Painful Sex After Coming Off Birth Control (Episode 413)

Full Transcript: Episode 413

Lisa Hendrickson-Jack:

Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery Charting Journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works, and how artificial hormones disrupt that natural process. I teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and I host live coaching programs to help you achieve optimal fertility and health, because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I’m a busy girl, but I managed to fit it all in.

This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health. And I’m so excited that you’re here with me today.

Today I’m sharing a brand new episode in my Fertility Awareness Reality series. I’m sharing my conversation with Carter and in today’s call, I feel like we cover a lot of ground. One of my favorite parts of these episodes is kind of at the very beginning when I have an opportunity to ask about their first menstrual period. And I think over the years, it’s just been very interesting to hear different experiences that women have when they start menstruating and how that kind of plays into their experience of menstruation up until their 20s and 30s and things like that. And we also touch on a sensitive topic, which is painful sex and delve into some of the reasons why that can happen. And I think on the podcast, often in previous episodes where this topic has been touched on, it’s often birth control related. And whether or not that’s the case, we’re not 100% sure, but it’s often been on the podcast, birth control related, whether it’s the use of birth control has changed the hormonal profile, which can then thin the vulvar tissues and create a situation where sex is more painful. But in today’s episode we talk about some of the other reasons why sex can be painful, potentially related to jumping in too fast and not necessarily taking enough time to warm up.

So I feel like today’s episode is a great reminder in the physiology of the female body, if you will, and the differences between men and women, especially when it comes to the arousal cycle and lubrication and all of these things that take time and really giving yourself permission to take that time if you need it and not to feel bad about it. I think that as we get into in the episode, I do think that the media and the porn industry has really made a negative impact by setting just completely unrealistic expectations of what intimate interactions between two people are supposed to look like. And I think it can create a lot of pressure on women to either perform a certain way or to be on a certain timeline or deadline or whatever the case. And so that’s one of the topics that comes out in today’s call and we really delve into it and talk about some potential strategies and solutions for moving forward. So without further ado, let’s jump into today’s episode with Carter.

And I’m excited to be here today with Carter. Carter is a member of my current Fertility Awareness Mastery Live program. And at this stage, I think we’re about halfway through. So we’ve had a hot seat together. So we’ve gotten to know each other a little bit. So welcome to the show, Carter.

Carter: Thanks for having me, Lisa.

Lisa: Well, thanks for being here. I always say not everyone wants to have these private public/private conversations on blast. So it’s a real treat to have you on the show and they know my clients love these episodes and I love them too. So I mean as per typical Fertility Friday style I would love to start just by asking you how old you were when you had your first period and you know what that was all like if you have a history of birth control and if you you know basically what brought you to want to do fertility awareness now.

Carter: Yeah well I had my period probably around about like 13 years old. I remember most vividly getting it and being like, “Oh shoot, I have to tell my mom.” And really not wanting to tell her, being pretty embarrassed about it, but then she’d be pretty mad if I didn’t tell her. So I think we were on like a ski vacation or something and I like pulled her aside and told her I got my period and she was like, “Oh shoot, no, like, oh, I thought we had a couple more years, like, oh, what a bummer.” And I was like, “Oh, like, oh, I didn’t know this was something to be like super like sad about.” But looking back on it makes a lot of sense because she’s had like really bad painful periods like her entire life. It’s been like a big inconvenience for her but that definitely set the stage for how I viewed my menstrual cycle through my teens of like being a big inconvenience and feeling pretty like embarrassed by it. I had pretty bad cramps from the very beginning, like my first period. I remember like being in middle school and just being miserable in class. But as I got older, I went on hormonal birth control at like, I want to say age 18. It was like my first serious relationship. And I didn’t really want to go on it at all.

