Vulvodynia in Sex and the City. Sort of.

I just remembered that Sex and the City has a storyline in which Charlotte apparently has vulvodynia. The unprovoked kind.

What i like about this is that vulvodynia got mentioned. That has to be a good thing. The more people know about it, the more likely it is to get addressed and treated and resolved. What i didn’t like is part of how it was framed.

a) It’s one episode. One small part of one episode. And then it’s never mentioned again. In reality, vulvodynia is a tricky condition to treat that usually takes a long time to resolve.
b) The whole ‘depressed vagina’ shtick. That’s not what it is. But antidepressants (tricyclics like amitriptaline) are often prescribed to treat the pain—as they are with lots of chronic neuropathies, like shingles. So that’s not that bad—and it’s not like this is a medical show so i wouldn’t really expect them to go into why an antidepressant can treat chronic pain. Overall, not that bad.
c) The suggestion that Charlotte’s self-image (of her vulva) is somehow responsible for her pain. In reality, the cause for vulvodynia is not clear and i think setting it up in this way sort of suggests that it’s a psychological problem first and foremost and it simply isn’t. Having said that, i think it’s a very good idea to become visually acquainted with one’s genitals, if you can. If nothing else, know thine enemy… that’s what i do.

Overall, despite its shortcomings, i think the presence of vulvodynia in such a hit show as Sex and the City is a good thing. 

Vagina monologues part 2b: my vagina hates me

See Prologue
Intro/part 1
Part 2a 

Dear readers,

I have a sexual disorder. My vagina hates me.

I have vestibulodynia. It’s a form of vulvodynia (vulval pain) localised to the entrance (vestibule, funnily enough) of the vagina. I have the provoked kind, meaning it only hurts when it’s touched. This makes penetration (with anything; penis, vibrator, speculum, finger, cotton bud) excruciatingly painful. As a consequence of pain associated with penetration, I also have secondary vaginismus—which is when the pubococcygeus muscle goes into spasm, effectively clamping the entrance to the vagina shut and making penetration difficult or impossible.

The cause of the vestibulodynia is unknown. Some women notice it occurring after times of great stress; others after a thrush (yeast) infection; others after childbirth or menopause; others for no reason at all. It is a type of chronic pain with no known cure—but many “try this; it might help” remedies are bandied about.
Vaginismus is often psychological—occurring particularly in virgins who anticipate painful intercourse/penetration and involuntarily tense up. This is primary vaginismus. Secondary vaginismus occurs in women who have previously been able to have pain-free penetration.

I’m not 100% on the cause of my ills. A conflation of really annoying shit, i think. 

Here’s what happened:

I hope i remember these events in the right order.
I was 17 and had not had penetrative sex but was sexually active. It was summer. I got my period and decided to try tampons for the first time. It was slightly uncomfortable to insert but not painful. I was really paranoid about getting Toxic Shock Syndrome so i was changing it up every hour or two, and of course i used a pad overnight. The next day, i had developed what my doctor diagnosed as thrush—but it wasn’t itchy, just very painful—a sore, stinging pain rather than an achey, stabbing pain. I got some canesten, no biggie.
The next day I got really ill. I had bronchitis that made me so feverish that i fainted twice (and i’m not the fainting kind). I went to the doctor again and she put me on antibiotics. Then i had an allergic reaction to the antibiotics, which was ghastly, and then my doctor switched me to a different kind and also gave me some more fluconzaole for the thrush (which was being exacerbated by my infection and antibiotic treatment). I was ill for another week or so and then i recovered.

A few weeks later i was about to have penetrative sex for the first time—and found it was impossible and extremely painful. And has been ever since.

In the five years since then, i have had both relationships and less-structured sexual encounters/arrangements. And in that time, i have had penetrative sex twice, both whilst drunk (to numb the pain) and under some duress coming from the man involved—something i really don’t wish to repeat.

I have had to undergo a number (larger than i care to remember) of painful pelvic exams, ranging from being probed with a cotton bud or a gloved finger (fucking ouch doesn’t cover it) to being penetrated with a cold metal speculum and cranked open, or having an internal ultrasound exam with a cylindrical probe about as wide as two fingers that went all up inside my vagina, past my cervix and into my uterus. I’ve been crying my eyes out (and i’m not typically one to cry, really) on examination tables (whilst also desperately needing to pee, in the case of the internal ultrasound). I’ve experienced so much vaginal tearing—because of the “force” involved in penetrating a ‘vaginismussed’ vagina. 

Many of you will have heard of a folkloric phenomenon called Vagina Dentata—toothed vagina. The myth (made more popular in recent years thanks to the Hollywood film Teeth) features a woman whose vagina bites off the penis of whosoever should attempt to enter her. This is what penetration is like for me—only i feel like i’m biting myself.

And all i read about in mainstream women’s (and men’s) magazines about “great sex!” is focussed on one after another of penis-in-vagina sex positions and techniques. The message this gives me is that “if you’re not having sex with a penis all up inside you, you’re not having good sex”. That’s fucked up!

Honestly? Getting a dick up there is the least of my worries.

Stay tuned for part three…