Catharsis

My husband bought me white roses, just like those that had made up my wedding bouquet.

He bought me a beautiful card that said 'To a special lady on a special day' that spoke about how much he loved and cherished me.

We both said the Yom Kippur Vidui where we asked God to forgive our sins, just like we said on the day of our wedding at the Mincha afternoon prayers.

We lit beautiful scented candles in our bedroom.

Then we dilated me with the large dilator and the dildo, 10 minutes each. We made it into a bit of a game, incorporating it into foreplay.

And then we slipped him inside me. And tears started in his eyes. Because he was in me. And I was smiling. And he wasn't hurting me.

And then we made love. Pain-free, happy, all consuming love. And we cried in each others' arms. Because this was holy and our marriage now bound us in a new and important way. And because we were letting go of the pain and walking into a new life, a new world of possibilities.

A world where our marriage was whole.
And consummated.

Closer

So we are getting closer to our inevitable goal...which is the happy consummation of our marriage.

In short, on the LaMotte scale (no clue how to spell that) they use to evaluate people, their pain and how severe their vaginismus is, I am way at the bottom end of the scale with just a 1 or a 2. So I do have vaginismus and I do tense up, but it's nothing like the more common forms of the issue which have people jumping off the tables or flinching away from the slightest touch, involuntary clamping not only of the muscles but of the legs etc; I have relatively easy vaginismus.

Last session we were able to insert the size Large dilator into me and I'm supposed to practice with that but also the penis dildo/ dong which is meant to be a bit bigger than my husband. That's on purpose because if I can fit the dildo in, I can definitely fit my husband.
Anyway, it's very likely I'm going to be totally cured in just three sessions. Next time being my graduation session where they discuss first-time sex positions with us and so on. Ridiculous, right? A year and a half of woe and misery all cured in just three hours (well, and all the practice time I spend on the dilators at home).

(By the way, this isn't the norm, so if you're in therapy and it takes a lot longer, don't worry- you can still get there!)

It doesn't hurt that we had the bracha of a really big rabbi who is known to accomplish amazing things just before we started this therapy as well.

But wow. It's crazy how close we are.

Virginity

Talli Rosenbaum sent me an awesome booklet that dispels all sorts of myths on virginity. It also has clear diagrams. It's really great.

You can download the English version here (just scroll down). I think everyone should read it.

The packet begins with the following words:

Known by the established term "hymen," the vaginal corona is the subject of many myths and misunderstandings. The most important of these is the notion that a woman's vaginal opening is covered by a membrane that ruptures on penetration. This is incorrect. There is no such membrane. RFSU wishes to dispel the myths and promote knowledge of the true facts. In this booklet, we aim to give you a more accurate idea of what you will find just inside the vaginal opening of every woman.

If a whole packet has to be written to dispel these myths, I am far from being the only person who thought them. Other myths include the idea that you shouldn't ride a bike or a horse because that might "break the hymen"- per this packet, untrue, because "the vaginal corona isn't a brittle membrane, physical exercise doesn't affect it."

Hymens

I'm pretty sure I broke my hymen with the dilators.

I'll ask the lady when I go to my next appointment, but I'm pretty sure.
And it didn't hurt.
And I'm furious.

Because now I understand why I got vaginismus. It did have a psychological factor. It was a psychological factor caused by poor instruction by kallah teachers and gynecologists alike.

It came from the following erroneous descriptions: flap of skin and breaking the hymen.

The hymen is not a flap of skin. Neither does one break through it.

The hymen is, in fact, a ring of skin/ tissue around the vaginal opening (which already exists). When a man's penis enters you, he is simply widening or otherwise stretching the opening. In doing this, he may tear it slightly so that your once perfectly circular opening now has a bit of a jagged appearance. But it doesn't hurt and it's nothing like the ordeal that I thought I would have to face.

You see, when people told me the hymen was a flap of skin or a flap of tissue, I literally believed it WAS a flap.

So I pictured a little square of tissue, kind of like flesh-colored saran wrap but a bit thicker. It was tacked over my vaginal opening, attached on top and attached on bottom. It wasn't attached on the sides, which is how my menstrual blood could leak out. And when I was told my husband would break my hymen, I literally pictured him powering through this supposed "flap" of skin or tissue with his penis, using a lot of force in order to break it. It'd be like piercing an earlobe with a needle, except he'd be piercing my hymen with his penis. And just like you bleed when the earlobe is pierced, I figured I'd bleed after he'd ripped through the flap.

Is it any wonder that I would seize up in totally terrified fear and pain when my husband would try to penetrate me? I had incredibly frightening thoughts of him having to pummel through my hymen at high speed in order to get up the necessary force to smash through and rip that tissue away. That flap of skin haunted my dreams.

