Disseminating Knowledge: The Road To a Pain-Free, Enjoyable Sex Life

So I've been thinking about all I have learned on this journey. I think I am probably going to go for the surgery, and we'll see how I fare with that, but even aside from that, there's a lot of knowledge I've gotten/ want to disseminate. Here's my list:

• Orthodox Jewish couples, when they are engaged, should read 'The Newlywed Guide to Marital Intimacy.' It is very clear, still tzniut, and even mentions pain (even though the only type of pain they mention is vaginismus, and their resources in the back do not include sexual pain guru, Dr. Goldstein). So there is definitely room for improvement, but this is still a great start for new couples to feel empowered and knowledgeable about sex. 

• In my opinion, all kallot should either wear tampons before they get married, and should seek guidance on how to insert them if they are confused about how, or should make a special appointment with a NICE gynecologist who will hold up a mirror to their vagina, show them where everything is and how it works and help them insert a finger into there, just so that they are totally familiar with their bodies and able to have sex without being afraid/ without having to rely on the man to know what to do (especially since, if the man is Orthodox, he's most likely never seen a woman's vagina or penetrated her before). 

• Every kallah should be taught what the hymen really is. That way, instead of being afraid of 'breaking the hymen' and having images of this flap of skin or tissue that the man has to break through, which sounds like he has to use force and plug into her like a needle piercing your ear, she will know from the beginning that the hymen is a vaginal RING of tissue which already has an opening because that is where the blood flows from, and the man's penis merely widens the opening. See more on this here. 

• If you are experiencing pain with sex, here's the road to take. 1) If you are totally new to sex, it might just be pressure/ the sensation of something new, so do try more than once, and do try adding lubricant (and try different kinds of lubricant, because maybe one kind will do it for you better than another kind) 2) Go to your gynecologist and check if you have a yeast infection or any other natural irritant that could be easily solved and 3) If you are still having pain with sex, do not ignore it, but rather make an appointment to see Dr. Andrew Goldstein in either DC, New York or Annapolis. Do not bother buying dilators or seeing other people before him; they might misdiagnose you; he has the highest chance of getting it right. Also, it is best if you go to see him ALONGSIDE your significant other or husband (if you feel that he can be supportive about this process). If possible, you and your partner want to be in this together so that the person experiencing pain does not end up feeling like everything is just 'on them' while you lolllygag along. (Obviously, this section may not apply if you were raped, abused or otherwise traumatized; it could still be worth it for you to see Dr. Goldstein, since that might not be all that is going on, but if you feel like the main issue is your anxiety or your psychological health, a sex therapist might be better. That having been said, I incorrectly thought for a time the main issue was anxiety, when in truth it is most likely a physical birth defect.) 

• Do not be ashamed of the pain you are feeling or consider yourself a freak. Rather, read 'When Sex Hurts' by Dr. Andrew Goldstein and see if you can get in touch with others like you (for example, me!) It is very helpful to speak to others who know what you are dealing with and who will not simply tell you that it will all be okay, but who can still respond knowledgeably and supportively to you.

• DO consider seeing a therapist to deal with the issues you are facing. It is very hard to have a unconsummated marriage/ pain with sex/ to not feel like a functioning woman/ possibly have a husband who feels bereft etc. There is no shame in seeing a therapist. There are some therapists who specialize in talking about this issue in particular; otherwise, just see any therapist who you feel could be helpful. I personally see a man who specializes in CBT and he has been very helpful to me.

• DO (if this is important to you) find a competent rabbi to ask your shailot to. My husband and I have a very competent one, who we can recommend to you if you are worried about asking a rabbi the kinds of questions that inevitably come up, such as whether you can have non-penetrative sexual fun (mutual masturbation etc) and so on. 

• Do find yourself people to support you throughout your journey. Whether it is a therapist, a family member or friends, you really do not want to be going through this alone. Even if you have the most amazing husband in the world (and I do), it is still better if you have someone else to help you, especially during those times when part of the issue might be your concern over how your husband will react to something etc. 