I think felt like I didn’t have another option. I felt like I was like just getting used to my cycles, like they regulated, I was like used to like, I’d get cramps right around the same time. And I’d know that’s when I was going to get my period and like based on how heavy the cramping was, I knew how heavy my period would be, so I was like just getting used to it and then I had this relationship and didn’t know what to do to prevent pregnancy and so it was also like the only thing I knew about the pill was that like you gain a lot of weight is what everybody would say if you went on it. I was like very conscious of my weight during that time too and so I yeah decided that it was it was worth it and went on the pill. And I was on it for about five years. And honestly, it worked like pretty great for me. I didn’t have any like major side effects that I knew of at first. I’d say like around 2019, 2020, I started — I had had like some digestive problems that started when I was in my freshman year of college. And I think that was probably due to some like really stressful events as well, but then started thinking maybe it had to do with hormonal contraception. And so I started having this feeling that like I wanted a break from the synthetic hormones and how I got into fertility awareness is that one of my friends was actually hosting a webinar on the menstrual cycle and I decided to participate and was like floored about everything I learned about the menstrual cycle and like what hormonal contraception can do. Like I think the most like in awe moment I had was when I learned that it like can shrink your clit. I was like, what? I just started having sex and like, I never really — I never knew what like it could feel like. Maybe I never will know what it could feel like. I was so pissed. But that’s kind of how I guess it led up to where I am today.

And I feel like I just really want to have a better understanding of my body and my menstrual cycle and pretty active. I like to run a lot. And so I’ve gotten really into like athletic training and timing it in regards to my menstrual cycle. So yeah.

Lisa: Yeah, no, I love — I definitely love this part. And I’m like a broken record over here. But in our hot seat sessions and in our other calls, it’s not that you really have the opportunity to kind of just share your story like that, more of like a story format, you know, like how you would just tell it. And so I always enjoy it because I feel like it helps to flesh out just some little details. And so let’s go back to your mom’s response. I think that’s really interesting. And I think it’s also interesting how you said that it clouded your own experience with your cycle, because it sounds like you weren’t expecting that, you know, you were kind of embarrassed but I wouldn’t really expect that either. And thinking about it, I mean, what you said, you know, she probably didn’t have the greatest experience with it. And then on the other hand, I’m thinking you were 13. So actually 13 is the average age. And I don’t know what your friend situation was like, but I mean, my first friend had her period in fourth grade, I think. And I was kind of last. So I got my period when I was 14. And I remember feeling that feeling that, like, most of the people I knew already had it. And I’m kind of like, looking at my watch, like, what’s going on here? And I know there was a couple, like one girl who I’m friends with who I know she got hers when she was 16, which is late. So it’s kind of surprising, even from that standpoint, that your mom was kind of like, “Oh, I hoped we had a few more years,” because it’s pretty much around the time when most women are getting it around 13.

Carter: Right. Yeah. I thought that was interesting too, because I think most of my friends had had their period at that point. And so it wasn’t something super talked about at school. I at that point, I think, I don’t know, my sex education was terrible. But yeah, it definitely caught me off guard and like had a lasting impression, I guess, on just — I mean, I think just all my friends too, like really thought of the menstrual cycle as like a big inconvenience. And I feel like as more the IUD became more popular and like taking the pill consistently, like not even having that withdrawal bleeding, like people were talking about like not even needing to have a period, which I now just think is so fascinating because it, as you talk about all the time, like it can be used as a vital sign. It’s such a window into your overall health that it’s crazy to think about not having it.

Lisa: Yeah. And when it’s interesting too because when you first said that, I thought — so you were like, she was like, oh crap — I thought it was like, we’re on our ski vacation, and I didn’t bring anything. I literally was waiting for you to say that. So she said — so I probably wasn’t the only one. But really interesting. And I mean, I’m like, I wouldn’t — it’s not saying anything negative about your mom, I feel like it’s a very typical kind of response like, oh man, now you have to deal with this kind of thing. Have you talked to her about it since like, has that ever — have you ever like talked about it now that you’re grown up and all of that?

