Dear Sasha: After several years of enduring excruciating pain during intercourse, along with doctors' glib diagnoses that I must be a hypochondriac who needed to relax, an abuse survivor in denial, or a prude (no, no and no), I finally discovered that I suffer from vulvar vestibulitis. Hallelujah! It's a relief to know I'm not going crazy, and to be able to prove to my husband that it is not him or his technique.

I have tried using lidocaine ointment to dull the pain. Unfortunately, it also makes me anorgasmic because I cannot feel anything at all. Moreover, the cream wears off after 15 minutes or so, and then the pain is even worse. I'd like to go natural, if possible.

My doctor has suggested that some women are able to lessen discomfort during intercourse by inserting a heavily lubricated dildo into their vagina for a few minutes at a time between sexual encounters, to help build tolerance. I have always wanted a vibrator, but was afraid it would hurt, and obviously I wouldn't be able to return one once I had bought it. Alas, my doctor is not well versed in sex toys. Do you know which toy (dildo or vibrator) would be preferable from a pain-avoidance perspective? » Not Funnin'

Dear Not,
The Vulvar Disorders List is an online support group for women who suffer from vulvar vestibulitis, vulvodynia, lichen sclerosis, vaginitis and other vulvar disorders. As their mission statement says, "We exchange personal treatments and feelings. Please be cautious to not include any comments that could be considered medical advice."

As such, I hate to question the wisdom of your doctor, but not one single vulvar disorder Web site or support group I found suggested inserting a dildo or vibrator to help lessen discomfort for vulvar vestibulitis, one even giving an emphatic no. Given the nature of the syndrome (inflammation of the opening of the vagina, tenderness upon pressure), it doesn't really make sense. When something is inflamed, doesn't stretching it just make things worse? A lot of women do find lubrication, presumably during sex, offers some relief, but some of the research I've done suggests that yeast infections are associated with vulvar vestibulitis, and if that's the case, you want to avoid them at all costs. Now, a lot of vulvar vestibulitis sites suggest Astroglide as a good lubricant, but Astroglide contains glycerin, which, if you suffer from yeast infections, may exacerbate them. Try Slippery Stuff instead.

The most empowering thing for any woman who suffers from chronic vulvar pain is to find community resources. I had a terrific e-mail exchange with the moderator of the Yahoo vulvar disorders group, who is very careful about screening potential members, in case you're concerned. "It's just that we've had a ‘few' characters looking for fun and sexual excitement or suggesting they join a sex club," she wrote me. "Imagine of all places to be looking for that with almost 800 women in vag/vulvar pain." You can join the group here: http://health.groups.yahoo.com/group/VulvarDisorders/. They seem to be on top of the most recent medical knowledge and can direct you to it, as well as being able to provide counsel and kinship.

Dear Sasha: What can I do about the state of my asshole area after it's been through a prolonged eating session by a man with five o'clock shadow? I can barely sit down the next day, it's so red and swollen. » Just Ass

Dear Just,
The diaper rash cream Penaten (available at all drug stores), would probably make things a lot more comfortable. And just for your files, Penaten can also, according to the company Web site, be used on boats or yachts to keep barnacles from clinging.

If you are looking for something a little more DIY, go to a health-food store that offers bulk herbs, get some chickweed, stinging nettle and calendula, and brew yourself up a tea. Apply the infusion to your ass on a compress or wash. A plain calendula salve, available in health-food stores, may also help matters.

You might also ask your gentleman eater to use a dental dam during the meal, to lessen ensuing discomfort.

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