Everyone endures their fair share of sexual growing pains, but mine were especially agonizing and embarrassingly unique. While other freshmen girls were discovering the pleasurable powers of showerheads and the joys of fucking your boyfriend while your roommate was at her afternoon Anthropology class, I was popping pills and deep breathing to relaxation tapes. My body felt like an awkward, lumpy prison – as it does to most women in their late teens – but I wasn’t boosting my self-image by taking suggestive selfies or spreading my legs at a mirror to examine the mollusk folds of my vulva. Filling the gap between the glistening goddesses I saw spread across glossy magazines and the body I touched alone in the shower was a much more elaborate process for me. Ultimately though, I do believe that it was a more rewarding one.
After I changed into my bare-ass dressing gown and had my feet up in metal stirrups, I realized that my new GYN bore a disturbing resemblance to my ex-boyfriend’s father. I’d been trying to pinpoint why he looked familiar just a few minutes earlier as I listened to him talk in his office, but the reason had escaped me. I wished I hadn’t figured it out.
A nurse stood in the corner of the room to supervise – a bubbly, walking indemnity for the practice – as the doctor shoved the speculum in my vagina. She tried to talk to me about school and the poems of William Wordsworth as the doctor shined his headlamp towards my crotch, peering into the cave between my legs like an old coal miner. I gave her halfhearted replies, trying to relax my muscles as they struggled against the speculum.
Following the regular exam, I was poked and prodded with needles for what seemed like a small eternity. As asked, I rated the pain 1 through 10. My distress grew as the process pressed on, anxiously waiting for the agonizing electric shocks to run through my pelvis. What place did such a subjective rating system have in a doctor’s office, anyway? I pictured all the charts and graphs and empirical sheets that my nurse mother had complained my entire life. Where was all the empirical information and blood work? Though I’d been told that this doctor was one of the top GYNs in the country, I felt my hopes falling by the minute.
When we finished the exam, I changed back into my clothes and returned to the doctor’s office. It was strange to listen to someone describe your own body to you, as though you hadn’t been living inside the thing your entire life. He explained that a damaged Pudendal nerve was responsible for the agonizing stabbing sensation I felt every time I was penetrated. He had no way of telling whether the nerve was permanently damaged or being constricted by tense muscles. In one sense, hearing this explanation was a relief. My first GYN – a chronically indifferent nurse practitioner with small hands – had insisted that I either had an STD, deep-seated psychological hang-ups about sex, or simply wasn’t getting wet enough (apparently I didn’t know what foreplay was). But when my tests came back negative and her impassioned Astroglide recommendation hadn’t done the trick, she simply shrugged her shoulders and pushed me off on a pelvic pain specialist.
Of course, this sense of triumph over the incredulous nurse practitioner was quickly replaced by pure dread. The doctor thought the nerve was the source of my troubles, but he wasn’t exactly sure why. I had no name to match with my problem, nor a streamlined treatment plan. Until we discovered the exact origins of the problem, he was simply going to throw every possible remedy and experimental treatment at me until we began seeing improvements. The only solid diagnosis he could give me was a disorder that went by the rather Victorian name “vaginismus,” meaning that the nerve pain was causing my vaginal muscles to involuntarily tense up for self-protection. He told me that I’d probably be able to have penetrative sex again, though the word “probably” had the strongest presence in that statement to me. When I asked him how long I’d have to wrestle with this problem, his answer devastated me: “Most likely the rest of your life.”
Being a pessimistic person by nature, I initially walked out of that office feeling worse than when I walked in. I didn’t have a name for my disease or a shred of hope that I would ever enjoy a penis inside of me again. All I had to show for my appointment was a prescription for some archaic anti-depressants. Supposedly this medication was now used for chronic pain and insomnia, since the psychiatric world had since moved on to bigger and better things like Zoloft and Prozac. The self-loathing voice in my head whispered that these were just phantom pains conjured up by my mind like my previous GYN had suggested, that the new doctor was just trying to handle me with kid gloves and passively remedy a mental problem. Of course, doing such a thing would be highly illegal, but my anxiety rarely listens to rationality.
Regardless, the idea of taking anti-depressants certainly didn’t thrill me, but I was willing to try anything to get my sex life back to normal. In time, I did discover that the medication dulled the stabbing pains that plagued my vagina. Unfortunately, my muscles still made penetration an ordeal and left me with a terrible burning sensation afterward. The medication wasn’t without its downsides either. After a few weeks of consistently taking the meds, I found myself devouring everything in sight – particularly sweets, something I usually abandoned in favor of saltier snacks – which only enhanced my college freshmen 15.