Try as I might, I couldn't find it, though. I saw the opening, I felt the pain but I didn't see the "flap." So I just figured it must be somewhere deeper down than I could see. I also thought this more recently, when I was able to put my finger inside. I figured I can fit my finger in but I'm still a virgin, I guess that flap of skin must just be further down still (it's kind of funny in retrospect, I sort of conflated the hymen with the cervix). My gynecologist (the first one I saw, the one who made me feel like a freak) just added to my fear when she told me that it's better if the husband just bams on through because it's easier on the girls that way.

Please tell me: why in God's name do we use misnomers like "flaps" of skin or tissue or "breaking" through the hymen when that is simply not what happens?

There's a ring of tissue around the vaginal opening. That ring is the hymen. When the penis penetrates, it widens and sometimes tears that ring, causing the opening to now look a bit more jagged. The End. Not scary at all.

But instead I wasted a year and a half of my life being terrified with that terror just being added to by the gynos and first therapist I saw.

I found these pictures online of the hymen in different stages (as a virgin, when one has had some sexual activity, when one has had a child etc) and they're really helpful in terms of demonstrating how the hymen is a ring, not a flap.

Maybe I'm the only one who took what I was told really literally and envisioned a real flap of skin. Maybe I'm just particularly stupid. But I don't think it helps anyone when the educators themselves are using misnomers and erroneous terms that lead people to get a really wrong idea about stuff.

Jubilant

Today's appointment at the Center for Female Sexuality was TERRIFIC.

It was awesome. It was amazing. It was inspiring. It was fabulous.

I went to the office in Manhattan. It is a little office on the seventh floor of a nice official-looking building. It is nice and innocuous; not imposing or scary at all.

First, they explained to me how payment works. The deal is they have a certain amount of money that they submit to the insurance as what they think their procedure is worth. So let's say the Center says vaginal dilation is worth $500. The insurance evaluates and tells them how much they think the procedure is worth. Let's say the insurance thinks vaginal dilation is only worth $100. You only have to pay whatever amount is left over after the insurance pays their portion of what they think the procedure was worth- you're only paying what is left over out of that $100. So just hope your insurance estimates a low cost for procedures and you're home clear.

After I filled out some paperwork and surveys, I went inside into a nice room with a round table and three chairs and a window and a bunch of very interesting books about sex to meet Barbara Gross. Barbara is a sexual counselor and she asked me to explain my sexual history and background to her. It was like a therapy session where I just explained and gave background and she asked some more details in order to clarify some things I had said. Barbara is really understanding, compassionate, kind and supportive. I had a great time with her. She even complimented me on stuff and she made me feel totally normal about everything. She says we'll work together on my vaginismus.

After I had finished the psych evaluation regarding my sexual life and history, I went with Kathleen, who is either a nurse or a physician's assistant, and she did a basic physical on me. She took my blood pressure, did a breast exam, had me breathe in and out and listened and then she checked if I had vulvar vestibulytis by taking a Q-tip and swabbing me very gently around my vulva to see if it hurt, which it didn't. Then she worked on dilating me. We started with the smallest dilator- she took it out of a box (it was brand new) and cleaned it and put gel on it and then told me exactly what she was going to do before she did it. I didn't tense up AT ALL. We were able to put THREE of the dilators (sizes Small, Small Plus, and Medium) into me and I only tensed up a teeny-tiny bit the last time, nothing like what it was like with my husband or the two fingers.

I took home four dilators- sizes Small, Small Plus, Medium and Medium Plus. She wants my husband to practice inserting the Small one into me and out of me so that he can understand the angles and not be worried about hurting me because he'll see for himself it doesn't hurt me. The Small Plus I'm supposed to insert into myself and move around and up and down. The Medium I am supposed to dilate with- just let it sit inside me for 10 minutes while it opens me. If I can work my way up to the Medium Plus, that's good, but if not, that's also okay. She'll just work with me the next time I see her.

There are only seven sizes of dilators so I'm already halfway there! They use a dildo for the last size and it looks like a man's penis. I think that's smart because it allows you not to feel frightened because if THAT can fit inside you, then your husband definitely can!

Kathleen mentioned that a lot of times women buy the dilators on their own and they can't get them in, only to come to the Center and with their help, suddenly they can. Sometimes having that person there as a support and an extra push can really help. I asked her how she got involved with the Center and she said she and some of the other women at the Center had worked for Planned Parenthood and then had also moved here. She's really dedicated to this job- she commutes 2 hours to get there!

What was really nice about Barbara was I told her how I felt about how all the Hasidic and Charedi couples can figure sex out and have kids in a year or so and she said that's actually not true. A ton of these couples come to see these people in the Center because they need help. What's nice about Barbara is she can be as open or not open as you need her to be. If you are into using vibrators and experimenting, she'll help you with that. And if you just want dilators for intercourse and no frills, she'll do that for you. She won't try to put her point of view on you, and that's really nice.

