For as long as I can remember, intercourse has been painful. I barely recall it being enjoyable in my 20s, but for the most part, it has hurt me more than it has pleasured me. Let me explain.
I have been plagued with intolerable menstrual cramps, abdominal pain and heavy periods since my teens. Irritable bowel syndrome (IBS) was added to the mix in my 20s, and later came my stage 4 endometriosis diagnosis, which explained my laundry list of issues and is the reason I could only get pregnant with IVF. Thank goodness for an official diagnosis in the early stages of trying to get pregnant, which saved me from months, maybe years, of unsuccessful attempts with Clomid and IUI. After a hysteroscopy/laparoscopy, my doctor found proof of my suspected endometriosis, and I went straight into IVF, which blessed us with a son. Let’s just top this cake off with a cherry of symptoms while we’re at it, too — endometriosis is also a common cause of painful intercourse. Lucky me.
After the birth of my son, intercourse became even more painful. I endured the pain for many years, coming to terms with the fact that this is how it could be for the rest of my life. During my first visit with a new gynecologist this year, I opened up to her about my whole intercourse issue. I had NEVER discussed it with anyone except my sweet husband. She informed me that there is a name for my condition, vaginismus. Excuse me, vagi-what?! Vaginismus. (It took me a few attempts at pronouncing it.) And even more surprisingly, she told me there is physical therapy for vaginismus. Physical therapy for my WHAT?!
Me: “I guess my vagina is broken.”
Dr. Lady Parts: “It’s called Pelvic Health physical therapy.”
Me (to myself, in an awful British accent): “I shall henceforth refer to this as VPT (vagina physical therapy).”
Pelvic Health therapy treats a myriad of issues, not just vaginismus. Most common dysfunctions treated with PH therapy are abdominal pain, bladder pain, constipation, diastasis recti, endometriosis, interstitial cystitis, urinary incontinence, post pregnancy organ prolapse, post prostatectomy (men!) and other post surgical related to pelvic floor issues.
My husband and I discussed VPT as an option. Our intimate time together was always amazing — believe me, he is a superstar in that department. But it didn’t always include intercourse. And when it did, it was for him. I felt he deserved it. He’s such a hard-working, loving and supportive husband and father, he deserved to have sex with his devoted wife. But my thinking began to shift as I considered this therapy. I deserved it, too, dammit! Based on my age, I am supposed to be in the prime sexual time of my life. I should be craving it! How many more years of this do I have to enjoy it anyway? Alright, let’s fix this broken thing.
I met with my VPT specialist soon after for a patient intake meeting. She wanted ALL. THE. DETAILS. I left nothing out and opened up to this stranger in more detail than I had ever spoken aloud to anyone. Ever. My second session with her included an “internal exam” with her identifying some of my muscle issues. It was thorough, to say the least. Immediately after, I texted my husband.
Me: “I just got fingered by a random woman, and they call it physical therapy!”
Husband: “Too funny. Hope it wasn’t better than me!”
Me: “Ha! Definitely not! Never! This is a comical situation.”
At my third visit, she taught me some exercises to practice at home, and we would progress our therapy at the next session. We used a mirror during the exercises so I could not only feel what a correct exercise was, but I could also see it. Lovely. This week’s message to the huz was received a little differently, as I texted him, unbeknowningly, during a meeting.
Me: “Had to look at my vag in a mirror as I did exercises today. That thang ugly! I’m so glad it’s dark when you’re down there. You’re a good man.”
Husband: “My phone is sitting face up on a table with four other people looking at it. Now it is face down.”
If my situation wasn’t so hilarious, it would be humiliating. I often choose hilarity. It gets me through many challenges and offers perspective.
After my third visit, I realized I definitely needed help. I had to practice “bulging” exercises which lengthen and relaxed my vagina. “Bulging” — that word is almost as bad as the word “moist.” Just upon her observation in the lovely mirror, she could see I was weak in this area. Later I would discover how weak I truly was. We scheduled 16 sessions, twice a week, hoping this would fulfill a complete treatment plan.
Another session began with her saying, “Please go into the bathroom, wash your peri-anal area. We will be attaching electrodes to you that will provide biofeedback of what’s happening internally.” Do what? At this point, I just do as I am told. I haven’t had sex with my husband since we started therapy, and I am ready to find out if these sessions are going to help me. But, I was still intimidated by these little electrode stickers. I don’t usually get intimidated. I went through SIX FULL cycles of IVF with all the poking and prodding that entails, and finished with an emergency cesarean and recovered only with ibuprofen in the hospital. I’m tough. But, these “stickers” were different – would they finally give me the answers? Yes. Yes, they would.
We learned through the biofeedback that I was in a constant Kegel. I needed to learn to relax my muscles more — yep more bulging — not learn to Kegel, like so many other women with pelvic health issues. I had that down! Or up? Whatever! On a scale of one to 10, one being a normal person’s vagina’s relaxed state, I was a five at what I considered myself completely relaxed according to the biofeedback. I was so good at Kegels that I wasn’t accepting intercourse like I should. No wonder it was so painful! Many women deal with stress by enjoying a glass of wine in the evenings, working out, grinding their teeth or other common stress relievers (whether intentional or unintentional). Apparently, I hide my stress by Kegel-ing 24/7! I’ve always described myself as a duck on a lake — calm and smooth on the top, but kicking like crazy underneath. Guess my vag is a good kicker.
So, my therapy is focusing on exercises that help me identify muscles and relaxing them. It is multifaceted, to say the least, which involves tools in addition to exercises and stretches. That’s all I am going to say about that.
Six weeks into therapy, I initiated intercourse during our intimate time. THERAPY IS WORKING!!! I could not believe it. I wasn’t completely pain-free, but it was noticeably less. I have so much work ahead of me, but I can see the light. Intercourse may never be completely pain-free for me because I can’t physical therapy my way out of endometriosis, but the hopes of it becoming pleasurable are exciting. Keep bulging!
As moms, we consistently put everyone and everything before ourselves. It’s instinctive, and it has certainly been a paradigm shift for me to start putting myself first. Pursuing this therapy has been enlightening in more ways than one. I feel more in control, powerful and relaxed at the same time. Learning to relax my relevant muscles is actually forcing a more overall relaxed state, which has been beneficial in all aspects of my life. I’ve also learned the importance of sharing my story.
A close friend recently made a joke about herself being in pelvic floor physical therapy, for a different reason than mine, but what are the chances we were both in VPT?! I admitted to her that I was, too, so we looped in our other closest girlfriend and weekly wine nights began, shocking our lucky flawless-vagina friend with our therapy stories and testing the insulation quality of our children’s bedrooms with the decibels of our laughter. During a moment in life when I thought no one could possibly understand, I learned I wasn’t alone. That laughter can be the best medicine. And don’t forget to bulge!