoretical conversation. “Trying” in this case means passing along books, DVD’s, raising the issue while you are having sex, making specific suggestions and keeping them coming. And all this means you need to make sure you are comfortable with this part of yourself and don’t start backtracking and back-pedaling. “You know I didn’t really mean it when I said I would get a kick out of sex in the parking lot.”


And another small warning.

When you are having this conversation make it absolutely clear that there has been nothing fundamentally wrong with your love life until now. That you do really and truly enjoy the other kind of sex, the kind that you have more regularly. It’s just… this is something new that you really want to try and build in.


The second option, having a different kind of sex in your head, is much easier and definitely more comfortable and I’ve seen it work for a myriad of couples.

This is the option where you say, tonight I really need a different kind of sex, so while my body is definitely on the bed with my lover, my brain is in my car where I’m trying to get out of ticket with a controlling and angry cop.


Before I get jumped on by a host of angry sex therapists who are horrified by my suggestion that you don’t always have to stay present in your body with your current partner each and every time you make love, let me clarify. Yes, it is likely your love life might suffer if, every time you are with your partner, your brain goes on vacation with someone else. You may find yourself having a difficult time staying with your body and its normal reactions and at some point your lover is likely to catch on if you are “away” during every sexual encounter.


But that’s not what I’m saying. I’m suggesting that sometimes, using your brain to access a different kind of sex than what is actually happening in your bedroom can be a liberating and erotic experience. And even though your brain is hanging out with dominating aliens, a stranger you just met in the bar or the brother of the guy in 50 Shades of Grey, your body is safely at home with a loving partner.


What I’m saying is that there is nothing at all wrong with you, or your relationship if you sometimes fantasize about a very different, erotic encounter somewhere, far, far away, while still enjoying the tactile sensation happening right now in your very own bedroom. It’s normal. It’s natural. It’s not having an affair with your imagination, and it is definitely not disloyal. If anything, using your brain to spice up your love life and keep you coming back to the same person and the same bed every time — that’s the important part.


So there you have it. Own the kind of sex you really want to try and then make it happen in reality or make it happen in your head. Either way you don’t have to give up on the kind of sex you want!


(And read more in my book: Satisfaction Guaranteed: How to Have The Sex You’ve Always Wanted.)



Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

What if you Want a Different Kind of Sex: Part I


I saw a client who is in a long-term relationship with a man she loves very much. He is warm and caring and gentle and loving. Their sex life is good…well, we got it there. It wasn’t always. She and her husband have sex 1–2 times a week. She gets turned on and has orgasms and for the most part enjoys it, except… Except that there is a part of her that doesn’t really want gentle and loving sex all the time.


There is a part of her that wants to be grabbed and thrown on the bed. There is a part of her that wants her husband to tie her hands above her head and push her against the wall and take her from behind. There is a part of her, the part that got turned on when she was reading 50 Shades of Grey, that wants something different from the gentle, loving sex she is currently having. And she doesn’t know what to do.


This is not a unique problem. Believe it or not, I see it fairly frequently. It doesn’t always go this way. Sometimes it goes the other way. A woman wants gentle loving sex and her husband is aggressive and more demanding than she likes and that’s a big issue also. And men get stuck in this dilemma as well. But more often than not, the problem I’m presented with is that a woman wants rougher sex than she is currently having. 


I suppose it makes sense on a number of fronts. We choose a partner for many reasons but hopefully a part of that is to find someone who can support us, love us and take care of us. Partners who are loving, solicitous, and gentle often rank up high in the relationship department. That doesn’t necessarily mean that they rank up high in the rough-sex department.


Also, I think we live in a society that assumes that women want a certain kind of sex. Your partner, one of the enlightened, egalitarian set, might assume that rough sex is just not kind enough, supportive enough or romantic enough. He might think “of course she wants gentle, loving sex”. Isn’t that what every woman wants? That is our cultural assumption.


In the end, we make our decision to marry (or get into a long term relationship) for a myriad of reasons and great sex might not necessarily be at the top, or a certain kind of sex might not necessarily be at the top. And let’s be honest, our lovers might not naturally understand what we want and it may be quite different from what we want out of the bedroom. So what’s a person to do?





Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

If Intercourse is Painful Your Sex Life Does Not Have to Be Over

Our view of sex as having to revolve around penile/vaginal intercourse is perhaps the single most limiting and misleading element of our current sex education. There are many kinds of sex. There’s oral sex, manual sex, anal sex. There is sex using every potential part of your body. If you can’t have sex one way…there are so many other ways!!


Why does someone who can’t have vaginal intercourse feel as though she should be embarrassed to discuss this?

And why does she feel like her sex life is over??? I had a patient who had vaginismus (a condition in which you can’t get a penis into the vagina.) She was married for 3 years when I saw her. (And yes, we I her!) She had one of the best sex lives I’ve seen. She was having sex with her husband about 3 times a week, in various ways. She had an orgasm (or more) most every time they had sex. She was having fun. Now — do I think she’s probably having more fun now that they are having vaginal intercourse? Yes. Probably. (Although she’s quite clear that intercourse is not her favorite sexual activity.) More options is usually better. BUT do I think someone’s sex life should be over because they can’t have vaginal intercourse?! No way. And I think we’d do ourselves, our daughters and our partners a big service if we put vaginal intercourse into perspective.


Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was the queen of blow jobs (kind of how she describes herself), who brought him to orgasm with her tongue, her lips, her breasts, her feet, her butt, her anus? Would her husband be having a grand old time if he was having sex 2 times a week with a happy, excited, willing partner who was having orgasms using his hand, a vibrator, his mouth. My guess is yes. Would he miss vaginal intercourse? Probably. Is that a price he would pay to be with a woman he loves? Would it be that be so very different from a guy who is heartbroken because his wife won’t go down on him and he loves oral sex? Perhaps not so very different.


