Breaking Free From Pelvic Pain

I apologize for my absence last week. The end of the summer has proven to carry about as much emotion as I can handle. There has been tragedy, about which I don’t have the heart to write yet, and there has been joy. The two juxtaposed together feel incongruous to my deeply feeling heart, but in reality, it’s just the way of nature (a topic perhaps I will be able to verbalize in the coming weeks).

Today, though, I want to talk about something incredibly personal and vulnerable. If you’ve followed my blog for a while, you’ve probably heard me make reference to my sexual abuse. What I haven’t mentioned were the physical effects that abuse caused.

Vaginismus is a generalized term that doctors use to describe pain in the vagina, usually related to spasms or contraction in the vaginal wall with insertion of any object. Doctors “don’t know exactly why vaginismus happens,” as WebMD bluntly puts it, and six years ago when I first started to experience the excruciating pain associated with vaginismus whenever I tried to have sex, get a pelvic exam, wear a tampon, or even go to the bathroom, I was told that not only was the cause unknown, but so was the cure.

Basically, I was told I would live with near-constant pain all the time, and the best that I could do would be to stretch my stubbornly shut vagina with smaller objects before I had sex…if the pain wasn’t so bad as to prevent me from having sex.

Last year in April, I went in for the dreaded pelvic exam that I get every year. It was also the year that I had to get my merena replaced, and what was supposed to be a “painless” process of removing the merena and a “mildly painful” process of inserting a new one was so excruciating that I was doped out of my mind on tranquilizers and still managed to scream loudly enough to have a sore throat later. Ripping my uterus out would have probably been less painful.

I had the procedure done at Planned Parenthood, and the gynecologist who worked with me took some time to talk to me about my pain. It was the first time any doctor had ever sat down long enough to try to understand it. She wasn’t able to do anything in that moment to make what I was there for any less painful, but she mentioned that there was a physical therapy that could help me with my pain.

Naturally, I was afraid to hope. If it were treatable, why hadn’t I been told sooner? But I let her write me a referral to a physical therapy center in my area…and then I sat on it for two months in absolute terror of what physical therapy might include.

A year ago this month, I finally went to my first appointment and began a journey that has ended Friday with some of the happiest tears I’ve ever cried. I learned that the cause of vaginismus isn’t quite as “mysterious” as other doctors would have me believe. I learned that it wasn’t all in my head due to sexual anxiety triggered by the fear of flashbacks and memories of abuse; my pelvic muscles had suffered physical trauma just as my soul had suffered emotional trauma. No amount of talking therapy was going to address the injury that had occurred to my vaginal wall when I was a child.

But pelvic floor physical therapy could.

It was awkward as all hell going in to see a woman who would stick her finger inside my vagina once a week to teach my muscles how to relax. I think I wouldn’t have been able to do the work if I had gone before last year because there’s nothing in mainstream society that teaches us that vaginal insertion and vaginal massage can be anything other than sexual. It was something I had to learn through my voracious reading of feminist and sex-positive books.

It was painful as all hell too. Initially the only way to get my muscles to release their tension was through trigger point therapy, which basically stresses the muscle until it releases from exhaustion.

And, of course, it was hard as all hell. My muscles were so used to being contracted that relaxing them took effort, concentration, and training. I had to do internal work on myself in between my appointments in order for them to be effective. And the emotional work of my therapy definitely came in. In fact, I learned that muscles often hold memories and emotions. Releasing the muscle releases a flood of things that my mind has buried.

But this week, I finally graduated from my physical therapy with the majority of my vaginal and pelvic muscles at normal tension and tone. The therapist couldn’t fix everything. There’s permanent damage in some parts of my pelvis, but for the first time in my life, I can go entire days and almost weeks without spasms. I know what pain-free sex feels like. I know how to manage my pain and release the spasms when I have them.

So on some levels, the doctors were right. I will never be entirely free from pelvic pain.

But they were so so so wrong because managing my symptoms and pain now means reminding my body how to get to a pain-free place again rather than ignoring the pain.

Why am I writing about this?

Partially because I think we need to slough off the shame of talking about pelvic health. If I were having epiphanies associated with menstruation, I’d be writing about that too.

But mostly because I know there are other women out there who have pelvic pain and vaginismus, whether because of sexual abuse, a physical accident, or anything else.

And I know that they’ve likely been told the “cause” is unknown.

And I know they probably believe there is no treatment for it.

And I want them to now know that that’s not fucking true. There’s a difference between “complicated and caused by multiple factors” and “unknown causes.” There might be some ways in which this is “incurable,” but it’s not untreatable. If doctor’s believe the unknown and untreatable bunk, it’s because women’s sexual health isn’t taken as seriously, but there are people out there who care and who focus on helping women (and some men) heal themselves.

So as the successfully former patient, I’m here to say: There’s hope.

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