Caz Killjoy's Sexual Intimacy with Chronic Pelvic or Genital Pain

I’ve experienced chronic pelvic and genital pain for more than twenty years, but it took me more than fifteen years before I realized that those pains could be addressed. Below, I’ve tried to summarize what I’ve learned and what products work best for which symptoms. If you find this useful, please feel free to let me know, to share this information with others, or to bookmark this for future reference.

Do you experience chronic pain and its related symptoms in your pelvic or genital region? If so, you’re not alone. A 1996 study estimates that about 15% of post-adolescent, pre-menopausal (presumably cis) women ↗ have chronic pelvic pain and three studies from 2002-2010 estimate that between 5% and 18% of (presumably cis) men have chronic pelvic pain ↗, too. (Unfortunately, there are currently no studies available on the prevalence of chronic pelvic or genital pain in the non-cis population.)

Anyone of any age and gender can experience chronic pelvic or genital pain. You might not even realize that what you’re experiencing is considered to be chronic pain because pain manifests in so many ways.

Manifestations of Pain in the Pelvic and Genital Regions

If you experience localized pain that is sharp, dull, aching, throbbing, or gnawing, these symptoms of pain can often indicate damage or injury to bones, muscles, joints, or skin.
If you experience generalized pain that is aching, cramping, or manifests as a “deep” pain or pressure, these symptoms of pain can often indicate inflammation or injury of internal organs.
If you experience neuropathic (nerve) pain that manifests as bladder dysfunction, burning, constipation, numbness, prickling, sensitivity, shocking, shooting, stabbing, tingling, twitching, weakness, or sexual dysfunction, these symptoms of pain can often indicate nerves that are injured, compressed, or damaged.

Chronic pain in the pelvic and genital regions can have many ↗ causes ↗ and many presentations. It can start as a sudden onset of pain or as slowly-developing pain which may or may not intensify over time. The pain can encompass the entire abdomen, but it can also cause just one spot, no bigger than the head of a pin, to bring immense discomfort. In some instances the pain can be made worse by movement or during a medical exam; in other instances the pain may intensify with sitting or from urination. These types of pain can affect the anus, the pelvic floor muscles, the pubic bone, the vulva, the clitoris, the penis, the vagina, the scrotum, the introitus, the perineum, and everything in between.

Sometimes, chronic pelvic and genital pain can be so overwhelming that it can cause avoidance of sexual experiences or other life experiences. Abstaining from sexual pleasure is a valid choice at any time and it’s perfectly natural to want to avoid exacerbating these symptoms. However, if you would like to engage in sexual activity when you have chronic pelvic or genital pain, it’s important to know that there are many ways to help mitigate the symptoms.

Suggestions for Sex with Chronic Pelvic and Genital Pain

Do you prefer vibrating toys? If so,

Be careful when using vibrating toys as the vibration can irritate the pudendal nerves and the pubic bone. This can cause temporary increases in pain. Keep in mind that rumbly ↗ vibrators can cause temporary numbness and nerve spasms, while buzzy ↗ vibrators can cause temporary pins and needles.

Does your pelvic or genital pain increase with sexual activity? If so,

Avoid buzzy ↗ vibes and small-tipped vibes if there is pre-existing clitoral pain or sensitivity.

For some, increasing the amount of time spent in foreplay can help reduce the amount of pain felt. For others, the less time spent aroused means the less time spent experiencing pain. If you’re comfortable, experiment with extending foreplay as well as quickies to find out which approach works best for you.

If you find that quickies work best for you, you can use a clitoris or penis pump before other direct sexual stimulation. Pumps quickly increase blood flow to the genitals; for some, this can enhance arousal, thus causing their bodies to release the feel-good hormones dopamine, oxytocin, and vasopressin faster than usual. For many people, this can shorten the amount of time spent reaching climax.

If your medical providers believe that THC and/or CBD will not interact with any medications you may be on or any pre-existing conditions you may have, you might want to try certain THC and/or CBD products before sexual activity to help mitigate the pain. Foria’s CBD-only products such as Awaken Arousal Oil with CBD & Botanical ↗ and Intimacy Suppositories with Broad Spectrum CBD in Organic Cocoa Butter ↗ can be delivered everywhere except Canada, Australia, India, Portugal, Spain, Malaysia, and Mexico. Their products with THC such as Pleasure Natural Arousal Lube ↗, Relief Vaginal Suppositories ↗, and Explore Rectal Suppositories ↗ are currently only available in California and Colorado.

If you live somewhere that has legalized the sale of cannabis products, or in a place where you can get a medical marijuana card, there are many other brands that create similar products. Often, those products are made locally and can be purchased from your local dispensary with whatever documentation your area may require. I find the personal lubricant, massage oil, and suppositories by District Cannabis ↗ to be extremely useful for treating my pelvic and genital pain.

Do you have genital sensitivity? If so,

Figure out which sensations cause less sensitivity. For example, some people feel pain from light sensations like those experienced from feathers, such as the Bijoux Indiscrets Feather Pom Pom ↗, but don’t feel pain from sensations like those experienced from impact play, such as with riding crops ↗.

