I like it when you… How to tell your partner what you want.

A little to the right… down…

Down to the left a bit.

Ah…wonderful. Sigh…

Today we’re going to talk about sex, or more specifically, we’re going to talk about how couples talk about sex. Couples engage in many different forms of communication in their relationships, from day-to-day chitchat to negotiating who is going to take out the garbage. Some couples may even spend loads of time discussing what movie to watch or which restaurant to go to. But one type of communication that the average couple doesn’t do a whole lot of is sexual communication. Research suggests that the average couple knows about 60% of each other’s sexual ‘likes’ and 25% of each other’s sexual ‘dislikes’. Sexual communication—and I don’t just mean talking dirty between the sheets—is really important! It includes talking to your partner about what you like sexually, such as what positions, pressure, movements, and activities turn you on, and it also includes disclosing things that feel, well, not so great. Research suggests that sexual communication is special, and that it adds to sexual satisfaction above overall relationship communication. Which means that having great communication between the sheets (or wherever else you want to engage in sexual activity!) is going to contribute more to a pleasurable sexual experience than negotiating whose turn it is to do the dishes over morning coffee.

So how does sexual communication happen? Researchers propose that the more we tell our partners what we like and dislike, the more they understand what feels good (and what doesn't), and the better the sexual experience! But HOW does this yumminess happen? Are partners feeling warm and fuzzy and understood? Are partners making behavioural changes to incorporate more of what their partner likes and less of the things they don’t like? Or is something else going on?

We don’t know, but we want to find out.

Before we start our quest though, we note that most of the research out there has focused on individuals in mixed-gender (e.g., heterosexual) relationships—so what happens in same-gender relationships? Are the processes the same? We really don’t know the answer to this question, but we are trying to figure it out since there seems to be some basis to the idea that there are different processes happening in same- as compared to mixed-gender couples. Studies that have looked at relationship (but not sexual) communication suggest that same-gender couples communicate and negotiate at higher levels than mixed-gender couples about household tasks. This difference may be because same-gender couples cannot assign household chores based on gender roles (where women would be expected to do things like cook, laundry, etc. and men would do repairs, shoveling, lawn-mowing, etc.), and therefore, they have to communicate more about who should do what. As researchers have not taken this research into the bedroom, we don’t know if same-gender couples also communicate better than mixed-gender couples there.

Now I know what some of you may be thinking; all this information is great, but communicating openly about sex is really hard! How do I do it? This is why we’ve consulted our very own SexLab Sexpert Dr. Caroline Pukall to give us some tips on opening up communication.

1. Baby steps. Some people find it easier to break down their big goal into smaller goals. So start small and go slow. For example, if your goal is to bring up trying something new with your partner, you may start by letting out a moan or saying ‘that feels good’ during sexual activity, then, once you are more comfortable you may make specific requests like ‘down a little’. Eventually, as your comfort grows, you can ask your partner if they would like to try a certain activity. But remember, even though you have put in a lot of work to open up communication, if your partner doesn’t want to engage in that activity, don’t take it as a personal rejection and don’t push the issue.

2. Show and Tell. One way to communicate what you want is to take the reins and show your partner! Masturbating in front of a partner can be a fun, sexy, and informative way to show your partner what touches, where, make you hot.

3. Right time, right place. Sex can make some people feel emotional or vulnerable, which makes the time right after sex usually not the best time to talk about sexual dislikes. Rather, it can be helpful to talk about these things in a neutral situation when there is time to talk, like over a cup of tea, or during a walk along the beach. Start with something positive—always. Then ease into one area for improvement. And when telling your partner what can be improved, don’t forget to also tell them what they can change to hit your hot spots. For example, you may say “I’m super sensitive to that kind of touch, can you do X?”, or you may refer back to something they were doing earlier that made your toes curl: “It felt so good when you were doing X--can you do that again (please?!)”

4. Sex it up with tech. Using technology can be a fun, convenient, and sexy way to break the ice. You can use text messages to send a flirty text, or to send a message telling your partner about your likes: “I love it when you do X”, about what turns you on: “It’s hot when you do X”, or about what things you’d like to try: “I’ve fantasized about X”. Feel free to spice up your text messages with (preferably suggestive) emoticons. If you and your partner are into apps you could also try an app like Kindu that asks you and your partner to rate various sexual activities as ‘I like this idea’, ‘I’m open to this idea’, or ‘Not even on your birthday!’ The app then tells you which sexual activities you and your partner match on – the ones that you both want to try.

Talking to our partners about sex can be difficult, and it may be a little uncomfortable at first, however, we hope that our tips help you break the ice. Remember, the only way to get more comfortable with talking about sex is to try it! So this year, instead of chocolates for Valentines Day, maybe tell your partner ‘A little to the left’, ‘swipe right’, etc.

Queen’s SexLab: Addressing the Need for More Inclusive Research

The topic of sexual well-being in diverse relationships is a hot topic at SexLab. We feel that it is important to conduct inclusive research that allows individuals in ALL relationships (e.g., same-gender, mixed-gender) to participate.

This study seeks to understand more about common sexual concerns that individuals in diverse relationships experience, and how their partners respond to these concerns. As well, we are interested in how individuals communicate to their partner about their sexual likes and dislikes. Sexual problems can be distressing for individuals, potentially negatively impacting physical, psychological, and interpersonal well being. We are interested in learning more about the shared and unique ways that different couple constellations negotiate and navigate sexual problems during sexual interactions. We hope this information will help inform sex and couples therapists when interacting with diverse couples who are distressed by their sexual problems.

