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Dear Dr. Betty,

I'm 20 years old and started having sex at 16. I'm not sure when exactly it started but I know it didn't happen the first time. Pretty much every single time I have or have tried to have penetrative sex it hurts and/or it tears just below the opening of my vagina. My boyfriend and I have tried more foreplay, lube, different positions etc. It only sometimes changes how bad the issue is not whether or not it happens.

We can usually still manage and both enjoy ourselves. If we can't there is a lot or oral/manual/dry sex. Most often we stick to those anyway. He is average sized. I've asked a gyno about it and a couple of nurse practitioners who work in the gynos office. Suggestions have included more lube and things like that. We have tried everything they have said. Have you heard of an issue like this before? I've looked around online and found a few women saying the same thing, but none have an answer. Like I said, we manage and things are enjoyable but sometimes its just tiring and depressing.

Dear P,

Yes, I've heard of this and like you have discovered, no one really has an answer as to what causes the tearing of the fourchette, the skin at the base of the vagina. You can bet if this was an issue for a man's genitals science would have found a solution by now. We are very slow and backwards when it comes to understanding female sexuality. It sounds like you have made the best adjustment possible.

By the way, sharing partner assisted masturbation is still one of my favorites. While one of you is masturbating, the other one does erotic touch to enhance the other person's orgasm. Exploring anal sex might satisfy some of the desire for penetration. But the truth we could live a life time and have a great sex life without ever doing penis/vagina penetration sex. And that includes getting pregnant. If you find any new helpful information please pass it on to me.

Dr. Betty