The irreverent attitude I had towards taking pills on time didn’t help matters. The first day I forgot to take my pill, I woke up in the middle of the night unable to move, listening helplessly as people dug through the closet at the foot of my bed. They whispered that I had nothing valuable for them to take, that they were just going to rape me and slit my throat. These night terrors about menacing presences in my bedroom – far more terrifying than any illegal drug I’ve ever experienced – inspired me to stick to my pill schedule. Still, I began to question whether the side effects of this drug were worth the slight relief it gave me.
For the next few weeks, I spent my nights laying awake in my bed feeling sorry for myself. The muffled sounds of R&B hits emanating from my roommate’s headphones served as the background music to my despair, my world’s tiniest violin. I always considered myself an incredibly sexual person, and – though I didn’t believe in a higher power – I felt that I was being punished. It all seemed so unfair. For God’ sake, I’d been touching myself since I was 5 years old! I remember having my first orgasm before I’d entered the double digits. Why did the pain have to be so mysterious? I’d also read somewhere that vaginismus was usually reserved for the extremely religious and guilt-ridden. Why was this happening to me?
The doctor had also suggested physical therapy to ease my muscular problems, but I had avoided going, hoping the meds would serve me a quick n’ easy solution on a silver platter. Of course, when I returned to the doctor complaining that the meds hadn’t magically poofed my pain away, he gave me a very professional reality check. He calmly explained that the meds simply treated the nerve pain symptoms, but was doing nothing to actually repair the nerve or counteract the vaginismus. If tense muscles were constricting the nerve and causing the pain, then physical therapy could possibly get rid of my problem altogether. If nothing else, my vagina wouldn’t be inviting a penis back in anytime soon unless I trained my muscles to relax and stop associating sex with discomfort. Either way, physical therapy was an essential part of the healing process.
As he explained all this to me his voice sounded like a taut string being plucked. He had a condescending undertone that was honestly much deserved. I’d been handed the possible solutions to my problems – something that many women with these issues never get – and then threw it away because it wasn’t conducive to my lifestyle. That visit marked the beginning of a real treatment plan that I’d actively participate in, rather than a few pills popped before bedtime.
My first visit to the physical therapist’s office immediately made me feel self-conscious, not that this was a particularly difficult feat at the time. The practice specialized in pelvic therapy and as I sat in the waiting room, I realized that I was the only patient there under the age of 50. In my mind, only old people got sick and the apparent demographics of the practice only confirmed my misconception. I’d hoped to see other girls like me, but sitting in that waiting room made me feel like a defective product thrown off an assembly line.
My physical therapist was a petite red head with three young boys and a soothing voice. Occasionally I’d see her leave the practice on my way out, her fiery hair and sharp face peeking out from behind the wheel of her gargantuan white escalade, looking a little overwhelmed at prospect of wielding the beast. Initially, we discussed my issues with penetration as she gave me a preliminary exam, testing the severity of my muscle tension. I reclined on an artificially warmed bench as she placed a pair of gloved fingers inside me, putting pressure on muscles I didn’t even know I had and asking me which ones hurt the most. Meanwhile, I tried not to think about what a weird porn scene this would make. Luckily it was far too clinical to be sexy. The power of context is truly awe-inspiring.
After I got dressed again, she sat me down and began asking me questions. Gently, she asked me what my home situation was like and how I was raised to view sex. I thought about an instance where my mother – young herself at the time – had caught me masturbating as a child and warned me never to do it again. By nature I sought approval from others, so for a long time I stopped touching myself and when I did cave in to the desire, I felt incredibly guilty about it. I chalked my mom’s reaction up to confusion. After all, my parents weren’t exactly puritanical. They were agnostics who’d conceived me out of wedlock and didn’t hide the more sexual part of their relationship from me. I saw glimpses of intimacy between them throughout my childhood, the occasional passive touch that suggested they still enjoyed a good romp in bed when I was out of their way. Surprisingly, I found all of these thoughts marching their way out of my mouth like a line of little soldiers. The physical therapist treated them with quiet interest, nodding and taking a few notes.
“This next question is completely optional, since I’m not a licensed therapist or psychologist. If you don’t feel comfortable telling me it’s fine,” she began, making me slightly nervous. “Have you been sexually abused or assaulted?”
I paused for a moment. I thought about the previous year, when one of my boyfriends and I were alone in his bedroom together. He’d put his face to my neck, kissing tenderly, but I was far too absorbed in my stresses about work and school to think about having sex. Despite my numerous protests, he’d pushed me down on the bed and hiked up my skirt. My physical resistance was minimal – nothing above some light pushes – but as he moved above me, I fought between feelings of betrayal and guilt. He’d stopped when he saw me crying and held me on the edge of the bed with tears in his eyes when he’d realized what he’d done. He’d told me it was misunderstanding, that it would never happen again. It didn’t. But I thought about the sourness our relationship took on after that and the unexplainable pain that appeared only a month or two afterwards. I thought about his sincere tears of apology and – for reasons I’ll never quite understand – I felt that I had no right to call it rape.