Eligibility In order to participate, you must be in a committed romantic relationship for at least three months. We invite men and women with or without sexual concerns, to participate. For all participants, you must speak, read, and write English fluently, and be 18 years of age or older.

To participate in the survey please visit: https://surveys.psyc.queensu.ca/SexualWellBeing.aspx To download more information click on: Sexual Well Being Infographic

Stéphanie Gauvin, MSc Candidate

Caroline Pukall, Ph.D., C.Psych.

Vulvo-what?! Vulvodynia: Chronic genital pain - it really exists!

Sex is supposed to be a fun, pleasurable activity enjoyed by oneself or with one or more partners. However, sometimes pain during sexual activities occurs, especially when vaginal penetration is involved—maybe from a partner penetrating too deeply and hitting the cervix, or perhaps there is not enough lubrication to keep the friction from chafing. Genital pain during vaginal penetration can happen to most people at some time or another; it shouldn’t cause concern if it happens from time to time, especially if there is a reasonable explanation (for example, seeing a long-distance partner for a weekend of sexy times can leave a person feeling a little sore and tender!). But, if the pain happens over a long period of time and nothing seems to explain its presence, the pain may be there because of something that needs to be treated, like an infection, a skin condition, etc. And if the pain is there and there is no observable cause for it, then it will likely be called “vulvodynia”—a term reserved for chronic external genital (vulvar) pain that has no medical explanation.

If the belief is that pain that has no apparent cause then the thought processes of a person experiencing genital pain will likely reflect those of many health professional out there – which is that the pain is “imagined”, “made up”, or “not real”. However, this is not true; most causes of chronic pain are simply unidentifiable. Healthcare professionals and researchers cannot pinpoint (yet!) a “single cause” of genital pain (we wish we could!). It might be because assessment tools are not that accurate, or it might be because the chronic pain has evolved from where it started into something that cannot be traced since it now involves many other systems in the body and brain. But understand this, genital pain is real.

Because we can’t see what is causing the pain, we must rely on a person’s self-reported experience. Herein lies the issue: the pain is real, but we can’t see it, and many health professionals out there just won’t settle for this paradox. Especially when it comes to painful genitals during sex. This combination has led to many patients being told things like: “the pain is all in your head” or “just relax!!” or “have a glass of wine before sexual activity”, or “go see a sex therapist”. These comments are likely meant to be helpful (and probably come from a place of genuine concern!), but many report to us that the messages they receive are harmful and that the pain itself remains untreated. Can you imaging getting up the nerve to ask about pain you’ve been having for years, only to be told that there’s “nothing wrong”? It might make you second-guess your own judgment, or worry that something must be wrong with you or your relationship (Hey! Maybe Freud is working in mysterious ways to cause you pain during sexual activity with your partner because your partner is not right for you…). You might just continue to “grin and bear it” during sex to continue pleasing your partner. Some people probably quit looking for help right then and there and accept that this is the way it is, whereas others keep searching.

We are not talking about a rare pain condition here. We are talking about a pretty common condition called: vulvodynia. Vulvodynia affects about 16% of the population. It impacts sufferers in many areas of their lives, including psychological wellbeing, sexual function, and quality of life. These people usually search for years for effective treatments, if they approach health professionals at all. There are different kinds of vulvodynia, with some being more well known these days than others. However, vulvodynia is still relatively unknown as compared to other chronic pain conditions. (*Side note: one awesome resource for information is the National Vulvodynia Association’s website (www.nva.org) for those of you who would like to learn more, as well as get in touch with others who have vulvodynia. Our website also has some great resources! (sexlab.ca).

The Sexual Health Research Lab (SexLab) has been studying vulvodynia for over a decade. We have heard time and again about the negative experiences participants have had during treatment-seeking. Despite the good intentions of the healthcare professionals they worked with, they weren’t receiving the care and validation they needed to cope with their pain. We decided to use the power of research to help change that.

We know that when trained professionals ask really good questions, they’re quite accurate at giving the correct diagnosis. This is amazing news, since it means that when we work well with patients and ask good questions, we “get the job done” very well. However, not all doctors have that kind of expert training.

To make those good questions easily accessible to those without such training (and those suffering from vulvar pain), we created the Vulvar Pain Assessment Questionnaire (VPAQ). The VPAQ can help describe the characteristics of the pain, how it impacts one’s life, how it relates to one’s partner, and how a person is coping with that pain. We even tried part of it out with our collaborators at Oregon Health and Science University, and early results suggest that both doctors and patients found it accurate and helpful! However, our work has only just begun.

Now that we’ve got the questionnaire ready to share, we need to test it out to make sure it reliably works like we believe it does. In fact, we’re about halfway through our next study. This is where you come in. We are inviting anyone experiencing chronic vulvar pain to fill out the VPAQ online—twice (4 weeks apart)—so we can see how the pain might change over time, and why. The more research we have to back up the usefulness of this questionnaire, the easier it will be to make it better, and to convince health care professionals all over the world to start using it.

Even though this is one small step in the quest to help people with vulvodynia find relief, we are confident that having this questionnaire available to patients and providers will help with communication, finding the right diagnosis and coming up with a treatment plan that is tailored to each person.

Please click this link to find out more about our study and to participate.

As well, a here is a link to our website's vulvodynia resources page.

Emma Dargie, Ph.D. Candidate Caroline F. Pukall, Ph.D., C.Psych.