You can always write to me, and while I may not always have the time to answer, I do try to write back when I can. And I wish all of you good luck.

Lidocaine

So I got my 5% Lidocaine topical gel and applied it tonight. I wore gloves and smeared 1/4 of a small tube of gel all over my vestibule and also a little ways inside of my vagina. I then waited 20 minutes. Not only did it not numb me, but I experienced intense itching and burning. I immediately wiped it off, then took a shower to get rid of the rest of it. Even now, after the shower, I'm still feeling kind of raw and itchy.

I'm not sure whether this means I did not apply it correctly, or if I had some kind of allergic reaction. I'm going to call my doctor and find out.

Congenital Neuroproliferative Vestibulodynia

I went to see Dr. Goldstein today. He performed an examination, drew blood (to check my hormone levels) and then held the following consultation with me.

CONSULTATION 

At this point, it is highly unlikely that my pain is being caused simply due to contraceptives. For one, I wasn't on them that long (only 4 months or so before getting married). Also, my blood tests last time I came in showed my hormones were back at appropriate levels. So what that means is that whatever dryness or thinness the tissue was experiencing due to not having enough hormones should be rectified at this point, as much as it could be. However, I am still feeling pain, ranging from slight amounts to INTENSE pain (depending on where in the vulvar vestibule he touches with the Q-tip.)

Thus, it seems most likely that what I have is Congenital Neuroproliferative Vestibulodynia. Congenital means 'from birth', neuroproliferative means 'a proliferation of nerves, so basically, too many nerves' and vestibulodynia means 'pain of the vestibule area in the vagina. Women who have this condition can have up to 30 times the amount of nerve endings as should be there, which is a 3000% increase from what should be in there.

The presentation of Congenital Neuroproliferative Vestibulodynia is such that it presents as a burning, cutting, raw, searing, "hot knife" kind of pain. 

So what are my options now? 

There are three (the first two are akin to bandaids; only the third one actually solves the issue):

1) Systemic 

2) Topical

3) Surgical

Systemic: This is where they would have me take anti-depressants or anti-seizure medications, not for those illnesses, since I don't have them, but because they dull nerve endings. They can also have me take SRRIs. Side effects of all these medications are very serious (weight gain, nausea, intense sleepiness, lack of clarity of thought/ dulling of thought etc). Moreover, they do not work very well.

Topical: He can prescribe me LIDOCAINE which is a numbing ointment. I apply it topically to the area and wait 20 minutes before having penetrative sex. For some people, this works well. Problems with this are a) it wears off after a time (it will not always be so effective at numbing you out) b) sometimes it can start numbing your husband, too, which makes him lose his erection and c) there can never be any spontaneity to your sex life because you always have to apply this first. 

Alternatively, he can prescribe me CAPSAICIN which is the extract of chili peppers. The idea is that I would apply it topically which would cause ALL my nerve endings to fire at once, releasing Substance P. I would do this daily for months and basically be wearing the nerve endings down. After consistently making the nerve endings fire over and over again they get tired of doing it. So then I would need to apply it (if I understood him correctly, I'm not sure) at least twice a week for the rest of my life, because if I stop applying it, then the nerve endings go back to being full strength. This is the best non-surgical option because women who do this can get 70% relief for the most part. HOWEVER he does not really recommend it for me because it's basically causing all my nerve endings to fire full strength which means I would be in excruciating pain each time I put it on, especially at the beginning. He says in the end of the day it is up to me, but most women who try it call him up the next day and say "Dr. Goldstein, are you crazy?"