Carter: No, I haven’t. We — I should bring that up someday, but it’d be interesting. Yeah, yeah. She’s frustrated now because she’s in her like late 50s and still has like really heavy periods and all that. So I don’t know, I’ll wait a couple years.

Lisa: Yeah. Her experience probably wasn’t the greatest. Yeah. Well, and so one of the topics — I mean, I get a lot of questions around coming off birth control. So you — it sounds like you took the pill, you know, for a while, obviously, like five years approximately. And so you said your cycles had kind of regulated and you had kind of gotten into that groove. And that’s something I talk about a lot too on the show, just in terms of the timing when you come off of the — or when you start taking it and how that could affect your experience when you’re coming off. So there is a bit of a difference from in your situation when you actually went on it, when you needed it, you weren’t put on it for, you know, acne or irregular cycles or whatever. So your cycles were just able to kind of do their thing, normalize, regulate. And in a sense, from that perspective, you were like a good candidate, you know, you had some pain, but you didn’t have this horrible situation in that sense. So tell us a little bit about the decision to come off. So a lot of women are terrified. So probably, you know, there’s a few women listening right now who are literally listening because they’re just like, how does this work?

Carter: I was definitely really hesitant. I think I started having that feeling where like I wanted to get off of it and take a break — probably a year before I decided to actually come off the pill, because I was in — and still am in — like the same relationship. So I definitely grew up being told that condoms were not like a good option and that they didn’t work. So I didn’t feel like there was another option. So I definitely was at a loss of what to do. But then once I found fertility awareness, it was a bit of a journey with my partner to — like I think at first he was kind of like, what the heck are you talking about? Like, and had a hard time trusting the method, which is funny now because he’s so on board and can tell you about all the different phases of the menstrual cycle. But I definitely found your podcast and was listening to it for like months ahead of time, like listening to similar episodes of people, like learning about the experience of what it’s like to come off of it. But once I made that decision, it wasn’t anywhere near as scary as I thought because we were super conservative and used condoms. And I didn’t have any like super negative side effects coming off of it. I still have digestive problems. And one of my big questions for you is also low libido — it’s been something since I’ve come off the pill I’ve been noticing, like more so.

Lisa: Or more so than when you were on it? Yeah. Well, and then just a couple other questions along these lines. So when you did come off of it two years ago, how long did it take for your period to return?

Carter: It returned about a month. It was pretty regular. I think it took a month, and then my cycle came back. I did read a bunch of books before, like trying to prep myself, and so I did start taking supplements and following kind of a strict diet for like I’d say I stuck with it for like three weeks. I don’t know if that helped or not but I tried to be mindful beforehand.

Lisa: I think some of the fears, obviously, like when am I going to get my cycle back? And am I going to be able to like know when I’m ovulating and when my period’s coming? But I think the other one people are really afraid of is the post birth control syndrome. I mean, I typically don’t use that language a ton. I know it’s super popular, and it’s a big topic. And I know it’s a real thing. Also, I don’t know that I would go so far as to call it a syndrome. I would think of it more as like a transition phase when your body’s rebounding. So it’s like more of just a language issue for me. But it’s a real thing. And so some women are scared that they’re going to have a rebound of really bad PMS, emotional issues, feeling unbalanced, acne coming back, just all kinds of random stuff. Were you scared of those kinds of things as well?

Carter: Yeah, I definitely, in regards to the like cramping with periods, it definitely — when I was on birth control the cramps lessened. So I was worried that that was going to come back full swing. But something like really interesting happened and I actually went the opposite way. So like, within that first cycle, I stopped having cramps like altogether. I have no idea why. I’m really curious about that because, I mean, it’s a great thing, can’t complain. It was like really stoked about it. But like now I don’t get any cramps at all — for the past two years I haven’t had any cramps really at all. And it’s pretty funky because I’ll like be bleeding really heavily and not know it. So the opposite happened for me.

