Ask the Doctors: Vulva Cancer, the Clitoris, and Pleasure (Part 2)

This is a follow-up response to Survivor, addressing less-genitally-focused possibilities. Her original letter:

Do you still have feeling and sexual sensations if you do not have a clitoris? If I would put a vibrator there could it give me a orgasm? I lost mine to vulva cancer. Haven’t had intercourse in 4 years. I heard that it is painful. Before my cancer I would play with my clitoris and bring myself to orgasm. What can I do or use to get that back? I am willing to try anything! Thanks.

I know it’s possible for you to achieve orgasm again because it is possible for spinal cord-injured people who have no sensation at all below the waist to be orgasmic with erotic contact. The orgasm is not situated in the genitals — it happens in the brain, and genital touch is only one trigger for it. Some people are able to climax through other erogenous areas on their bodies: from kissing, breast or feet stimulation, and so forth. I already mentioned anal play. So please try to stay open-minded about your experiences and you may find that other parts of your body are helping to take on the focal role to help you climax. Again, high arousal will be important in discovering these, probably. But if you do not let your hands wander and explore, you might not find new possibilities at all. Besides touch, let your body move any way it wants to as you conduct these explorations into pleasure — sometimes writhing, or pumping your hips, or stretching out your limbs adds to the erotic sensation.

Another thing to suggest is the practice of Tantra. This is usually described as a very couple-focused practice — Yin meets Yang, and all that. (It’s often described in very heterosexual terms, to boot.) But part of Tantric practice involves breathing and awareness exercises that can help you more deeply connect with this whole-body erotic state I’m discussing. The focus on breathing can be especially important. A wonderful book to check out is Urban Tantra by Barbara Carrellas. This book contains couple’s exercises but also solo practice and meditation — even BDSM play.

BDSM, which stands for bondage/discipline-dominance/submission-sadism/masochism, is an often-misunderstood form of erotic experience.  I am bringing it up to you specifically because it, too, is a form of eroticism that doesn’t necessarily focus on or require genital touch to be full of intense, pleasurable sensations, including orgasm. All the dominant/submissive stuff may or may not seem sexy to you — for some people these roles are very erotic and for others a complete turn-off. But you don’t have to engage in any of that for experiences that might open your eyes to new sources of arousal and peak experiences, in which the primary erogenous zone is your skin (and the idea that BDSM players “eroticize pain” doesn’t go very far at all to explain what they actually like — it’s more correct to say they eroticize intense sensation).

I don’t know where in the country (or the globe) you live, and it’s possible you’re not in a place where you can easily access Tantra workshops or BDSM clubs. But these are not just San Francisco things any more, if they ever were — the National Leather Association, for instance, can guide you to organizations all over the US and Canada. A short documentary called BDSM: It’s Not What You Think might interest you if you are curious about this playstyle or wonder why I’m suggesting you consider learning from it.

It is also possible that, compared to a general group of people you’d find in a non-sex-community situation, the people you would meet in the Tantra and BDSM worlds will be more understanding and accommodating of physical and sexual difference. Partly because it’s possible to have intense Tantric experience with another person without any genital contact, and because BDSM community is filled with people who have wildly different fetishes and turn-ons, there may be a generally broad-minded tone there that you might find supportive of your own quest to find out where your strongest sources of pleasure lie. You may not be at all interested in seeking out partners, and that’s not really why I’m suggesting these communities as possible places to explore. However, you can probably be more open about your own individual situation there that you could be in many other groups of people — for what that’s worth to you.

Finally, I have a PS about vaginal penetration causing pain: Another fairly common reason for this after radical surgery of the type you’ve had (and radiation too, if you had that) is vaginismus that developed from involuntary pelvic muscle contractions. If it turns out that penetration is painful, cramped-tight pubococcygeal muscles might be to blame, and exercising those muscles can help. Tightening — and, in this case, most importantly, releasing — the muscles give you more vaginal flexibility and relieves the muscle spasm that makes penetration so painful. (Never try to force through this feeling — you must respect your body, not ignore its messages.) Beyond this, those muscles are the source of the pleasant pulsing contractions that go with an orgasm — and will help bring better circulation to your pelvic area. Having good pelvic muscle tone will make it easier for you to be orgasmic again.


We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at education@goodvibes.com! For product-related questions, please email or call our customer service staff at customerservice@goodvibes.com.

Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at carolqueen.com.

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