When the doctor told me I would have to go to physical therapy for my vagina, I nearly passed out, because I had no idea what that would entail. It's not something I've heard anyone else talk about before. So, I'm here to tell you what pelvic floor physical therapy looks like, for anyone who is curious.
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The following conversation has happened countless times in the last four months of my life:
“I can’t, I have physical therapy.”
“Oh, for what?”
I’m sure you can imagine the look on people’s faces when I decide to tell them what my appointments are really for.
I struggle with something called vaginismus, which essentially means I can’t control the muscles in my vagina. Like, no matter how mentally or physically relaxed I am, my vagina doesn’t follow suit. It spasms involuntarily, and if I attempt to insert something during a spasm, it feels like I’m being stabbed in the vagina. Even tampons can cause pain on a bad day.
It wasn’t until after attempting to have sex and experiencing excruciating pain for four years that I finally got an answer, after two weeks filled with four different gynecologists. And when the doctor told me I would have to go to physical therapy for my vagina, I nearly passed out, because I had no idea what that would entail. It’s not something I’ve heard anyone else talk about before. So, I’m here to tell you what pelvic floor physical therapy looks like, for anyone who is curious.
Before my first physical therapy appointment, I was practically shaking in the waiting room. I had no idea what to expect – was it just going to be stretches and yoga? Or was she going to physically, forcibly, you know…stretch my vagina? I was nervous, to say the least.
When I met her, all my worries washed away. She came out with a bright smile on her face and welcoming me back to the treatment room, where we spent forty minutes talking about my problem, the cause of it, and various treatment options. We spoke of yoga stretches, about treatment timeline, and different topical treatments. She answered all of my questions and told me everything I would need to know about pelvic floor physical therapy.
Pelvic floor physical therapy consists of both external and internal work once a week, plus there’s a ton of homework. We do stretches, and then, when it comes to internal work, she plays relaxing music and gives me heating pads while she literally, yes, stretches out my vagina. It sounds really strange, and it is, but at the same time, I’ve never felt so empowered and in control of my body. She makes me feel more autonomous than any medical professional ever has before. I obviously can’t speak to all pelvic floor physical therapists in the world – but if they’ve received training similar to mine, then I bet they’re awesome.
At home, I have to use dilators, which is a whole process on its own. I have to get myself relaxed (i.e., grab my heating pad and watch Netflix), use TONS of lube, and use the dilators. They’re basically plastic dildos that come in six different sizes, and my goal is to make it up to the biggest size. For reference, the smallest one is about the size of a tampon. For anyone who is trying out dilators to treat painful sex – I highly recommend doing something fun while dilating. Otherwise, your brain will just continue to associate insertion with pain and discomfort. If you binge a Netflix show while doing it, sure, it’ll be uncomfortable and probably painful, but your brain will also associate dilating time with whatever you’re currently binging. Positive reinforcement for the win!
Despite spending time in college on the Health and Wellness Crew, studying women’s health, and educating myself as best as possible, I hadn’t heard of vaginismus until I watched a YouTube video about the condition. According to my pelvic floor physical therapist, it’s not uncommon at all. It’s just not talked about because women are told that pain during sex is normal and healthy (spoiler alert: it’s not).
If you or anyone you know is struggling with painful sex, there are treatment options. Pelvic floor physical therapy is just one of them – there are also topical numbing treatments, dilators on their own, even surgery. You’re not a lost cause, and you’re not alone. And by talking about this, I hope that I can educate people about painful sex because sex is NOT supposed to be painful and if it is, there are ways to treat it.