Lisa: Yeah, I mean, it doesn’t always happen that way, obviously. And I mean, that’s an interesting topic. So ultimately, though, you did make the decision, you did come off. And so far, the condoms have been working and fertility awareness made it easier. And that’s one of the things that I found as well. I found that knowing your cycle and knowing you’re not fertile all the time, takes a bit of the pressure off. And then if you are approaching it conservatively, meaning not having unprotected sex in the pre-ov until you’re comfortable doing that, then yeah, it’s totally doable.

All right. So where would you like to start? Did you have any questions for today? Did you want to dive into the period pain issue or other things?

Carter: I think my main question has to do with the low libido and the pain with sex. And that was something that I’ve spent more time thinking about. So I’ve had some developments on like hypotheses if we want to talk about that. Those are my two main things.

Lisa: Well, so we can start with the pain with sex. So if I remember correctly, you didn’t have that issue. And then ironically, you came off of contraceptives and then started having that issue. And so in our last session I asked you a series of questions just to try to help determine — could it be a hormonal issue related to the pill, or could it be a physical issue related to the time of the cycle and things like that. So you said that there’s some new developments so what have you learned so far?

Carter: Well I guess I spent some time really thinking because I haven’t been able to find a pattern in regards to like when in my cycle I’m having that pain. So I’m curious if I had like a not so great relationship before the one I’m in now. And so like the sex is a little bit weird. And so I’m curious if it’s a kind of a mental thing potentially, paired with like when I came off of hormonal contraception, maybe my cervix — like the position of my cervix changed? I don’t know if that’s possible, but yeah, just funky to me that no change in partner, no change in like the way we’re having sex or anything, but change in pain.

Lisa: Yeah, I mean, one of the possibilities — when you’re on the pill, you’re not having a real cycle and so you’re not experiencing the cyclical cervical changes that you would be when you’re not on it. So that’s one possibility. I would say that, you know, generally speaking, if you think about it, then you would expect if it was something related to that, that it could be cyclical, that you would notice at least — it doesn’t — we’re not robots. So it wouldn’t be so specific. But I have had a number of clients who do find that sex feels more uncomfortable after they ovulate, because that’s when the cervix tends to be lower. And then around ovulation, it’s a little bit better. That’s something that would be different off of the pill. But when we talked about it, I think that there were two things: one, you hadn’t really seen a pattern so far, and another, I think you mentioned your partner works away sometimes so you’re not always together.

Carter: Right, yes, we aren’t always together, which has been hard for tracking it. But I was looking back at all my charts because I’ve tried to like make notations on like when it’s painful and when it’s not. And there’s not — there hasn’t seemed to be a pattern between like when he’s here and it’s pre-ov and when he’s here and it’s post-ov or like during ovulation. But there have been random times when it hasn’t been painful, so yeah.

Lisa: Well, and your comment about your experience before with your past partners — so I mean, that could be complicated. So the first thing that came to mind is that if there were — and I’m kind of going blind here, because I’m not sure exactly what the situation was — but if there was a situation where it just wasn’t that great. I’ll just give a couple of possible scenarios, maybe hypothetical, just to give a little context. So it could be something where you don’t get the opportunity to warm up enough. You kind of feel like pressured, or it’s like when you don’t want to do it. So in a scenario like that — let’s say you do actually want it, like you’re good, you’re turned on, you want to go, but you’re not necessarily having a long enough lead-up time to penetration. That in and of itself can then lead to — if you just picture that kind of situation — you would be tense and you would start to like anticipate that it would be not great and potentially tighten up, and that can make it worse. And then in an example B, when you don’t really want to do it but you feel like you need to — your partner is kind of pushy — you’re doing it, but you don’t really want to. So that doesn’t help because if you’re not even legitimately warmed up, then that is going to make it less enjoyable. If you’re not wet enough, if there’s no lube involved or whatever. And then again, what can happen — outside of any particular situation like that — is that you could maybe be tight. And by tight what I mean is nervous.

