Woman to Woman

Women and Sexuality: The Myth of the First Time

By Alice Y. Chang, M.D.
Brigham and Women's Hospital

I was enjoying the film, Something's Gotta Give, until the menopausal character was portrayed in the throes of pleasure from her first sexual experience in 10 years. Especially in a film focusing on the realities of an older woman's personal life, why did they choose to glorify what is potentially an uncomfortable physical and emotional experience? Perhaps a less than orgasmic experience doesn't have the same comic potential as a woman explaining that menopause is her form of birth control. It got me thinking about the sexual myths perpetuated about the first sexual experience, the first sexual experience with a new partner, as well as sex after menopause.

The Reality Of The First Time

Frequently, in books, films and talk among friends, we encounter the myth of the first time being wonderful. The first time is usually not all fanfare and fireworks.

First, for a woman who has never had sexual intercourse before, the hymen may not be broken. The hymen is a membrane that covers and protects the vagina and uterus through childhood and adolescence. There is a hole that allows the passage of your menstrual blood flow each month, and you can use a tampon with the hymen intact. It may be broken by activity or exercise. If it is not broken, the first sexual experience can be not just "uncomfortable" but painful as the hymen tears. You may even notice a little bleeding. Sometimes, the hymen does not need to break much, and you may feel just a little sore. Other times, the torn area is painful enough that you might not feel like continuing with vaginal intercourse. So if you are not prepared for this, you can understand how both of you might be disappointed.

Then, there is the orgasm. As most women tell you, it takes some time to learn how to get the right stimulation, physical and mental, to have an orgasm. You may be thrilled to experience an orgasm the first time with vaginal stimulation, but don't be disappointed if you can't get it all together the first time.

Another, myth related to sex is that you cannot get pregnant your first time. Big, big myth. Ideally, if you are going to choose birth control pills, start taking them at least a month before your first time. You can also get a sexually transmitted disease the first time so make sure you have condoms.

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Other "First Time" Occasions

Sex can also feel like the first for sexually experienced women in their reproductive years in at least two situations:

After a baby is born
Even if you have a Caesarian, you can have significant vaginal dryness due to the big hormonal changes. These hormonal changes are particularly apparent if you are breastfeeding. Be prepared to go slow when you start having sexual intercourse again, and have some water-based lubricant handy.

After a sexual hiatus
In one of my favorite episodes in the series Sex and the City, Charlotte quotes an article about becoming a virgin after a year without sex. I believe either Carrie or Samantha replies, "Why would you want to do that?" Well, sometimes, we don't have the luxury of controlling when our next sexual encounter will occur. In any case, the discomfort you experience is not a hymen growing back but tightness in your vaginal muscles. The vagina is really an impressive muscle that can stretch to a heroic, baby-head size during delivery. But like any muscle, if it is not exercised, you may need to ease back into using it. So just be prepared to go easy the first time with a new partner.

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Ways To Improve Your Experience

Lubrication
Usually physical and mental arousal before intercourse allows for vaginal lubrication. After birth or after menopause, women's hormone levels are altered and you may experience significant vaginal dryness. You may have to reassure your partner that there are physical reasons why vaginal lubrication is not occurring. Then, use a water-based lubricant like K-Y Jelly or Astroglide. It is especially important that you do not use petroleum jelly (Vaseline) because it can destroy condoms and diaphragms.

Estrogen cream
The low estrogen levels during menopause can lead to more sensitive vaginal tissue. In some cases, you can have atrophic vaginitis, inflammation of the vaginal tissues because of the low levels of estrogen. Menopausal women who experience these symptoms have a couple of choices. In addition to using water-based lubricants, topical estrogen creams can make the vaginal lining stronger.

The importance of communication
This is the real reason to make sure to wait for the right partner. Talking about what feels good and what doesn't will go a long way to improving your sexual experience.

Having a sense of humor can also lift your spirits when things don't go the way you dreamed. If I were to rewrite the menopausal woman scene, the man would stop, look down and say, "Wait a minute, I've gotta let the Viagra kick in," and the woman would rummage through her drawers for some K-Y Jelly and a condom. Because it is fun and funny, as long as you know what to expect, and it's the couple who are truly close that can share this flip side of life.

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When Should You Have A Physical Exam?

Aside from tearing the hymen, whenever sex is painful, you should make an appointment to see your health care professional. But warning signs to get seen sooner are:

If you have bleeding during intercourse when you are not having your period or if you are postmenopausal, you should call your health care professional for advice.

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A Final Note Of Encouragement

Just because you're a realist doesn't mean you can't be a romantic. Physical intimacy for the first time with anyone is a special experience when you love each other, and it allows you to share a special sense of closeness. That is no myth.

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Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.

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