Sex advice: I heard something ghastly can happen in bed to women like me. I need to change that.

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How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!

Dear How to Do It, 

I’m a woman in my early 30s, and though I’m not asexual, I am single and celibate.

I’ve never had sex, but I might want to when I find the right person. I recently heard that women who do not have sex might have some vaginal atrophy or other negative consequences when they do end up having sex. Is this true? And if so, is there anything to do about it? For what it’s worth, I do masturbate.

—Celibate But Interested in Future Prospects

Dear Celibate But Interested,

I had never heard of this, so I spent a little over three hours across two days trying to find something online that matched what you heard, using search keywords ranging from medical language to my best approximation of young people’s current slang. I found no examples of the concern you describe: vaginal atrophy in a person’s 30s due to abstinence from partnered sex. Nada. Zilch. Ništa. Nothing.

Vaginal atrophy (a term no longer in use—it’s now thought to be a symptom of a larger condition called genitourinary syndrome of menopause), or the thinning and drying of the vagina’s inner lining, is a well-documented symptom leading up to, during, and past menopause. It happens when the body has less estrogen. Other known scenarios where people are prone to experiencing changes in vaginal and vulvar tissue, and dryness, all involve a change in hormones as well: the period of time after giving birth, during breastfeeding, female-to-male transitions that incorporate hormone therapy, surgical removal of ovaries, hormone imbalances, and other medical conditions that involve the endocrine system. Most of us who menstruate can also notice more subtle ebbs and flows in the amount of lubrication we produce that correlate with our cycles.

The “use it or lose it” advice that your letter hints at is frequently given to women who are approaching, at, or after the usual age of menopause. If you look at the section I’ve linked to, you might recognize what you heard. If you scroll up, you’ll see that this is directed at women in their 40s who are likely nearing menopause, and, higher up the page, information that generally applies to women in their 30s. The “use it” aspect is fulfilled by masturbation, and does not require a partner at all, much less one of any particular gender or in possession of any particular set of genitals. If your masturbation does not involve penetration, you may be tight, unfamiliar with how to relax the muscles around your vagina, or some combination during the first few attempts. If that’s the case, be patient with yourself—pleasure is more important than achieving full penetration.

Since you didn’t note a source for your concern, I’m left guessing that either you or a friend encountered an excerpt of an article describing sexual health in or after middle age but didn’t have that full context, or a man was attempting to start a sexual interaction (and he perhaps had a desire to manipulate you using what is, at its core, an idea wrapped up with concepts of women as creatures who expire like single serving containers of yogurt, or the two of you had a misunderstanding).

Dehydration can make everything, including your mucus membranes and specifically your vaginal tissue, dry. Drinking alcohol, smoking, or simply failing to drink enough water can all contribute to dehydration. Lack of abdominal and pelvic floor tone, from having a sedentary lifestyle, can affect your sexual satisfaction, and some studies suggest that orgasms from sexual stimulation have some positive contribution to pelvic floor tone. Again, the ones you give yourself will suffice. Kegel exercises are also an evidence-based way to work on those muscles, but there is such a thing as too much kegeling. You do not need to be able to do parlor tricks or crack nut shells with your vagina, and, in fact, that is best left to the extremely rare and highly specialized professionals. Stress, as difficult as it is to avoid, can have similar types of negative effects on your genitals as the rest of your body. All the basic stuff that’s good for your brain, skin, and general physical health is the majority of what keeps you in shape for sexual activity as well: hydration, a reasonably balanced and nutritious diet, an adequate amount of low-impact and aerobic exercises, and activities that help you release stress.

If you don’t already have a gynecologist, I suggest you start seeing one every couple of years. It’s helpful to have an established relationship with a doctor and familiarity with the routine of a gyno visit. They can do a physical exam (and you can ask to either go slowly with the speculum or skip it entirely), answer questions you have right now that relate to your individual body, and will be your first stop if you become sexually active or encounter any odd changes. And, you know, several exams, like breast exams, need to happen regardless of whether you’ve ever engaged in any type of sexual contact.

Please keep questions short (<150 words), and don‘t submit the same question to multiple columns. We are unable to edit or remove questions after publication. Use pseudonyms to maintain anonymity. Your submission may be used in other Slate advice columns and may be edited for publication.

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Dear How to Do It,

I’m a 28-year-old woman, and my boyfriend (29) and I have been together for about two and a half years now, but because of his job, our relationship has been long-distance. Before we started dating, we were friends with benefits, and the sex was incredible, and for a lot of the relationship, it has been great. He has had some issues with erectile dysfunction in the past, and the one time he tried taking ED medications, he said it made his “heart feel like it was going to explode,” so naturally, we’ve been a little hesitant to try them again, as I’d much rather he lose his boner while we’re banging than have a heart attack.

Recently, however, he has come home, and as someone with a very high sex drive, the distance has been brutal, so I’ve been particularly eager to have sex; the issue is that it seems like his ED has gotten worse, and sex has been … lackluster.

I’ve been focusing a lot on making him feel good and mostly just getting him off because I know that adding the pressure to make me orgasm isn’t going to help the situation, but I’m more frustrated than when he was gone. I’m OK with going slow and working on getting back to our normal sex life. I know it’s not all going to instantly go back to the way it was before he left, but it’s his resistance to doing certain things for me that don’t involve penetrative sex that is driving me mad. Usually, sex stops halfway through when he loses his erection, and he always offers to help me get off, but he doesn’t seem very willing to do that in a way that I want.