Adjusting the temperature of toys and lubes can help some people. To decrease temperature, check that a toy can be chilled (steel and silicone are best for this) and place in a freezer or refrigerator until the desired temperature is reached. Lubricants can be chilled in a refrigerator. Note that most people with genital sensitivity prefer warmer, rather than colder, touch, but the opposite is true for some. If you feel comfortable, experiment to discover which temperatures you prefer.

To increase temperature, check out Warm ↗, which increases the temperature of certain toys, and Touch ↗, which increases the temperature of lubricants. The Svakom Emma Heating Wand Vibrator ↗ is a flexible wand vibrator that heats up to 100° Farenheit, and the Zolo Warming Dome Pulsating Male Stimulator With Warming Function ↗ increases the temperature of the glans (head of the penis).

Do you have decreased genital sensation? If so,

You may benefit from toys that are more powerful or more specialized than the average toys on the market. The Fun Factory Cobra Libre II Luxe Penis Vibe ↗ focuses its strong vibrations on the glans (head). The Hot Octopuss Pulse III Duo Penis Vibrator ↗ (for use with a friend) and the Hot Octopuss Pulse III Solo Penis Vibrator ↗ both work without the user having or maintaining an erection.

The massage wands by Doxy ↗ are some of the strongest wand vibrators available; for added sensation, put a compatible wand a ↗t ↗tachment ↗ on it. For something non-vibrating but nearly as powerful, there’s the Eroscillator 2 Plus Soft Finger Combo Oscillating Stimulator ↗.

Cock rings, particularly those that vibrate as the VeDO Overdrive Vibrating Silicone Cock Ring Plus ↗ does, can help provide more sensation.

Is your pain worsened by tilting and thrusting your pelvis? If so,

Avoid positions that increase pelvic movement such as doggy style (receiving) and being the partner “on top.”

Roll up a towel, like the Aramoure ↗ by AnnaRae and place it under the lower back for lumbar support and manual pelvic tilt. Or try a wedge. Some of the multiple positioning aids by Liberator, such as the Kiss Wedge ↗, Jaz Motion ↗ (when placed on its flat side), Wedge ↗, Jaz ↗, and the Decor Heart Wedge ↗ work well, as does the Pillo ↗ by Dame Products. If you can afford to splurge, try It ↗ by The It Collection.

If your budget allows, some sex furniture is made specifically to alleviate your pain: check out the Tantra Chair ↗ by Zen By Design and the Archer Bowchair ↗by Kaz Dezines. If those are too pricey, the Sportsheets Door Jam Sex Sling ↗ can provide similar accommodation to the person in the sling.

Do you have a painful public bone? If so,

Use caution with rumbly ↗ vibrating toys if you have pre-existing pubic bone pain, as these toys can cause an increase in pain.

To assist with decreasing the depth of penetration, try the Perfect Fit Bumper Thrust Buffer ↗ or their Bumper ↗, or try the Ohnut Custom Penetration Depth Bumper ↗.

Do you have pelvic or genital pain and desire to receive penetration (anal or vaginal)? If so,

Start with dilators such as the Blush Wellness’ Silicone Dilator Kit ↗, Cal Exotics’ Inspire Silicone Dilator Set ↗, the Sinclair Institute’s Deluxe Silicone Dilator Set ↗, or any of the antimicrobial silicone dilator sets ↗ from BioMoi.

Avoid internal vibrators, including vibrating dilators.

The THC and/or CBD products mentioned above are especially beneficial for lessening or eliminating pain with penetration.

The suggestions listed above for pain that is worsened by tilting and thrusting the pelvis, as well as the suggestions listed above for painful pubic bones, can also assist with lessening pain upon penetration.

Do you have pelvic or genital pain and your partner, who does not experience pelvic or genital pain, desires to receive thrusting penetration? If so,

Let a toy do the thrusting for you. Try out one of the many thrusters and pulsators available, such as the Velvet Thruster Mini Teddy Powerful Thrusting Silicone Dildo ↗ and the Fun Factory Bi Stronic Fusion Pulsating Vibrator ↗. Please note that if you have an implant such as a pacemaker or neuromodulator stimulator, you must not internally use toys with motors, especially not electrical stimulation, as these toys can cause your implants to malfunction.

If your partner wants something a little more intense, give the Cowgirl Premium Remote Controlled Riding Sex Machine ↗, the Motor ↗Bunny ↗, or the Sybian ↗ a try.

Links to products, unless the brand names are mentioned within this document, are only examples of the suggested products, and are not endorsements. No product listed here is officially endorsed by the author (Caz Killjoy). There are no affiliate links used. Purchase items from your preferred retailers and use at your own risk.

The information provided in this document is for educational purposes only, and does not substitute for professional medical advice. Readers should consult a medical professional or healthcare provider if they’re seeking medical advice, diagnoses, or treatment.

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