There’s a completely different thing happening when you’re really excited, really warmed up, really lubricated, and you’re ready versus when you’re not ready and kind of on the fence. And I often wonder, especially with younger women, I think that a lot of us grow into our autonomy and our comfort with demanding what we want. I feel like there’s a lot of porn out there and I feel like it really puts this idea — many problematic ideas, not just one. So one of the problematic ideas is that women are just ready to go like men are. For the male sexual arousal cycle, it starts when he has an erection and then he’s good to go. But for females, we have a bit of an equivalent kind of thing to an erection. Like the clitoris does expand and fill with blood and the clitoris extends internally beyond what we can see. But obviously it’s inside. So for women, the normal sexual arousal cycle is not just like “penis is up and we’re thrusting” — that’s just someone’s fantasy, that’s not real.

I wonder how many women feel quite comfortable with their male partners to say, “No, I don’t like that. No, I don’t want this position. No, I’m going to need some warm-up time before you penetrate me.” How comfortable. So anyways, I just threw out a bunch of stuff. Let me know if any of it’s stuck and like if any of those scenarios could be a possible factor.

Carter: Yeah, I think you hit the nail on the head in regards to like women feeling — I think it is hard, it’s hard to like slow it down when you need it to slow down, and to have a stronger voice. And I think yeah, I feel like a little embarrassed if it — because I mean, I went to a bunch of like doctors to try to figure out this pain. Like I was so confused by this pain and like why I was having it. And so now I’m realizing that maybe it is as simple as that I’m just not ready, but I think I should be ready. And so I guess I want to share it because I want — if there’s like anybody else in my shoes that’s like so confused about that — I want them to like hear this that like it could be that like your partner is just like hitting your cervix and it’s uncomfortable and it doesn’t feel good. But I’m just curious as to why that switch happened then.

Lisa: Yeah, I mean, it’s hard to say. So obviously I don’t have an exact answer for you. So really, I’m trying to help you just to fact-find. And so I mean, what hormonal contraceptives do — they do make a difference. And there is — I’ve talked a lot about the studies around it and how about fifty percent of women have side effects, often sexual side effects. So the most common side effects are sexual side effects and then the emotional side effects — like depression, low libido, anxiety. And so one of the reasons that that happens — going back to the science part of it — is that when you’re on hormonal contraceptives, the primary mode of action is suppressing ovulation. And so when ovulation is suppressed, it suppresses our natural production of estrogen and progesterone and testosterone. So what happens is, regardless of the side effects you experience — so there’s with the pill there’s a certain hormonal thing that happens to everybody and then the fallout, how you experience that as an individual, is a separate issue. So everybody on the pill has about 50% or more less free testosterone than is available when you’re not on it. And so there’s a combination of less being produced, and then there’s a protein called SHBG, sex hormone binding globulin. And I explain that as like a magnet and an iron filing. So it really kind of absorbs the free testosterone. So there’s just overall less. And so as women, what that means for us — so women make significantly less testosterone than men, like 90% less than they do. But that little bit that we make is essential for our normal sexual function. So having that testosterone helps us to have a libido, and it helps us to have a really heightened sensation in that area. And so one of the possibilities — and I don’t know if this is applying, let’s put that out there — is that when you’re on birth control, this is one of the reasons why some women, not all, have a harder time to orgasm and have a harder time with — even reduced sensation.

Yeah. And this is one of my — I have a thousand questions. So one of the other questions that we don’t have answers to is: if you go on the pill right around the time you start having sex, do you ever know what the full sensation would actually feel like?

Carter: Right, which is like I’m so interested in that. Because that’s also hitting the nail — that’s me. Like I definitely have a hard time orgasming. I’m so curious if that — and I don’t know beforehand because I wasn’t having a lot of sex before I went on the pill.