Namely, he refuses to go down on me. He’ll offer to finger me or use a dildo or some other toy, but for me, that just doesn’t really work. Dildos are usually more uncomfortable to me than anything else, and while I’ve tried to show him how I like to be fingered, it just doesn’t seem to click. We’ll use vibrators pretty often, which is fine, but there’s a certain lack of intimacy attached to my partner just holding a piece of plastic between my legs. The thing is that oral is really the most reliable way of getting me off. And he just won’t. It’s not like he’s some misogynistic bro-dude who thinks eating me out is gay or something; he acknowledges that it’s a reasonable thing to want, but he keeps saying that he’s too nervous because he thinks he’s bad at it. The very few times he’s actually gone down on me (for about two minutes at a time) have been OK, like he’s not going pro, but I’ve certainly had worse. I don’t voice any criticisms because I’m just glad he’s doing it. I am positive it’s not a hygiene issue either, both because I am pretty meticulous about my personal hygiene, and I have asked him.

I feel weird and scummy pressuring him to do a sex thing he doesn’t want to do, so I don’t bring it up often, but I’m starting to feel a little hurt that our sex has been so one-sided lately, especially because I am very, very generous with oral. He always gets to nut, and I end up getting to orgasm maybe a third of the time. How do I improve things? Sex is a particularly important part of a relationship for me, and while I see a future with him, I also don’t think I can live without having him eat me out for the rest of my life.

—It Doesn’t Help That My Ex Had a Golden Tongue

Dear It Doesn’t Help,

A boyfriend who is not a misogynistic bro-dude is a great start, in the sense that the bar is truly on the floor, but exceeding that bar is still fairly rare. Before you start looking at how to approach the conversations that need to be had, put some thought into how important receiving oral sex is to you.

Is it truly required for you to feel fulfilled in a sexual relationship? What exactly makes receiving oral so significant? Is it the physical act of his mouth and tongue being used on your vulva, or is the most important aspect a genuine desire from him to focus on your pleasure? Is your partner taking the initiative in this area a big part of what you like about it? How about confidence on their end? To put it bluntly, if your partner were engaged in intimate contact with you instead of “just holding a piece of plastic between your legs” during vibrator use, doing things like embracing, stroking, and kissing your body, would that suffice (presuming that you find a vibrator that feels pretty spectacular)?

If you absolutely need to have oral, think through whether there’s anything you might have done that could have compounded his nervousness. For instance, your signoff references your ex being talented at oral. Did you indicate that at any point? If so, work on diffusing the effect that probably had on him. This might require asking him whether you contributed to his performance anxiety, and apologizing for your part in that. When you weren’t voicing criticisms, were you also withholding gentle, useful feedback, such as “this feels better than that” or “I really like this kind of stimulation, more like this, a little more” that could have felt like instruction and therefore information about how to perform oral sex well? You might ask him whether he would feel comforted by that sort of coaching to help the two of you get through this.

Regardless, when something is an actual sexual requirement, it does need to be communicated. You’re right that there’s a fine line, on the other side of which lies coercion. Ideally, you’d be up front about the requirement in question during the early stages of sexual interaction. In your situation, focus on the unfortunate disconnect between what you need and what he is open to, and underline that you’re broaching the subject in the hopes that there’s some way to bridge that gap. Depending on how you both feel about monogamy, this is a scenario where opening the relationship can be helpful (as long as getting your oral elsewhere would function for you).

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If the more significant need is a desire for reciprocity, start with the question of whether this man sees sex similarly to you. Is it an important part of life for him? An important part of relationships? If you’re on the same page about that, what defines sex and good sex for each of you? Is an erection required? Orgasms? Any certain order of steps? Are there kinks that he hasn’t brought up? And, given that there are different types of erectile support medications and more than one therapy, such as cognitive behavioral sexual therapy, available, and several possible health conditions that could be causing his difficulty retaining erections, why did his pursuit of a treatment end at one pill that caused an unacceptable side effect? Pursuing interventions for ED is his choice to make, but understanding why he’s making these choices can help you understand where he’s at.

When it comes to fingering and the use of toys on you, do either of you see that kind of sex as lesser than penis-focused interactions? Is your boyfriend nervous about fingering, dildos, and vibrators in the same way that he’s nervous about oral sex? Would it help to walk him through your anatomy and explain and show what feels good to you?

Start by establishing what’s in the way, decide together whether those obstacles feel surmountable, and then dig into the nuances with kindness and respect so you can figure out, together, how to move past them. Good luck.

Share Your Story With How to Do It!

Readers often have great suggestions for our letter writers, occasionally disagree with a point our How to Do It writers make, or simply want to provide some additional advice. Each month, Jessica and Rich will be replying to some of these comments and suggestions from readers. Write to us!

Dear How to Do It, 

What is a happy medium between someone who likes doggy and someone who really does not, that doesn’t involve sex on one’s side?

—Doggone It

Dear Doggone It,

I’m missing two big pieces of information here. What does the first person like about doggy, and what does the other dislike? If what one likes is the disconnect between themselves and their partner, while the other is put off by the lack of contact and intimacy, there is no happy medium other than taking turns doing the positions each person prefers. If it’s about angles and sensation, the happy medium is going to be specific to the two bodies involved and can be found through examination of the details and experimentation with what provides and avoids the stimulation in question. Feel free to write back with the specifics, and I’ll do my best, including drawing diagrams if needed.

—Jessica

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