Most are unaware of two facts: Cervical Health Awareness Month is discussed in January every year, and Cervical Health and Vaginismus are intertwined. A brief definition of vaginismus; is the body’s automatic reaction to the fear of some or all types of vaginal penetration.
For some individuals, it can take a few pelvic floor physical therapy appointments and some at-home dilation sessions before they have completed their vaginismus treatment. However, this experience is not the same for everyone. It can take a significant amount of time before an individual feels ready to manage the symptoms of vaginismus/pelvic pain, which can feel a bit demoralizing.
After an extended period of time going to medical appointments and visits to the physical therapy office, it’s easy to begin wondering, “When is this chapter of my life finally going to end?” Or, “Will I ever be completely healed?” These are big questions often fraught with a lot of emotion, uncertainty, and frustration.
The vaginismus healing journey is different for everyone. And for some, it may take a longer period of time, but that’s okay. Below are my 6 tips for dealing with vaginismus:
Understanding pain catastrophizing
The academic literature on the topics of painful sex and pelvic pain often references the term “pain catastrophizing“. This is essentially when a person has increased anxiety when anticipating that they will be in pain. It can also mean that they feel increased anxiety while actually experiencing pain. Anxiety emotions can cause individuals to feel less hopeful when it comes to minimizing or resolving their pain and allows for a cycle of pain and anxiety to continue.
Part of physical therapy is learning techniques that help patients self-soothe, freeing them from negative emotions that the pain may bring, but efficient physical therapy also emphasizes how influential feelings of self-efficacy are- especially as it relates to long-term treatment outcomes.
Feeling in control of your symptoms or your reactions to them can help you feel better equipped at dealing with pelvic pain in a constructive manner. When clients feel less anxious about pain, they can redirect their thoughts away from the pain toward the useful strategies they have acquired through physical therapy. This begins a new pattern where individuals recall instances where they were successful at minimizing their pain.
Overcome your negative feelings associated with needing physical therapy
When first starting out with physical therapy (or with a new physical therapist) it is entirely normal to feel anxious and possibly even frightened. Because you don’t know what to expect. However, as you and your provider work together, collaborating on the situation, and progressively strengthening that therapeutic alliance, you may begin to sense your anxiety levels going down with each successful visit.
Check-in with yourself and compare the way you first felt about going to physical therapy with the way you currently feel. Ask yourself what changes have been made here and why you think those changes have occurred.
Learn more about vaginismus and physical therapy
Knowledge about physical therapy is overlooked as a win, which is interesting to think about because of how much power lies within just knowing more about a situation. Dealing with vaginismus can be scary for several reasons, but a big underlying theme is that this health challenge is not widely discussed even among several gynecologists, sex educators, and therapists (Professionals that we probably expect to be well-versed in and comfortable discussing these topics).
That being said there is definitely increased awareness that has been possible in large thanks to the spread of social media. All in all, for many who first get diagnosed as having vaginismus or pelvic pain, it is easy to get overwhelmed, especially when you are not even 100% sure what this diagnosis means for you, your life, and how to go about treating your symptoms.
Learning more about vaginismus, whether that’s from reading books that feature first-hand accounts of what this experience can be like, joining support groups, or learning more from your physical therapist, helps to sort of orient yourself. Aside from that, it can increase feelings of self-efficacy when it comes to handling vaginismus symptoms which will help regulating the emotions that might come up for you.
When you feel unheard and unappreciated, it may be time to find another provider. Don’t be afraid to advocate for yourself. Afterall, you are your own biggest supporter. When it comes to your attention that you need more support, or that you are considering trying new resources that may work better, do not hesitate to reach out to your physical therapist, gynecologist, or primary health provider. They are there to help.
Rely on your personal toolkit
Similarly to how learning more in general about vaginismus is a victory, so is having a selection of tools in your tool kit that you can rely on for support. Tools in this instance can be almost anything. Maybe it’s a meditation app that you enjoy using when you dilate, or maybe it’s a soothing playlist.
It can be a breathing technique you learned in physical therapy, a personal mantra you use to empower yourself, or even the specific physical tools you employ, including your favorite dilators, dildos, stress balls, lucky charm bracelets, and lubricants. Any item that is meaningful to you can also be a tool. Even if it does not appear to be related to vaginismus treatment on the surface.
Explore Feeling Empowered
Feeling empowered to make decisions for yourself is a super win! Vaginismus can influence individuals into feeling like it is unsafe to try anything new or to deviate from what they know, even if what they currently experience is not helpful or beneficial to them and what they want in their life.
When those thoughts shift and patients feel more comfortable with trying new things, whether that is trying a new technique with your physical therapist, or experimenting with what position feels the most comfortable when trying to insert something vaginally, these examples all highlight the immense resilience that lies within each of us. And exploring something new does not have to be drastic at all.
When we explore we do so at our own pace while honoring what we feel is best for us right now. If you felt empowered to just try a different silicone firmness with your dildos or to buy a sex pillow for added comfortability, you are exploring. Maybe you felt ready to allow your partner to be part of your dilation sessions. Any informed true decision you take for yourself in your journey is a sign of major strength.
Embrace Your Physical Changes
Progress can be physically observed. Some clients may have been so disconnected from their vulvas that they felt very limited to no sensation at all from their pelvic region. When that shifts and you begin to notice what your pelvic muscles feel like, whether they are really tight and tense, or loose and relaxed, that is a noticeable difference and a sign that things are progressing. The process is working, you are putting in the time and seeing results.
Actually, seeing physical changes is a bit difficult however, feeling less discomfort or anxiety with penetration is an indicator that your body and mind are increasingly improving when it comes to managing the pelvic floor muscles’ responses to penetration.
Periodically check in with your body and evaluate how things are going. This comes with a small caveat, though. When examining physical changes associated with pelvic pain, it is crucial that this is done from a non-judgmental perspective that does not add any unnecessarily harsh expectations. As this could derail the amazing progress currently underway.
Check-ins with your body are not performance evaluations or anything like that at all. They should only be done as a way to let you know how you are doing.
Remind yourself when necessary that everyone’s story is unique, and so are their body’s needs. Healing is not a linear process either. There will be ups and downs, but the downs do not necessarily negate all the great progress that your body, mind, and spirit are making.
Life can be unpredictable, and recognizing the victories along the journey is one way you can remain engaged with the healing process. There are numerous examples of pelvic pain treatment wins. Whatever your wins are, I highly encourage you to embrace them with gratitude and pride.
When you feel unheard and unappreciated, it may be time to find another provider. Don’t be afraid to advocate for yourself. After all, you are your own biggest supporter.
Here’s to all the victories made big or small.