Lisa: Well, exactly. So this is one of those questions that we won’t have the answer to. So if you are on the pill — and it’s not — again, I didn’t make this up, like you could read the research — testosterone can thin the lining, it can shrink the clitoris. There was a study, and yes, it was a small sample size. I’ve had people all up in my grill like, “It’s a small sample size, you can’t talk about it.” I can talk about it. Because they had a small sample size, yes. But every single woman in that particular study had a reduction of the clitoral volume, and the average was 20%. So I say, okay, so yeah, it’s not a big sample size, we can’t make broad generalizations. But where’s the follow-up study? Like, why hasn’t that been done? There are literally 100 million women on the pill. But they don’t want to fund it because they can’t fund the study that shows that it shrinks their clitoris and then have an actual proper sample size to show that this is a thing that happens all over the place. Because it’s just not good PR.

So with that, I don’t say these things to scare anybody. But we’re adults, right? So we have the right to know how this works. So one of the possibilities could potentially be that maybe the sensation was a bit reduced. Maybe you were also young. Maybe our culture doesn’t gear things to women’s pleasure and satisfaction. And so maybe you were doing it the way he liked it. And then when you came off of it, now you have a full profile. Your testosterone does kick back up. So it does. The sensations can — it is a real thing. It is possible that when your hormones are in full swing, like when you have optimal estrogen production, progesterone, etc., that you could have a greater sensation, the orgasms could be better, the sensation could be better. These are things that are real. So I mean, that could potentially be working against you, but I don’t know if that’s the issue. I’m just kind of putting it out there as: this is what I know about how the pill affects your hormones and how that could affect your sexual response. And so these are the possibilities, but we’re not really sure what it is.

And I’m definitely — we’re not trying to minimize this. So one of the first things that we talked about was certainly making sure you do get checked out by someone who works with this — whether it’s a pelvic floor physiotherapist or whether it’s your medical doctor. You always do want to double check these things. Pulling it back to the sexual response — that is something that is tricky, especially when you’re with a partner who you’ve been with, meaning that you’ve always been doing things a certain way. But at the end of the day, I’m going to stand on my soapbox: sex is supposed to be fun. It’s supposed to feel good. It’s supposed to be a way to bond, a way to connect. And it’s not supposed to hurt. Period. And it’s not okay. Period. So like imagine if someone was shaking your hand with like a thumbtack in there — you’d be like, yeah, that hurts. So why is it that we’re okay with sex hurting?

Carter: Right. That’s the question. Because like for a long time I was just like, oh, what is this, this is weird. Like I was just trying to like ignore it. But then I was like, wait, this is actually impacting my desire to have sex. Like this is not — why am I just putting up with it?

Lisa: So you’re definitely not the only one. At the end of the day, I do think that this whole porn culture messes it up for women because it sets this expectation that we’re supposed to just be there. And when he’s aroused, we’re supposed to just go. I think what are some strategies — let’s bring it back to the practical. So we can say okay, hypothesis B, maybe this is related to the arousal cycle, maybe you’re not getting warmed up enough. So if that’s the case, then a couple of things you could try to see if that’s it — because it could still be something else. But if that’s what it is and that’s what you’re thinking, then what you would do — I mean, you would want to have a conversation with your partner. Have you guys had a conversation about this?

Carter: Yeah, we’ve talked about it a lot I guess. And I think yeah, it’s just continuing that conversation probably.

Lisa: Well, that’s good. So the communication is open. Yeah. Well, and then I think that from a practical standpoint, it’s a little tricky because there’s this idea that it’s supposed to just happen, right? We’re not supposed to talk about it. We’re just supposed to fall into bed and it’s supposed to be wonderful. But sometimes you have to talk about it. So whether that’s beforehand or in the moment — maybe make a point where we’re going to have a sex date on Saturday or whatever, and make a point of you know, spending some time, and not — I mean, I’m not trying to make it weird, right — but make it like, have some time so that you don’t feel rushed. Do whatever needs to happen — from cheesy to whatever — close the door, candles, I don’t know, music, I don’t know, but do something, right. And then make it so that the sex part — the actual intercourse, penetration part — doesn’t happen for at least half an hour. So whether that’s like a nice body massage or whatever, be creative about starting with non-penetrative sexual activity. And maybe make it all about you.