Basically I'm super psyched and excited to do my homework working with the dilators this week (which I bought- they cost $15 each) and I'm looking forward to the day that me and my amazing husband are going to have gloriously amazing sex.

Another thing- using the dilators means at some point I'm going to break my hymen myself, most likely (just because of the insertion and penetration of the things). Once that's out of the way, any remaining fear I have will likely disappear.

I feel really blessed that my vaginismus case isn't as severe as some other people's. I feel like there's a light at the end of this tunnel and I recommend that anyone who isn't seeing progress goes to see the people at this Center because they are great and this visit was nothing like that other one I had been on which just traumatized me even more.

I like nice people.

Excited

So this has been a great week full of learning, information and other awesome stuff.

Talli Rosenbaum recommended some therapists to me, ranging from sex therapists to physical therapists. So I, not knowing the difference, called up the sex therapist, Shoshana Bulow. She listened to me talk and said that I was all confident and open and very different from most of the people who call up and talk about this issue and are embarrassed and sad and who even may have histories of rape or sexual abuse. Hence she felt that talk therapy, which is what she does, is not what I need. Conceptually, I'm already in a good place. It's the physical stuff I need to work on.

I hadn't even known that sex therapists aren't licensed to work with women in my situation who need the physical aspect or dilators. It disturbed me that the first woman I had gone to see had led me to believe that she was licensed to follow up with dilators when now here was Shoshana saying that sex therapists are not trained in that. You can learn more about the difference between sex therapy and female sexual dysfunction here.

Shoshana recommended that I check out The Medical Center for Female Sexuality located in White Plains and Manhattan. This place is awesome. It's headed by a frum woman, Bat Sheva Marcus. You can read Dr. Marcus' bio right here. The people who work there are trained in all sorts of sexual dysfunction ranging from vaginismus to vulvar vestibulitis to erecticle dysfunction and so on. The best part about them is that they work with you so that you can pay them. They will let you create an interest-free payment plan so that you can pay them the money over a longer period of time (even maybe a year) because they want to work with you and help you and not bankrupt you. Apparently this center is one of the only centers in the country that does this work. People fly in from all over (including Egypt!) so they can just start the treatment plans they need there and then go back to doctors in their home country with the information they need to continue the plan back home.

This place is relatively new; it was only founded only eleven years ago according to the lady that I spoke to on the phone. You need to put $300 down in order to start - they do take insurance. So you give $150 when you book an appointment and another $150 when you come into the office. The way it works is that the first appointment takes an hour and a half. The first part of the appointment is you sitting down with a therapist and doing a psycho-sexual workup where you discuss your whole sexual history, your fears, worries, concerns etc. Then they take your bloodwork and a nurse practitioner does an exam on you (probably to see the symptoms, like in my case, how and when I tense up). After all that, they come up with a personalized treatment plan for you.

I really liked the section on the website talking about vaginismus, which is the condition I have. I especially liked that they had a section talking about painful sex or intimacy for men to read so that he can understand his wife/ girlfriend better. The site also has testimonials and other great stuff and vlogs and video presentations from Dr. Marcus talking about various issues.

So I have an appointment with the center for after Shavuos and with any luck it'll be good.

Misconceptions

I've been realizing (through the emails I've been getting and the comments to this blog) that there seem to be some misconceptions regarding sexual issues in general and vaginismus in particular. So I'm going to address some of those.

1. Just Relax- Why don't I "just relax" and have sex with my husband? This "just relaxing" taking the form either of taking pills, drinking alcohol or just placing myself in an intimate setting with delicious-smelling candles that makes me feel relaxed. Let me illustrate the answer with a mashal. Let's say someone stabbed you and you were bleeding. Would you say to your body "Just don't bleed?" It's not in your control. Your body is physically deciding to do something that you can't stop. You can try to fix it, of course, by putting a bandage on the cut, but just saying or even thinking really hard "Stop bleeding" doesn't help. And it gets even worse, of course, if you're a hemophiliac. So in my case, even though my mind is thinking really hard, "Just relax," my body doesn't want to. My body is scared and pain-avoidant and anxious and I'm going to have to train it not to see penetration as something scary. That's why I'm going to actually have to go through a process to train my body to relax.

2. Why don't you use lubricants?- Firstly, my husband and I DO use lubricants. We use KY Jelly and olive oil. Aside from this, my husband is great at foreplay and he has no problem getting me wet. I can be wet and wanting him and very lubricated but that doesn't mean we can have sex. Lubricants have nothing to do with having sex when it comes to an issue like vaginismus. Vaginismus, you see, is the vaginal muscles spasming and closing against the penis. When the penis tries to penetrate, it literally can't. I spasm really really tightly so that I kind of close myself off to him. He's lucky if he can even get two fingers inside of me, let alone a penis.