Surgical: I would have a surgery called a vestibulectomy where they basically remove very superficial layer of skin plus the nerve endings there, and replace it with the skin already in my vagina that does not feel pain (aka all the skin outside of Hart's Line). You can look of all the graphics and instructions of the surgery here (but ignore the pictures of hooks; they don't do it with hooks- med students hold it open instead) - also be aware that the graphic is kind of cartoon-y, and that you do not have such a large opening as it seems there. Your opening is normal-sized. They suture it up and I have 6 weeks of recovery time, with 3 weeks of absolutely not being able to go into work. I have to work with dilators to re-stretch the area afterwards, and while I won't feel this kind of pain, I will feel soreness (so a different kind of pain). The surgery is an outpatient procedure. Typically, hospital fees cost $3000. Dr. Goldstein's fee is $9000. He says that you WILL need to fight with your insurance to try to get this covered, and that people have successfully been able to recover up to 2/3 ($6500) back. However, this is with a lot of intense fighting, writing letters on legal stationary etc. Dr. Goldstein is happy to do a Peer-to-Peer Review if we can succeed in getting a doctor on the phone at the insurance company to explain a) why this surgery needs to be done and b) why he is the man to do the surgery. 

In terms of the surgery, there are mixed results. But in short, the vast majority of women experience real relief. The ones who still experience moderate pain are also the women who did not do the dilators nightly after having the surgery.

If I do the surgery, it should be with him. He has done 415 of them or so, and has had other researchers/ people who are not part of his department follow up with 215 women to find out how they fared. 207 of the women are now 100% better and can have pain-free sex. He advocates for my doing the surgery with him vs. anyone else because the devil is in the details and he has done the 2nd-most of these surgeries in the world (the only person who has done more of them than him is Dr. Jacob Bornstein in Israel).

If I want a second opinion to examine me, here are doctors he recommends:

1) Richard Marvel in Annapolis

2) Susan Kellogg in Philadelphia

3) David Foster in Rochester, NY

4) Irwin Goldstein in San Diego

5) Lara Burrows in Akron/DC (but she is also Dr. Goldstein's associate)

In terms of contraception, I should not go on birth control pills (especially if I plan to do the surgery) because the tissue needs to stay as healthy as possible. I cannot get a diaphragm inserted because it will be physically way too painful for me to put in (he thinks) and the same applies to an IUD. So I'm pretty much out of luck with contraception (if I don't do the surgery) unless a rabbi wants to give me a heter for condoms. 

Comparing

Something that I struggle with is comparing myself to others. Not only myself, but my life, my husband, the things I've accomplished. Instead of looking at myself and my life through the lens of: Am I satisfied with what I have done, am doing and where I am going, I instead have looked at it, for most of my life, as a comparison to someone else.

So much so that I actually felt embarrassed about dating some people who I really liked just because I was worried about what other people would say when they found out I was dating them. I worried other people would think that I was dating someone who wasn't handsome enough, wasn't good enough, didn't have enough wealth, didn't have enough material accomplishments.

I realized that if I let all this self-censure go, drop these comparisons at the door, I am able to live a much happier, healthier focused life. When I focus on the fact that I love my husband and I think he's handsome- no matter whether anyone else does or doesn't think so- I become happier. When I focus on the life that I lead and the fact that I am satisfied with it, I feel a lot happier.

This seems like a rather obvious realization, but for me, it wasn't at all obvious. First of all, comparing myself to others had gotten ingrained like a bad habit. And second of all, it isn't so easy to just stop.

But I'm working on it, and seeing positive effects. I am trying to focus on what I like and what pleases me instead of what I think other people will like or what will please them. Because there's something really wrong about me worrying about whether or not the person that I was dating was "handsome enough" or "good enough" to please someone else. After all, I'm the one who would have to live with him, aren't I?

Luckily for me, in the end the man I married is a gem. Part of the reason that I was able to marry him is because 1) I kept it a secret from a lot of people that I was dating him, which meant I didn't have to worry about their censure and 2) Someone I really respected did like him and thought it was great that I was dating him, which kind of gave me the green light. I am very lucky that this happened this way, because at that point in time I don't think I would have had enough courage to go ahead and marry him on my own, by myself, even if others didn't approve of him or think he was "enough."

