When it comes to sexual pain, women often have to be their own advocate. This is hard to do when the subject is so taboo that no one talks about it.
When I got married several years ago, I was looking forward to finally enjoying sex with the love of my life. I had waited out of principle, and was told by so many people and articles that it would be worth the wait. But it wasn't. It was incredibly, unbelievably painful. And, moreover, it was just plain impossible. My husband and I tried for a month or two, but it just didn't happen, and the pain kept getting worse.
So, like any reasonable person, I made an appointment with a gynecologist to try and figure out what was going on. I searched on the internet, and thought that maybe I had a microperforate hymen. But, less than a week before my appointment, everything changed. I got a positive pregnancy test. Somehow, without penetration, I was pregnant. And suddenly, everything became about my baby's health and not my own.
Vaginismus and Pregnancy
At my prenatal appointment, the doctors tried to check my cervix, a routine procedure to make sure the pregnancy is healthy and proceeding normally. But the experience left me in searing pain and tears, and the doctor couldn't even reach it. They tried to do a pap smear, but couldn't get the swab into me, and had to downsize to their very smallest size, used for young girls. More pain. More tears. But at least I didn't have a microperforate hymen and need surgery? They decided I was fine and sent me home in pain, with no answers. So I turned back to my trusty friend, the internet.
Vaginismus is a medical condition where the muscles of the vagina clench and allow nothing to penetrate.
In my search for answers, I discovered that I had undiagnosed primary vaginismus. Vaginismus is a medical condition where the muscles of the vagina clench and allow nothing to penetrate. Nothing — not tampons, not my husband, and not even those long, medical Q-tips used for pap smears. And not only does vaginismus prevent penetration, but it also causes great, searing pain with any attempt.
The internet had told me that this was an extremely rare condition, maybe affecting five in every thousand women. We know now that’s not the case. It affects at least 5-17% of women. Probably more, because women have been taught by society that bad sex, even painful sex, is normal. So we don't speak out, even when it’s changing our entire life, and quite possibly causing us physical and emotional trauma.
Vaginismus and Childbirth
At my next prenatal appointment, I took this to my doctor. He told me he'd seen quite a few cases of vaginismus, but that 9 out of 10 would resolve with childbirth. So I suffered through months of the most painful cervical checks imaginable, and waited patiently while a little human being grew inside of me, hoping for the magical childbirth that would change everything.
He also told me that an episiotomy might help my vaginismus. If the cut was made, then sewn back together more loosely, maybe it would make more room in my vagina, and sex would be less painful. Ok, I agreed. Anything was worth it, anything that might lessen the pain.
Many women's sexual pain tends to actually get worse after childbirth, not better.
Well, childbirth came, and it just made the pain so much worse. After three months of my episiotomy not healing, of constant pain every time I sat, stood, or walked for extended periods of time, I found a new doctor. It turned out that I was allergic to the sutures that had been used during childbirth. My episiotomy hadn't only not healed, but I also had a ton of painful granulation tissue surrounding all of my scars, both inside the vagina and out. It took another three months to finish healing the episiotomy and to treat the granulation tissue. And I was right back where I started, the "one woman out of ten" who still had vaginismus after childbirth.
It was better than it had been, I told myself. Penetration was still painful, but it was finally possible. So I continued to muscle on, working with dilators, until things started yet again to get worse instead of better. Finally, two years into my marriage, things were so bad that I started going to see a therapist who specialized in trauma, particularly sexual trauma. And that was the point where things finally took a turn for the better.
Seeking Healing Through Therapy
I worked with my therapist for a year, slowly unpacking the complex trauma and PTSD I had developed over the course of my marriage. I delved into some of the psychological causes of my vaginismus, did some targeted eye movement desensitization and reprocessing (EMDR) therapy on specific traumatic sexual experiences, and finally came to a place where I could work on the physical side of things.
I discovered pelvic floor physical therapy, which focused on exercises and massage to help my vaginal and pelvic muscles relax. And I found out that, in contradiction to what my doctor had told me, many women's sexual pain tends to actually get worse after childbirth, not better. In fact, it’s fairly common for women to develop secondary vaginismus after childbirth. My physical therapist helped me understand why the internet advice of "just do kegels to strengthen the vaginal muscles" had done the opposite of help. I needed to focus on exercises that relaxed the muscles, not ones that clenched them! It seems painfully obvious, but in a world where conversations about sexual pain are avoided, how are young women supposed to figure this out?
I no longer have extreme anxiety and freeze up at the very thought of having sex.
Finally, seven years into my marriage, I’m at another turning point in my sexual journey. I have successfully had pain-free sex for over a year. I no longer have extreme anxiety and freeze up at the very thought of having sex. Sex is more neutral than negative. It has been a long journey getting to this point. I have fought a lot of uphill battles, sometimes against the very doctors who should have been able to recognize my condition and help me.
My journey doesn't end here. I'm going to keep fighting, until I find a way to make sex a positive and enjoyable experience. But until then, I just want to say to all the women out there experiencing painful sex: it doesn't have to be like this.
If sex is more than uncomfortable, stop. Advocate for yourself. Find a doctor who takes your pain seriously. Find the cause of your pain. And get the help you need to fix it. You don't have to live with the pain. And you don't have to make this journey alone. There are so many more of us than you could possibly imagine. Painful sex doesn't have to be endured; it can, and should be, cured.
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