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I’ve always had, well, issues with my vagina.
As a teen, I never wore tampons. I had a rather traumatic start to my periods, so the thought of taking the next step and shoving a bullet of cotton up my cooch was not exactly appealing. I remember a time in my teen years when my mom and I were visiting her best friend. As it often does, the topic of periods came up. At that point, I was taking multiple dance classes a week but still hadn’t used a tampon.
“How’s she going to have sex if she can’t even use a tampon?” my mom’s friend asked.
As an adult, I now know that the two have exactly nothing to do with one another. But at that moment, my worst fears were realized. My vagina was broken.
Fast forward to college, and I got my first boyfriend. I was thrilled at the prospect of having sex, but each time we tried, it just wasn’t going in. For the better part of a year, this resulted in fights, tears, and even more proof that my vagina was straight-up f*cked. I would always reassure him that I wanted to, but I quite literally couldn’t. He had no idea what I was talking about.
Eventually, sex happened. It was painful. Sometimes excruciatingly so. It occasionally got better, but was certainly never pleasurable.
A couple of years later, the pain came back in full force. I went to the doctor for a transvaginal ultrasound hoping to get to the bottom of it. What I got was my first panic attack, which is (adorably) still listed in my medical history to this day. My doctor immediately recommended a pelvic floor therapist named Brooke David Margulies. I made my appointment shortly after.
“When Brooke told me what we would be doing, I laughed. It was worse than I could have imagined.”
I had no idea what a pelvic floor was, let alone what pelvic floor therapy could be. Would she be massaging my hips? Would she make me do stretches I was no longer capable of doing?
“If people know about pelvic floor therapy, they tend to associate it with pregnancy or postpartum,” Brooke shares. “And while this population can benefit hugely from pelvic floor therapy, it really is only a small fraction of the diagnoses you may see as a pelvic floor PT.”
She continues, “Some of the main reasons people go to pelvic floor PT is for bladder, bowel, or sexual dysfunction. As a pelvic floor PT at Origin, I treat a lot of people for bladder and bowel leakage, constipation, and pain with sex.”
When Brooke told me what we would be doing, I laughed. It was worse than I could have imagined.
“The first and foremost thing a pelvic floor PT can do is listen and work with the patient to understand what they are dealing with,” Brooke says. “Patients with chronic pelvic pain typically experience a significant impact in their sex life and their experiences with pelvic care, such as getting their annual cervical cancer screening. That’s why it’s important to meet the patient where they are at and work to educate them on how PT is different from going to a gynecologist’s office.”
But wait, there’s more.
Brooke explains, “When the patient is ready, we do an internal assessment, but we don’t use stirrups. (We are not the gynecology office.) We have patients under blankets, resting their legs on pillows, and we are mindful of the patient’s breathing and demeanor,” she adds. “If a patient says they are ready, but their body is telling me otherwise, we find other things to do before doing anything internal. If the patient is ready, the pelvic floor PT will use gloves and lubricant while talking you through what they find during the pelvic floor exam. The PT will assess all three layers of muscles (if possible) and both sides. If indicated, the PT will ask if you are able to contract, relax, and bear down to get a better understanding of the state of the pelvic floor muscles.”
“It’s important to meet the patient where they are at and work to educate them on how [pelvic floor therapy] is different from going to a gynecologist’s office.”
To me, the first few appointments seemed futile. I squirmed and tensed up, and my body subconsciously rebuked her hand as hard as possible.
“I remember so vividly that each session would bring us closer to you being able to tolerate internal work,” Brooke recalls. “We started with you fully clothed underneath the sheets, and we would work on breathing and abdominal work. In the next session, you felt comfortable enough to take your pants off and leave your underwear on. We did more breathing, more abdominal work, and maybe some manual work to your legs or neck. The next session, you took off both pants and underwear and remained under the blanket. We still didn’t do any internal work.”
But Brooke was kind, calm, and patient. She never made me feel like my body was broken. In fact, she made it sound normal. She told me about other patients she treated, all of whom went to her for a range of reasons, from pain during sex to incontinence. It also helped that we watched the same franchises of Real Housewives.
“Finally, you were ready and consented to internal work. We did a lot of breathing, and you were very hesitant. Even though you wanted to do the work to reach your goals, it was still scary,” she says. “I don’t know if you remember this, but as my finger approached you, you got nervous, tried to adjust your position, and your heel kind of knocked my finger in! Honestly, it helped because it took the anticipation and discomfort away, and we were more productive.”
I kept going back to Brooke, and—as I put it to friends—got fingered on a table for 15 minutes while we talked about Bravo. Eventually, my pelvic floor muscles were retrained, and I no longer dreaded appointments.
“Once we broke the barrier of the internal work and you learned how to connect breath to body to nervous system, you did so great,” Brooke says. “We were able to focus on your goals, decrease pelvic floor muscle tension and pain, and our conversations became more lighthearted. We got to enjoy our time together while working on your body. By the end, you didn’t hold back at all, your body was more accepting of our work and, dare I say, you had fun at PT.”
Ugh, she’s right.
My experience with pelvic floor therapy taught me to listen to my body. That whatever I think is wrong with me is actually just something that needs the right solution. And that solution isn’t actually as terrifying as you think. Sex for me now is not only painless but pleasurable. I can say, without a doubt, that pelvic floor therapy changed my life for the better.
I still don’t wear tampons though. Some habits die hard!
Go deeper with: Myths and Truths About the Pelvic Floor
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TL;DR
I went to pelvic floor therapy to help with extremely painful sex. Through many sessions with a professional pelvic floor therapist, my muscles were retrained, and I’ve been able to have comfortable sex since. If I ever experience that kind of pain again, I know exactly where to go.