My husband is so immensely supportive of me. He adores me. He loves me. He does his utmost to make me feel loved, and to talk about all the positives in our intimate life rather than the downsides. He goes out of his way to focus me on what is good in our lives. I love him very much. Unlike me, my husband doesn't care about the judgement of others aside from him. As soon as he had decided he wanted to marry me, I was "enough" in his eyes and nobody could sway him.

I think part of the reason we are afraid to admit our weaknesses to others is the fear that we will be seen as less-than, as "not enough." But my husband, who knows everything about our situation, including all the things that I find shameful, embarrassing, humiliating or sad that have happened to us, always looks at me with love in his eyes. To him, I am always "enough."

And that is such a blessing.

Everything's A Lot Better

I've been seeing a therapist. It happens to be a man, but that wasn't deliberate on my part- that was just the person who was recommended to me. This particular guy specializes at CBT- Cognitive Behavioral Therapy. Basically, the idea behind CBT is that it's a triangle. You have your thoughts, your feelings and your behaviors. If you break into the triangle at any point and change one of those, you can help change the rest of the triangle as well.

What I hadn't realized is that aside from the physical issue of having vestibulodynia, and thus pain upon penetrative sex, my thoughts and feelings were also causing problems for me in the sexual realm and beyond. Here's an example of a conversation that I had with my therapist that helped open my eyes.

Me: So basically, I hate sex, and I feel really guilty about it because I know it's supposed to be this amazing thing that everybody loves.

Doctor: Okay, but you're not really in the same situation as other people. In your experience, sex has been painful. So why would you like it?

Me: I dunno, but still I feel bad. And also, I feel like my poor husband doesn't get to be intimate with me because I don't want to be reminded of sex, and I mean, it's not fair to him, is it?

Doctor: Well, is there anything that you enjoy about sex?

I paused. I had to think about this question for a while.

Me: Well, I don't think I've really let myself enjoy it. I mean, not the penetrative part, which I obviously don't enjoy, but the other parts.

Anyway, I went home and realized that part of what was going on is that I had this idea in my head that I always had to be giving to my husband. I had to be the one making it possible for him to come, and that was my focus in our intimate encounters, which put a lot of pressure on me and made me feel like I only existed for his pleasure. (And yeah, I put this whole burden on myself, mentally- he was on the opposite side of the story, really just wanting me to feel good and I really wasn't letting him.)

(I actually think part of this idea is that I misappropriated some Jewish concepts of selflessness and giving and made them into this thing to sort of punish myself with. I know that the ideal relationship is supposed to be about giving to others, so I made that into my standard, and when I couldn't live up to the standard, was avoidant and felt pretty guilty.)

So I changed my tune. I decided, I'm going to be a little selfish in the bedroom. I'm going to allow myself to focus on myself. And guess what, I suddenly discovered I liked intimacy, as long as it was non-penetrative. In fact, it was fun. So I went back to my doc and discussed it.

Me: So I figured out how to improve our sex life- basically I decided to be selfish in the bedroom. To let my husband give to me, as well.

Doctor: So let me get this right- for your husband to give to you is selfish. Does this mean you think that pleasure for you in general is selfish?

Me: Yeah, well, pleasure where no one else is getting something out of it.

Doctor: Has it occurred to you that maybe it makes your husband feel good to give to you in that way?

I was uncomfortable and shook my head. But I've been thinking about it more. Clearly, my attitude about pleasure and giving is a bit messed up. I am going to have to work on fixing it, but in the meantime, everything is going a lot better with me, my husband, our intimate encounters and our lives. Therapy is really helping me. The best part about CBT in particular is that my doctor gives me homework assignments so that I can really see if I feel like I am growing and progressing and realize I'm not just stuck where I used to be.

Sinfully Safe Sex?

So interestingly enough, The Sisterhood Blog of The Forward newspaper has published an article documenting that Orthodox Jewish women experience a decrease in libido and sex drive while on the pill. Therefore, their solution is to use condoms.

