Ask Debby Herbenick | Sex after pregnancy and low sex drive

Q My boyfriend thinks a gynecologist can tell a woman what size penis her vagina can accommodate. Is that true?
A Nope—gynecologists are not vagina whisperers. Most vaginas are 3–4 inches long when a woman is not aroused. When aroused, most vaginas “tent,” growing to about 5–6 inches. A gyn would not see a woman’s vagina in an aroused state (unless she had some gyn-exam fantasy life) and thus wouldn’t know how much tenting her vagina is capable of. Plus, the vagina is pretty flexible, so larger sizes can fit, too—though certainly some genital-fit combos are more comfortable than others. If your genital fit is comfy, then great! If you don’t feel much sensation, try dabbing some of the wetness off your or his genitals during sex. This can increase friction and thus sensitivity.

Q I’m 24. In November, I had sex with a girl I met in a bar. We used a condom and had normal intercourse, nothing wild. I got worried, though, when a month and a half later I developed a rash on my penis. My penis had one or two sores. It healed, but now I am getting rashes on my skin again. I have two rashes on my back, one on my left elbow and two on my right elbow. I am really worried now. Am I infected with HIV or some other STI?
A I cannot think of any STI that would cause sores on your back or elbow (rather than just your penis) at such an early stage. However, it is always wise to get tested for infections following sex with new partners. See a doctor, and not just about STIs: It is possible you have psoriasis, a skin condition that is not caused by sexual contact and often becomes noticeable in young adulthood. People with psoriasis may develop itchy red areas. Fortunately, it can be treated with topical creams and is not contagious. The only way to find out what ails you, though, is to get examined by a health-care provider.

Q I am married to a wonderful man who is supportive no matter the problem. However, I have a very low sex drive. I cannot tell you how many strawberries I have eaten trying to raise my libido (I’ve heard oysters help also, but I cannot stand those things!). I have bought sex toys, games, sexy outfits. I hardly ever masturbate anymore, and in the last three months, my husband and I have only had sex three times. I didn’t even want to have sex on our honeymoon! I mean, I did, but at the same time, I didn’t. It is so hard to explain. I love the feeling of sex, I want to have it more often, but I can’t seem to “get in the mood.” Is there anything else I can try to increase my sex drive? I feel like there is something wrong with me. My husband tells me that’s not true, but I know he’s just being nice.
A Desire problems are among the most common sexual problems that couples seek help for, and they can be challenging. My first question would be whether you desire anyone at all—do you feel warm and flushed when you see someone attractive on the street or on television? What about feelings of arousal—do you ever experience warm, tingly sensations or gentle throbbing in your genitals? If you do, how do you respond? Do you see it as a cue to start touching yourself, to fantasize—even for a moment—about sex? Or do you turn away from these feelings or brush them aside? If you never feel attraction to other people or tingles of arousal, it may be particularly helpful to speak with a counselor or therapist (apa.org or sstarnet.org). Sometimes women and men experience low desire as part of a larger picture of low mood (even mild depression) or anxiety. Addressing these issues—whether through talk therapy, medication or some combination of the two—can be helpful. So can enhancing intimacy. You mentioned that your husband is supportive, but is he someone you feel close and connected to, not just because you’re married but because you talk late into the night or sit close on the sofa and share personal and meaningful things with each other? Sometimes a lack of intimacy is at the heart of desire issues—people can feel love for each other but not always the kind of closeness that draws one another nearer. Then again, sometimes couples experience so much closeness that the intrigue is gone, and adding some space in your togetherness, to paraphrase Kahlil Gibran, can be helpful. The idea that too much closeness and familiarity can drown desire is at the heart of the book Mating in Captivity (Harper, $13.99) and may be of interest. I wrote about other perspectives on desire in Because It Feels Good (Rodale, $21.99). Specifically, I feel that agreeing to sex that doesn’t feel good can lead to cycles of dread and that learning to identify and choose pleasurable touch and sex can help to break the cycle and lead to the experience of wanting sex once again. Your attempts at trying to reawaken your sex drive through food, toys and lingerie certainly show your commitment, but they also suggest that you might be feeling pressure to make things better fast. You might take your husband at his word that it’s okay and that there’s nothing wrong with you. Also, no worries about the oysters. Neither they nor strawberries have been shown to jump-start desire—but your concern, openness and kindness have.

Q Sometimes sex hurts me, especially since our son was born three months ago. The four times that we’ve tried sex post-baby, I was nearly in tears from the pain. What can I do?
A It’s not uncommon for women to experience painful sex in the months following the birth of a baby. You may have genital swelling or you may have had natural cuts or a surgical cut (such as an episiotomy, in which an incision is made in the area between the vagina and anus)—any of which might contribute to pain. Although pain during sex sometimes persists for as long as six months postpartum, I would still suggest that you see a doctor, who can examine your body for potential causes. Unfortunately, some doctors stitch a cut vagina up too much—sometimes even intentionally under the assumption that women or their partners want a tighter vaginal entrance (the so-called husband’s stitch). I would like to say that this practice is extinct, but unfortunately I still hear about it happening and it’s worth asking if you were stitched a little tight. If so, this can often be corrected in-office. Finally, if you’re breast-feeding, you may be experiencing vaginal pain as a result of low estrogen, which can make for thinner vaginal and vulvar tissue and low vaginal lubrication. Using a store-bought lubricant might help—I like Just Like Me (pureromance.com) and Good Clean Love (mytulip.com). The New Mom’s Survival Guide (Bantam, $15) may be a helpful resource, too.