My vagina hates me: adventures at the sex clinic part 1

This is AKA The Chronicles of Poonarnia part one.
((AKA the lying, the itch and the hospital ward robe???) it doesn’t really fit my own symptoms or my experience, but it sounds darn neat…)

And so begins a new section of my increasingly large body of writing on vulval pain etc. in which i discuss my treatment. Elsewhere, if you’re interested, you can find discussions of how this condition (provoked localised vulvodynia, AKA vestibulodynia, previously known as vulvar vestibulitis) has impacted my personal and sexual life and  how i still have great sex.

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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. 

Anorgasmia—A Pleasureless Existence?

Given the overwhelmingly positive response i’ve had to my series on vulval pain, it’s becoming very obvious to me that what we’re being told about sexuality and gynaecology—what should happen, how it should happen, what’s normal, how stuff works, who does what, what’s wrong, what’s right, etc. etc. etc.—is near enough completely at odds with lived experience.

So, with that, i’d like to expand my focus on vulval/pudendal genitality and sexuality. 

First up is a guest post authored by my friend Captain Labia. This is not, unfortunately, her “real name”, but for privacy reasons she shall be known by her superhero name. She has anorgasmia and will shortly (fingers crossed!) be beginning psychotherapy.
If you would like to pass any messages on to Captain Labia, please do so via my Ask Box and i will make sure she gets them. 

Anorgasmia—a pleasureless existence?

Anorgasmia is a condition, affecting both men and women (mostly women), that prevents them from reaching orgasm. To put this into perspective, about 15% of women report difficulties with orgasm, and as many as 10% of women in the United States have never climaxed, while many women who orgasm regularly still only climax about 50-70% of the time.
All over the world there are people with this condition for any number of a variety of reasons. For some its is a physical inability due to paralysis, spinal injury, diabetes, MS, Cardio-vascular disease, drug and alcohol addiction, pelvic surgery or trauma, while for many others psychological distress triggers it, most commonly noted are caused by an individual’s incidence of rape and sexual abuse. 

Male impotence has gained attention for centuries, but it has only been since the 1960s and the beginning of the sexual revolution that female orgasm has gained its rightful place in our attentions. For this reason the treatment of anorgasmia is relatively new and somewhat surprising. While in some cases changing medications and repairing nerve and tissue damage (as much as is physically possible) is the way forward. One woman took part in an American clinical trial of a device fitted to her spine which engaged the orgasm reflex for her. When her husband was given the controls she described it as “the best foreplay I’ve ever had”. In other cases fixing the psychological “negative learned response” is far more complex and far more self-directed.
Most patients are encouraged to engage in masturbation to allow themselves the freedom to explore themselves and their sexuality without the pressures of the presence of a partner, slowly introducing the idea of allowing another person to engage in this with them. Without published recovery rates it is difficult to quantify my own experiences into facts. There are however, many sex therapists that specialise in this area of psychotherapy and the success rating they each claim is impressive. 

When I tell friends that I have Anorgasmia it’s always a tough subject to discuss. Many don’t understand it while others make broad assumptions about me, my partner and our sex life. All of my sexual partners have tried to “cure” me, making childish remarks about previous partners. It’s a condition where it is easy to point fingers and often as a sufferer it is easy to point fingers at yourself. In my case Anorgasmia stems from sexual abuse I suffered as a child. Now an adult, my “negative learned response” is to deny sensation when I lose control or to push my partner away. This learned fear controls many sufferers while in others it manifests in other ways with the orgasm remaining elusive despite significant and sufficient stimulation. Unsurprisingly, this has caused such problems as anorexia, depression, self harm within my life and has broken up many of my intimate relationships.
This makes life as an anorgasmic sound unfulfilling, frustrating and sexless but it is far from it. It would be incorrect and insulting to be labelled as an asexual person, likewise an asexual person would find being labelled an anorgasmic incorrect and highly presumptuous. In my case, having never experienced an orgasm it is not a sensation that I can actually miss. While I know there are those out there who feel betrayed by their bodies (something which I feel from time to time and continue to struggle with) I am still able to enjoy the sexual experience and it is something which I long for and enjoy. As a self confessed serial monogamist I love my partner and because of that our sex life is intimate, enjoyable and pleasurable beyond and regardless of whether or not orgasm ever happens for me. 

The stigma in our society is that to be a “whole person” one must first have experienced orgasm. I find this view insulting and entirely vacuous. It is also non-representational of the population and ever growing number of anorgasmic’s within the population. In a pleasure orientated society it is easy to lose yourself in promises of ecstasy and all too easy to overlook the realities of the lives of others. I have come to accept that orgasm may or may not happen for me and that is the bottom line for me.

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…