In How I Have Sex, we bring you candid retellings of people’s sexual lives that explore the multidimensional nature of this human experience. In this installment, 30-year-old K. talks about navigating a sex life with lumbar scoliosis.

I was diagnosed with lumbar scoliosis in 2014-15. It’s gotten worse with time.

It does impact my life now — before, it was mild back pains when I carried things. I’m not allowed to carry anything more than five kgs, not allowed to sleep on my stomach, nothing that strains the back. If I walk for a long period, if I sit on a chair for a longer period, then I start getting inflammation — the pain starts worsening. My scoliosis is caused by Systemic Lupus Erythematosus (SLE). The only thing that helps is a massage to relieve the tension.

In the beginning, my sex life didn’t change that much, but as time went on — it did. Searching for positions got really difficult and really painful. The most convenient position is definitely missionary, but it also gets boring because you don’t enjoy it as much. The other position that has helped and I have enjoyed as much would be doggy because it’s definitely more exciting.

Again, it depends on your pain level that day. If the pain is severe, I just take a break. I’ve made that mistake of pushing even though the pain was a lot, and then I would make up for it by being in bed the next two days.

I have a relatively high sex drive, too. I do masturbate pretty often, but it gets pretty painful sometimes due to some other condition. There were times when I’ve wanted to have sex or when I was aroused, but I couldn’t. You have to learn how much you can push your body and you just need to let go and let it rest. Sometimes you can push it; other times you’re going to push and you’re going to end up worse — physically, and also you’re not going to be able to enjoy the sex.

We had to improvise [with sex positions] — not to say it got boring, we improvised and found new ways to enjoy and make it work for us. We’re always experimenting with how much we could push, what alternatives we could use to make sex more enjoyable for us.

I think I surely loved my body. And that’s important. I felt I was hot. This was before my medicines made me fat; that’s going to come off because the medicines are changing.

What turns me off varies with my mood. Foreplays are a must, it’s non-negotiable. If you don’t go down, I don’t go down — that’s rule number one. Sometimes, a walk on the beach or heart-to-heart conversation [work]; some times, a steamy conversation. Of course, a lot of exploration of the body before the actual act helps.

My pleasure centers include the neck, [area] right below the ear, the clavicle — the clavicle is a huge center for me! Even the bottom center of your back. There’s also this one central point at the back which a lot of people haven’t recognized. That’s a really, really massive pleasure center. And then between the navel and the pubic region, the center part of that; if you take a circle from your belly button, and go around the body, that again is a massive pleasure point.

What do I like to do in bed? Play, basically, like have fun and be able to laugh. Being on top is usually more direct and puts more pressure physically on me. So I’m usually at the bottom so that my body is rested — like, physically, I’m not moving so much. So the pain is not as much [because of] scoliosis and my other conditions.

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One day, my boyfriend got an idea and blindfolded me, tied my arms, and then brought in a vibrator. And then when I was about to cum, he stopped it. And then he ran into foreplay. And then he entered me. That was annoying, but amazing — like, reach the peak, stop. reach the peak, stop. reach the peak, stop — and then you have that burst of orgasm. This is also my favorite cumming story.

A lot of my partners have been into BDSM, some of them are into soft play. A lot of them are into missionary which is very boring for me, I don’t do vanilla. I just don’t enjoy vanilla. I don’t like ungroomed men, you know, like down there. Some men just don’t care about grooming and keeping it clean and trim and all, it’s just messy. I also don’t like being forced, like that’s not a turn-on for me.

But of course, [sexual attraction] starts always with the connection — there has to be a connection, there has to be a vibe. I can’t do random sex. I can’t do casual hookups. Like I at least need to know the man, I at least need to know something about them. There has to be some connection.

And I can’t do it with immature men. Like I also have to be able to hold a conversation — it can’t be wham bam, thank you ma’am. I can’t do that. Maybe it’s the age, maybe it’s me. Experiences with women are definitely a lot better than with men, because they know what works. It’s a mutual, unsaid exploration. It’s not a one-size-fits-all [thing], but it does help. Women are a lot more sensitive and focused on pleasure than on the act itself.

I’m planning to buy the 39 and the rabbit [vibrator]. I’ve also gifted it to my friends, or rather send them the link and told them to buy it — I’ve changed their lives. And it does work. If you use it with a partner where you use a vibrator first and then stop right before you’re about to cum and then give him a blow job, and then have penetrative sex, and you both will cum simultaneously and it’s going to explode. A massive distinction [in my experience]: with women, you’re guaranteed to cum, with men, they’re guaranteed to cum.

I broke up with my last partner two years ago, because he couldn’t handle my health conditions. I was battling severe mental health conditions, he was battling his own fights, so it just wasn’t the best thing for us.

And also, you know, with time you also grow in your sexual freedom. At this point, I’m like, it’s my life. I need to have fun. I deserve to have orgasms. If a man can do it for me, great. If not, I’m gonna pleasure myself because I deserve it. And if a man feels inferior because of that, he’s not for me. But if they say let’s discover it together, let’s play with it together, then that’s sexy to me.

This interview has been edited and condensed for clarity.