Alternatives to Intercourse...or Othercourse

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Dear Sex Counselor,

I was recently diagnosed with vaginismus, which makes for painful or outright impossible vaginal penetration. My health care provider and I are currently working on a plan to help me overcome this issue. My partner is being very supportive about everything and we are trying to maintain intimacy through foreplay, but I feel like we are missing out because we can’t have “real sex.” My partner never mentions anything, but I still feel guilty about not being able to do things others do with ease. Do you have any ideas of some alternatives that will keep everyone in the situation happy while I get better?


First, I would like to commend you for taking the time out to get your health in order. Second, I think it is wonderful that you want to strive to keep the intimacy going in your relationship while you seek treatment. No matter what the ailment, a lot of people tend to forget to nurture other important areas in their lives, like their sex lives, when trying to combat health issues. This blinds people to the fact that having other things in your life that make you feel good besides your treatment can help relax the mind and body, which in turn aids in recovery.

Now, when you refer to "real sex", I assume you are referring to sexual intercourse, which is sexual contact that includes vaginal (and, by some definitions, anal) penetration by the penis. Cultural attitudes have led most people to think of this method--ending in orgasms for all parties--as the be-all and end-all of sexual activity, in spite of the fact that most women can’t orgasm through that method alone. This leaves many people who are unable to participate in that activity feeling cheated or downright defective because they cannot provide what is viewed by many as the ultimate act of love and pleasure. It also negates the intimacy non-penetrative acts provide. Fortunately, for couples who cannot have intercourse, whether it’s caused by health issues, like vaginismus, or male ones, like erectile dysfunction, there are plenty of alternative activities that simulate the feel and closeness of intercourse.

There are versions of sexual contact without penetration known as Othercourse. Depending on your beliefs, this can strictly refer to the avoidance of coitus (vaginal penetration with a penis) or be an umbrella term for all non-penetrative sexual activity, like frottage, role-playing, massage, kissing, masturbation, etc. People of all genders can do it. Couples enjoy this kind of play together to build intimacy and learn about their bodies without having to go "all the way." They also do it when health issues prevent penetration, to preserve virginity ( a term used VERY loosely), avoiding some STIs (with caution), avoiding pregnancy (with caution), when one person is tired, and most importantly because it’s fun! Othercourse should not be confused with foreplay even though most of the activities fall under people’s definition of foreplay. The word foreplay implies a warm up. Othercourse can be the main event.

Right now, let’s focus on contact that gets you as close to each other as intercourse, but without the penetration. There are several forms of outercourse that mock the feel and movement of intercourse:

1. Intercrural, also known as femoral or interfemoral intercourse. This activity is the closest thing to penetrative sex because it uses positions most commonly associated with "traditional" penetrative sex and provides the most body contact. Basically, one partner places a penis or dildo between the thighs of a partner, thrusting to cause the friction necessary for stimulation of the nerves on the penis. It can also refer to placing the penis or dildo between a partner’s vaginal lips (think hot dog on bun, but more fun) and  thrusting, stimulating her clitoris and other nerves in the vulva, as well as the penis. It can be done face to face, encouraging eye contact between and physical closeness between the partners. It can also be done from the rear, simulating the spoons position. Both positions are ideal for people who want positions with low exertion. Please note, unless you are using a toy (like the Maven or Tube), it is still possible to get pregnant or transmit STIs from this activity, so take proper precautions. Make sure you protect yourself from the fluid exchange.

2. Frottage. This is the mutual rubbing of one person’s body against another, and can include penis to vulva, vulva to vulva, or penis to penis. The greatest thing about this is its flexibility. Just about any position can be used and it can be done with or without clothes (also known as dry-humping). If you like eye contact, go for missionary or a seated face to face position. If one partner wants to dominate, you can choose from any of the person-on-top positions, like cowgirl and reverse cowgirl. You can have spontaneous sex around the house with the standing positions. And if you prefer a view from the back, try doggy-style. Just note, it may be very tempting to attempt penetration, but never do it without your partner’s permission.

3. Genitals to other body parts. These activities may be ideal when one person is tired, because they allow the active partner to do all the work. Activities that are common enough to get a name include Mammary intercourse, better known as the “boob job” (rubbing the penis between the breasts while they are held together), and Axillary intercourse, better known as a (arm)pit job. It might sound a little crazy at first, but pleasure does not distinguish one body part from another; it just recognizes what feels good. Women who like to “ride” can rub their genitals against the thighs of their partners while straddling the person. A variation of the blow job where one partner thrusts into to the mouth of the other is another example. The best part is couples can get as creative as they want and they should feel free to make a game out of it.

Hopefully, the list of activities provided has taken the sting out of your current situation. Just remember there are a number of other activities, like erotic massage, oral sex, the sharing of fantasies, use of toys and mutual masturbation, that can be just as intimate and blow somebody’s mind no matter what condition your body is in. The fact that the two of you are enjoying intimate contact is what is important, and may be why your partner is not complaining.

The Sex Counselor