So here’s advice if you (or your friend or your partner) has pain with intercourse:

1- Get help.

2- It’s probably not in your head

3- Try to build a fun, happy sex life anyhow.


You can do it.


Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

I struggle with the concept of casual sex

A generation ago the teens were horrifying the adults in their life because they espoused the viability of sex without marriage. Many felt that the adults’ values were antiquated and that sex was a potentially positive force within the context of a loving (albeit young and thus very possibly, superficial) context.


Now that same generation (while we have become parents or even grandparents) seems to bemoan the sexual activity of the current younger women because they have gone one step further and divorced sex from emotional commitment. What might be observed among our children’s peers is that they often take part in sex as merely a physically pleasurable activity or perhaps one with short-term emotional pay-outs.


Maybe it’s time we “older women” (the mothers) challenged ourselves and examined our need for a “meaningful relationship” attached to sex as another version of the “needed marriage." “Maybe the current view of sex is okay. Maybe it’s just another step in the road to demystifying and taking away some of the over-dramatizing of sex.


I can already feel the angry eyes upon me. “What????? You are suggesting that sex be so casual that it is OKAY outside the context of a meaningful relationship”? Well…Maybe. Maybe that’s not what I want. Maybe that’s not what you want. Maybe that’s not what you want for your child. Maybe in the long term most of us are looking for a meaningful relationship and love that includes passion. It is totally fair, even important, to communicate those values to your children.


But maybe, just maybe, for some people sex can also exist in a context outside of a meaningful relationship for its own sake — and maybe that’s not such a terrible thing. It’s just something for us to think about.


Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted

Reclaiming our fantasy life (part 2)

Part 2

Often women clients will say something to me, like “OMG, I have all these fantasies about women, but I’m not really interested in having sex with a woman. Am I a repressed lesbian?” To which I will always respond: “All it means, when you like fantasizing about women, is… that you like fantasizing about women. Period. And if it turns you on, great. Stop trying to figure out what your fantasies say about you or what they ‘really mean’. You’ll turn yourself into a pretzel for nothing.”   And for the record, (not that it should matter), it is extremely common for women who consider themselves heterosexual to enjoy sexual fantasies about women.


Also, very commonly women get upset about their fantasies because they think that they are not politically correct. “Oh my g-d, I fantasized about being overcome by a stranger in the woods.” Or “What is wrong with me, I fantasized about trading sex with a cop to get out of a parking ticket. Am I sick or what?” (And by the way, variations of these are also extremely common fantasies.)


I’m here to assure you that you should never worry about fantasies because the whole fun of fantasies is that they are merely that, fantasies. It does not mean you want the scenario to happen in real life. It just means there is some element of that fantasy that appeals to you.


Let me illustrate this with a popular fantasy. It is very common for women to have “overpowerment” fantasies when, if in real life, they were raped or taken without their consent they would be devastated and traumatized. That fantasy is one of the most common female fantasies. And there could be any number of reasons why it’s so popular.


Here are a few:

  • It allows a woman to feel as though she is giving up total control and can then completely submit to the pleasure that sex affords without the concern, guilt or second guessing she might have in real life.
  • Women get turned on by being the object of desire. A rape fantasy suggests that they are so desirable that someone is willing to go to crazy lengths to “have them” and being desired that much is a turn on.
  • The reality, of course, is that when you’re fantasizing, (even when you’re fantasizing about losing control) you have absolute control over your fantasy. The fantasy is exactly what you want, when you want it and how you want it. And you get to decide when and how that fantasy is going to end.


I’m constantly reminding people to enjoy, not edit, their fantasies. So what if there is a monkey in your fantasy? Two women? 62 people watching you? Whips and chains? It doesn’t mean that you are a lesbian, an exhibitionist, into BDSM or any particular activity — not that there's anything wrong with any of those things. It just means that thinking about those things turn you on.


If you are interested in doing a bit more soul searching, you can think about what appeals to you in the fantasy… it is the absolute power? Is it feeling beautiful? Is it a sense of equality? Is it the romance? Then you can see if there are elements that you might be able to incorporate into your real life sex. But only if you want to. Let’s see… you fantasize about being onstage having sex and people are throwing roses at you… so maybe a little bit of exhibitionism might turn you on. Maybe you and your partner want to leave the shades open sometime, or video yourselves. Or maybe you just want to do a striptease for your partner. Or not. These could be elements of fantasies that you have no interest in exploring outside the confines of your brain, and that is perfectly fine.


Now about sharing those fantasies with your partner, that is, should you tell your partner about your fantasies? My only advice is that the decision to do so should be totally up to you alone. If you think it would be fun to act out a fantasy or even just talk about it, go for it! You can shoot an email or leave a note or an erotic story on your partner’s bed if you can’t quite work up the courage to bring it up face to face. Or, snuggled up in bed when it’s dark and they can’t see your face is always another option. Be prepared though, you might have to follow it up with real sex, because, well, fantasies are a big turn on.


But never let a partner push you into sharing a fantasy that you want to keep private — you never “owe” it to someone to tell them your fantasies. Let’s remember that distinction between fantasy and reality I was talking about. Your fantasies belong to you alone and they are for your pleasure entirely.


It is so important for all of us to learn to enjoy our fantasies and not feel guilty about them. And even better, learn to revel in them. Fantasies can fuel your sex and love life for decades providing a variety and range that would be impossible in real life. So embrace your fantasies, as exactly that, fantasies and as always, make sure you are having fun.


Written By

Dr. Bat Sheva Marcus

Sex Therapist & Relationship Expert  |  Author of Sex Points & Satisfaction Guaranteed: How to Have the Sex You've Always Wanted