3. Religion causes sexual dysfunction. - Religion doesn't cause sexual dysfunction. Possibly growing up in a really strict house where sex is seen as a shameful thing and getting little to no education about sex at all can cause sexual dysfunction, but that doesn't have to be related to religion. My religious education was really open and broad and considered sex a great and wonderful thing but I'm still in this position. The reason women like me have vaginismus is still undetermined. What's clear, though, is that we see penetration as something that is painful and we are afraid of the pain and get very nervous, anxious and afraid which is why our bodies in a protective mechanism shut down and don't allow the penetration to take place. What we need to do is embrace that anxiety and figure out a way to work through it or past it, usually with the help of a sex therapist.

Talli Rosenbaum said something really interesting about vaginismus to me, in fact:

My approach is as follows: Women with vaginismus, like yourself, are confronted with a basic conflict between the cognitive and the emotional. Your cognitive side gives you a thousand reasons why you want to have intercourse. In fact you do really want to, are motivated to, can’t understand why you shouldn’t be able to. Yet, the emotional side experiences anxiety. This is the side you feel is your enemy. You don’t want that anxiety, that reaction. You want it to go away. My mindfulness based approach is not about choosing the cognitive over the emotional (not to mention, by the way, the physical…because the pain is real) It is about stopping to fight the anxiety that you try to repress until the moment of intercourse when it becomes so overwhelming that you are actually shaking. No matter what people tell you, it is not true that if you want it badly enough, you can do it. “Just Relax” are the two most useless things one can say to a women experiencing what you are going through.

If you want some example of non-Jewish women suffering from sexual dysfunction, you can watch the Tyra Banks Show episode on 'Sexless Marriages' or MTV special "I Can't Have Sex." I do not advise following the advice or actions of the participants on these shows without consulting your sex therapist; I'm posting it up solely so that you can see that plenty of women who aren't neccessarily religious have this issue.

Answers

Regarding my perspective on the modesty of writing this blog, let me put it like King Solomon might have: There's a time to be modest and a time not to be.

I believe with matters of emotional and physical health and wellness there is no time to be modest. This is a time to act, to educate, to inform and hopefully to save lives and people's marriages. People need to know this condition and situation exists and that there are folks out there who can treat it and they are not alone in it.

Regarding a lot of the well-meaning comments asking why I don't:

-Get really drunk and let my husband penetrate me
-Take muscle relaxants or anti-anxiety medication
-Have a hymenectomy (my hymen broken)

It's kind of like a mother  having her first child. She wants to have her baby naturally with a vaginal delivery. Now, if things go really wrong she might end up having a C-Section and that can be good and happy for everyone. And sure, she might have an epidural along the way as well. But she really wants to have the baby naturally if she can mostly because she wants to feel normal.

I want to feel normal. I would prefer to think my husband and I could make love when I'm not hopped up on alcohol (in that case it's also a sin; you can't have sex when your partner is drunk in Judaism) drugs, medicine or having to have some other person intervene and break the tissue.  I'm not saying I won't do these things if they become necessary. But I'd rather do dilators first, if I can/ something more natural and then move along to the more extreme remedies as we go along. I also don't want to become dependent on something (like anxiety medication) when the issue of spasming is something I can learn to control either on my own or the help of a physical therapist.

Maybe I'll change my mind but this is how I feel right now. Everyone is entitled to hold on to a little piece of normality.

Attempt

So we attempted intercourse and we failed.

First we tried the knee-chest position. Then I tried resting my legs on his shoulders. Then I tried the woman-on-top position where I can lower myself down on him.

I'm not sure why I thought this would work and I would be able to say: Yippee! Did it! It didn't work. I was in excruciating pain as always, my husband described the sensation on his end as though I had pretty much clamped up down below and in fact my entire body started to shake in pain and fear. You heard that right. Literally my entire body in uncontrollable shaking and spasms.

This is aside from the fact that it's one thing to get paper cuts on your thumb or finger but when you get the equivalent of paper cuts down below, it hurts. And that happened. I'm not sure how but probably something to do with all that pushing. So now I have minute pinpricks of blood that show up on Kleenex.

I'm not sure what my next step is. Probably dilators, although I'm not sure if I'll just buy them on my own and try to work with them or do them under a doctor's supervision.

I read Talli Rosenbaum's "When Sex is Scary" entry today and felt a little better. Of course, that didn't prevent me from crying hopelessly in my bed with my husband's arms wrapped around me wailing that he will leave me, that he won't love me anymore, that I will never have children and that this is hopeless. And that I don't know if I can love anyone anymore because this is so draining.

On the positive side of things, one person wrote a comment I didn't publish informing me that if I have vaginismus that is Hashem's (well, or his version of Hashem's) way of saying that I should be a nun or celibate all my life. That made me smile a bit because it was so absurd. Weakly. But still, watery smiles are better than nothing.