“No. I don’t think so,” I replied. Her eyes hovered over me for a moment, but she pursued the issue no further.
During our next session, she placed a small sensor into my vagina and hooked me up to a biofeedback machine, which digitally measured my muscle tension and charted it on a graph. She looked at my chart with knitted brows, informing me that the normal levels were around a 1 or 2. I watched the red line on the graph move with the passing seconds, measuring every movement my pelvic floor muscle made. My line hovered between a 7 and 8.
In light of the tests she’d performed and the questions she’d asked, she theorized that my muscle tension came from a combination of two things: fear of penetration due to the nerve pain and pure stress. “Some people hold anxiety in their necks and backs, you hold stress in your pelvis,” she’d said. The idea seemed strange initially, but when I thought about how often I critiqued myself to death or worried about completely irrational things, I decided that her postulation was totally feasible. When I asked her if it could be easily treated, she smiled.
“Perhaps not easy, but certainly within reach,” she’d said.
This was the beginning of a strange professional relationship like no other I’d had before or since. Had we been the same age, I doubt we would have hung out together, but she was easy to talk to and I felt like I could openly discuss sex with her without fear of judgment. I told her about what boys I was chasing at the time and which boys were chasing me. I’d give her pain updates when I’d have a chance encounter. Of course, her kindness extended beyond the simple act of listening to my trivial escapades. She was incredibly considerate of the many anxieties I had. The idea of having hands in my crotch doing whatever they pleased made me uneasy, so she’d let me know exactly what she was doing as she went.
The days passed in measures of pressure points: “6 o’clock, 7 o’clock, 8 o’clock…” she’d say, keeping me updated on which vaginal muscles she was hitting with her latex-clad finger. 6 o’clock was the worst one, the one that I’d tense in anticipation of, the one that still gives me the most shit today. When I read my clock in the early evenings and see the dreaded time, I grimace slightly. A year later I would have a terrible acid trip where I was caught inside the time 6 o’clock forever. The intense connection between the sexual and the mental is astonishing, when you think about it.
That broken feeling I’d had my first day in the practice lobby slowly faded. I actually began arriving 10 minutes before my appointments to chat with the nurse at the front desk, admiring her tattoos and carefree attitude. The daily routines of muscle stretches, vaginal exercises, glute massages, and even the simple act of spreading my legs at a stranger began to reset the relationship I had with my body. As instructed, I carved ten minutes out of every day to listen to self-help relaxation tapes while holding a dilator – clinically approved plastic dildos in varying sizes – inside of me to stretch the pelvic floor muscle and build a positive association with penetration again. As the weeks pressed onward, I found the muscle tension number on the biofeedback machine descending in tandem with my pain. When my line finally reached a 2 on the graph, I was told that I could continue to maintain these levels on my own and was released from their care.
Up until that point, that physical therapy office was the only place that didn’t make me feel ashamed of my sex life or my body. Pills dulled my sexual pains, but they couldn’t combat the disdain I had for my body, my beastly anxiety problems, or my inability to trust others to interact respectfully with my body. Though I’d been having sex for years, I don’t think I truly understood what it meant to be a sexually secure person before I set foot in that office. What does this say about the society we live in?
Fear and stubbornness chain people to their antiquated beliefs about relationships and sexuality. A vital part of this archaic prison is a code of silence surrounding sex. If you talk about it, you’re a pervert – slut in a woman’s case – at worst and inappropriate at best. But thanks to advancing societal attitudes towards relationships and the informative powers of the Internet, the word about sexual health, consent, and body acceptance is spreading louder and further than ever before.
Unfortunately, even this comes with its downsides. Concepts that are vital to sexual wellbeing have been reduced to buzzwords and catchy headlines that trendy magazines use to pull in readers. This only seems to make skeptics even more dismissive of these ideas. I’m not suggesting that this naturalization process isn’t essential, but I am suggesting that we change the dialogue around the way we approach the topic.
When people ask me why I am so passionate about sexual health, I try to explain to them that it’s not a matter of politics or spirituality, but rather a matter of health and wellness. I speak in concrete terms, like those charts and graphs I wanted so badly to see during my GYN exam. I tell them about my own sexual struggles – gory details and all – because ultimately it’s the only way people will listen. I tell them the mental barriers we have towards sex reveal themselves in strange ways, even physically. It’s funny, really. When something that creates so much hidden suffering actually begins to manifest itself out in the open – where it finally can’t be ignored – then people finally start giving it the attention it deserves.