Carter: Actually, yeah.

Lisa: Make it all about you. I mean, what I always say — the guy always gets off. I mean, not always, okay, I know. But 90% of the time, 95, 98, 99. So like, come on. In class I had recommended that book, She Comes First, which is getting at my point. So think about that. You know, have a think after the call. Have a conversation with your partner and just kind of like, can we just try it differently? I just want to see if it could be this. This is something that’s been bothering me. And so I’m wondering if we did it differently and we just held off on the sex part for a bit longer, if that would make it more comfortable for me, more enjoyable for me, etc. And if he’s a good guy, which I think he is, he’s going to be totally for it.

Anyway, so that would be kind of the first suggestion, because then you can have that opportunity to see if that makes a difference. So that you really are not moving forward until you’re so comfortable, like until you’re so ready, until you’re just like dying for it. Because it’s difficult in a loving relationship because it’s not the same as scenario B, when the guy’s kind of a jerk and you don’t really want to do it. But this is — it sounds like it’s a situation where you do want to do it. And I think that at the end of the day it should be fun. It should never hurt. And it should be fun every time. And you’re not obligated to do anything at the end of the day. I mean, it’s not ideal obviously, but no one dies if you have to stop and he doesn’t get to finish with you. No one dies. Everybody continues to live. The house doesn’t burn down, the relationship doesn’t end. And I think sometimes you just have to say those things out loud. Like it’s really not that big of a deal. It doesn’t necessarily happen every time, but sometimes it just has to stop. Sometimes you’re doing it and you’re uncomfortable. And sometimes it just has to stop, period.

Anyways, has this been a bit helpful at least to strategize that possibility?

Carter: Yeah, super helpful. Thank you. I think I definitely want to give that a real try this time. And because I think it could be super helpful.

Lisa: Yeah, I mean, like I said, I’m not sure if this is the issue for you. But I remember this saying — I don’t know if it’s true or not, I don’t know where it comes from — but I remember hearing this thing a lot in maybe the early 2000s: they used to say like men reach their sexual peak at like 25 or something and women reach their sexual peak at 35. And I always thought it was kind of dumb. But when I think back on it, I think that what it could mean potentially is that there’s a certain point when you get to an age where you’re done with bad sex. And then you know what you want. Like I didn’t — I thought my clitoris was inside of me until I was 19. Like I had no idea. And I didn’t know masturbation was a thing for women. Like I thought that was only for guys. So yeah, the message is not it.

Well, yeah. And the other — it makes me think about this time when I was in university, having a conversation with my girlfriends, one girlfriend in particular, and we were talking about sex, and I said something about orgasms and having them regularly. And she was like, like every time? And I was kind of like, yeah, why not? And she was like, no — every time? Because she was just like, what are you talking about, like that’s not a thing. Like you can’t have an orgasm every time. And I’m like, yeah, I can. So I think people also need to hear that as well. Not to put pressure — because that’s a whole other topic, and I’m not a sex therapist, this is not my area of specialization — but at the same time, I think that we need to have that permission sometimes. It’s supposed to be fun. It’s never supposed to hurt. If it’s ever uncomfortable, it means stop. That’s what it means. And it means maybe switching positions, maybe even stopping and finishing in a different way. It shouldn’t be painful. And all of those things are options.

Anyways, so hopefully that’s helpful. I feel like that’s probably what we have time for today.

Carter: Yeah, thank you so much for diving into it.

