My Doctor Sent Me to “Vagina Therapy”


I’ll never forget the day I held that prescription in my hand. The one that said, “Pelvic Floor Release.” I looked at it, laughed a nervous laugh, and as soon as I got the chance, I called all my friends and told them my insurance was now covering orgasms. Because I am basically a 12-year old at heart.

And because my anxiety surrounding this whole new adventure had me needing to laugh about it, if only so that by laughing, I could pretend as though it didn’t totally freak me out.

Pelvic floor therapy was what my doctor called it. I called it PT for my cootchie, or vagina therapy for short. After years of battling chronic pelvic pain as a result of endometriosis, I was experiencing muscle spasms … down there. I hadn’t even known this was happening. My doctor was the one who discovered it as he prepped me for what would be my third surgery in just two years. According to him, every time he tried to perform a basic exam, my vagina clamped shut.

Apparently this is somewhat normal for women with pelvic pain conditions. You get so used to it, you don’t even notice it’s happening. When you’re in pain like that all the time, you start clamping down. And just like any other muscle in your body, all that tension can eventually cause spasms. In my case, my vagina was in a constant state of clench. Completely unintentional on my part. Completely out of my control.

A lot of women with endometriosis have pain during sex as a result of this issue. I enjoyed sex, personally, but there was always pain associated with getting started, which I now understood to be a result of having to push past that clench. Long before, I had simply decided that I preferred small penises. In fact, this was so completely my normal state of being that I was convinced all other women secretly preferred small penises as well — that the “bigger is better” thing was a myth perpetuated by male ego. When you deal with something for long enough, you start to convince yourself it’s normal, no matter how abnormal it may be.

But here this doctor was, telling me it was actually an issue — one that was contributing to my pain levels, and one that could be treated.

With pelvic floor therapy.

He told me it would be just like seeing a physical therapist for any other muscle. That it wasn’t as scary as I was already making it out to be in my head. And then he promised to find a female doctor in my area to help me find the “release” I apparently needed.

I smiled and nodded, tucking that prescription in my purse, knowing I would never use it. I might frame it, just because it was funny, but there was no way I was ever going to submit to a pelvic massage, or anything of the sort.

It took six weeks after that surgery before I was cleared for physical activity. As soon as I was, I signed up for a Pilates boot camp, determined to start getting back into some sort of shape after over a year spent laid up in bed in pain. That first night, however, the instructor handed out a pelvic floor self-assessment. I hadn’t even really thought about how Pilates might be related to my pelvic floor; it had just been something I’d been wanting to try. But as I looked down at that sheet, my heart sank. It included 10 items. Things like:

  • Do you experience pain during intercourse?
  • Do you have ongoing lower back pain?
  • Do you lack control with urination?

The instructor was telling us that pelvic floor issues were common, especially among women who had given birth. She said that Pilates could help, but that if you answered “yes” to more than five of the items on the list, you should also seek out pelvic floor therapy.

I could confidently say “yes” to seven of those items. But still, I pretended like this wasn’t something I needed to do.

Around that same time, I was at the start of a new relationship. Things heated up between us one night, and it seemed inevitable that we would be taking the next step. But when he reached his hands down between my legs, he paused. Looking up at me with concern, he said, “Is this even going to work?”

Apparently I was clamped tight. And he could tell. I hadn’t explained any of my issues to him; he just knew … things were abnormally tight down there.

Me being me, I made a joke: “What, aren’t tight vagina’s sexy? Just pretend it’s my first time!” But I knew. I knew it was time to give pelvic floor therapy a chance.

So I made my first appointment a week later, telling all my friends that I was cashing in my prescription for an orgasm.

I didn’t really know what I was walking into, and as much as I joked about it, I was terrified. I had been told there would be massage and exercises involved. The idea of laying back and allowing a doctor to just go to work on me, down there, seemed incredibly uncomfortable. And what if I did get turned on and have an orgasm at an inappropriate time? Surely, that would be humiliating.

It turned out, I had nothing to worry about. Spontaneous orgasms aren’t really a major concern in life, but certainly not during pelvic floor therapy. There are treatments meant to get you there, for women who struggle with orgasms as a result of these issues, but … it doesn’t just happen. Nothing that goes on in that room will reduce you to a puddle of convulsions without you being aware well in advance of what is to come.

For me, there never was a payout on that prescription for an orgasm, but there was about a year of fairly intense pelvic therapy. Sometimes that involved massage to calm the muscles. Sometimes it involved me inserting a small piece of equipment that looked a bit like a sex toy and was attached to a computer and measured the strength of the contractions in my vaginal walls — an exercise meant to help me learn how to control the clamping I otherwise hadn’t even realized I was doing. And sometimes, therapy consisted of me doing exercises you might see anyone else at physical therapy for any other reason doing.

Those times, I was out in the main room conducting my exercises with everyone else. All of them wholly unaware of the muscles I was meant to be focusing on. Other times, during my sessions that required me to be more naked, we were in a private room — my vagina therapist guiding me calmly through each step of whatever we were undertaking.

Until eventually, my pelvic floor was released. Not in the earth shattering, orgasmic way I had originally pictured, but in the sense that I was no longer having spasms. I was no longer the girl with a clenched vagina. And I graduated out of pelvic floor therapy.

I still joke that my vagina has super-human strength. I saw those readouts when it was hooked up to the computer; my clench numbers were super high. It was something to laugh about. And it still is. Which is good, because when you spend years being ravaged by a disease you have no control over, finding humor wherever you can is important.

But as much as I joke about my year spent in vagina therapy, I’m forever grateful that I went. Because even though I hadn’t known I needed it, it wound up making a huge difference — both in my pain levels and in my ability to enjoy sex. Something I hadn’t even realized I was struggling with until I knew what it was like not to struggle.

You don’t have to have endometriosis to benefit from vagina therapy. A lot of women who have gone through childbirth have experienced issues as a result of those ravaged muscles as well. And there are a handful of other conditions that can also leave the pelvic floor in shambles.

It turns out, vaginas are fairly fragile. Who knew?

If you’ve been suffering in silence, though, or tend to pee a little every time you laugh (another sign that those pelvic muscles could use a tune-up), I highly suggest talking to your doctor about the potential of pelvic floor therapy for you.

You probably won’t get an orgasm out of it, but … you never know.

Image source: Thinkstock

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