Lisa: You’re welcome. I’m glad that we did. And again, I’ve done a few episodes — I think I’ll link a couple episodes in the show notes. I have had actual sex therapists and sex specialists on the show before to talk about some of these topics better than I can. And I think it’s always a very important topic to go back to. Because ultimately when you’re charting, and especially in my field, these are the topics that come up, because I’m seeing the sex on the chart, right? So it definitely comes up. And then also another reason that it comes up is that I do have — not a large percentage, but there is a percentage of clients who do experience painful sex, usually in a different respect. So often while they’re on the pill, and that can be related to some of those hormonal issues. And then the low libido and difficulty reaching orgasm is definitely something that can be exacerbated by contraceptives as well — not in every case, obviously, but in some cases. So it definitely does come up and you’re definitely not the only one.

So as we bring today to a close — first of all, do you have any other questions or anything, or are you good?

Carter: No, I’m great. Thank you for all that.

Lisa: Cool. And so for the listener who’s thinking, okay, I’m thinking about coming off the pill and I’m scared — if anything, what would you want to tell her?

Carter: I think just that the menstrual cycle is amazing. And that you can learn so much about your body and it’s worth maybe that learning curve to really dive into it. And it’s not anywhere near as hard as I thought it would be once you get in the groove.

Lisa: Awesome. And for someone who’s scared of using fertility awareness — because in your case, you’re not trying to have a baby right now, you’re definitely avoiding — what would you want her to know if she’s thinking about switching to fertility awareness?

Carter: I mean, I already feel like way more confident after taking your class for just like — I think we’re like six weeks in right now — on charting my cycle and like feeling confident that I can get to a point where I’ll know how to avoid without having to use condoms every single time. So yeah, there’s a way to avoid pregnancy for sure without having to be on hormonal contraception.

Lisa: Awesome. Yes, couldn’t agree more. It is possible, ladies. All right. Well, Carter, thank you so much for being on the show and thank you for bringing out a topic that really doesn’t get talked about a ton. There’s a lot of topics that kind of get — that we go into a lot — but this is one that doesn’t get talked about a lot on the show. It really hasn’t come out for a little bit too. So I feel like it’s perfect timing. But thank you for being so open and vulnerable. I know that it’s a little bit of a sensitive topic and not everyone would feel comfortable bringing it up. So I really appreciate your openness and willingness and we hope — well, at least I hope, and I think most of the listeners are hoping — for some amazing sex in your future with zero pain.

Carter: Thank you.

Lisa: All right, well I’ll see you soon. Okay, bye.

Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/413. I hope that you enjoyed today’s episode with Carter. I feel like we really delved into a lot of important topics and I’m really glad that we had an opportunity to kind of flesh out some of the possibilities around her main concern, which was the pain that she’s been experiencing with sex. And through her conversation, it seemed to be a bit of a different scenario. Her pain started after she came off of contraceptives — not exactly sure why. But through our conversation and through the kind of questions and the different explorations, there did seem to be this possibility that it could be more related to the arousal cycle and that aspect of it. In this case, we really did look at some of the possibilities so that we can try to figure out which one it is. So if it’s something hormonal, then potentially a hormonal solution could work. If it’s something else, then going through say a pelvic floor physiotherapist for a full examination to determine if there’s an issue could be helpful. And then if it is related to the arousal cycle and potentially jumping in too soon before she’s comfortable and relaxed, then some of these other strategies might improve it.

And if you have personally had an experience similar to that where it’s not necessarily always painful, but if you’ve ever had the experience of sex being uncomfortable sometimes or even painful for one reason or another, hopefully today’s episode has at least given you some ideas if you need to strategize around modifying your actions to be more in line with the natural kind of female arousal cycle. And also, if you’ve ever felt uncomfortable asking for what you need or asking your partner to slow down or to stop or to switch positions or whatever the case is, if you’ve ever felt a little bit uncomfortable doing that, then hopefully today’s episode has given you permission and a good reminder that it is okay for you to ask for what you need and ensure that you’re happy in this whole process. So with that said, I hope you have a wonderful weekend, whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.