I'm glad the article talks about the side effects of the pill, but I think if they really wanted to be thorough they should have consulted with people like Dr. Goldstein who could explain how the pill can also cause sexual pain (like I have experienced, at least in part). Moreover, I don't understand the solution to use condoms. Dr. Goldstein has told me that it is in my interest never to use contraceptive pills from now on, so obviously I will be looking into other birth control options. I don't quite understand why these women can't use diaphragms or IUDs (but then again, I haven't tried it myself yet).

It seems to me like the use of condoms, given the issues for observant women in terms of halacha, should be a last resort rather than the first step.

25% Better!

Today I went to see my doctor (Dr. Goldstein at the Center for Vulvo Vaginal Disorders). He performed an exam where he did the Q-tip test again, took a culture (because I thought I might have another yeast infection since I was experiencing some pain aside from my usual pain) and then discussed his findings with me.

The deal is that this time when he performed the Q-tip test I rated the pain from 3-6 as opposed to last time, when I rated it from 4-9. This means that the pain has decreased somewhat simply from me going off of my birth control pills and applying the estrogen/ testosterone cream. I am 25% better, so this is a good thing. However, I still have a ways to go.

The doctor and I have determined that I will continue with this treatment for the next 3 months, at which time the maximum benefit that I could potentially reap from this will be apparent. At that time, if I still feel pain, I may need to get a surgery (the vestibulectomy). So we will see.

Last time, when they took my blood, my hormone levels were in the dumpster. Now, the way birth control pills work is that they depress hormone levels to begin with. But apparently, I had a really weird reaction to the birth control pills in that they depressed my hormone levels more than they do those of others who are on the pill who don't get this kind of side effect. And the pill I was on, for those who are curious, is Yasmin (the generic is Ocella). So, to quote Dr. Goldstein "your hormone levels reflected those of a menopausal woman." Here I am, barely 25, and I've got the hormones of a 50-year-old menopausual woman. So the fact that I wasn't getting lubricated or aroused (my libido was not a happy one) was solidly due to the fact that my hormones wouldn't really be allowing for that.

They took my blood again this time, and the hope is that when they run their tests, the hormone levels should be back to normal.

I also learned that it's possible for yeast to be excreted via the rectum because if you eat a high-sugar diet (as I am wont to do), yeast can come that way. So even if I don't have a yeast infection in the vagina, I could be feeling irritated by yeast due to my diet- so I should stop eating lots of sugary foods, if I can. (This because he saw that the external part of me, the perineum, looked a little irritated- potentially by yeast).

Anyway, getting off the birth control pills meant that my vaginal tissue is a lot healthier now, looks less atrophied, and is all around happier.

Apparently there are actually studies that have been done that show that sexual dysfunction is often linked to the use of hormonal contraception. 

There's a bunch of fun side effects to having low estrogen levels. I wonder whether my moodiness this past year has been because of this. Gosh, that sucks- to be ingesting something into your body, thinking that you just want to get settled into your marriage, and yet that same thing is making you moody, depressed, anxious, unable to get lubricated as much as you should be and potentially dry and in sexual pain (in the worst case scenario).

Anyway, I HOPE that I can just get totally cured through this treatment and I won't need the surgery at all, but the doctor said that even if I do need the surgery, everything I am doing to get the tissue as healthy as possible is really important as the first step. So either way it's good.

Apprehensive

I meet with the doctor tomorrow. Guess we'll see what happens.

Tisha B'Av

I don't really relate to tragedy on a national scale. It's too hard for me to wrap my mind around; too great for me to fathom. So while many thoughts flitted through my mind this evening - including the sweet dead baby from the Fogel family- what I found myself most relating to was my own issue of sexual dysfunction.

The entirety of Chapter 3 of Eicha brought it home to me. I really connected to those words. They resonated with me.

"He has worn away my flesh and skin; He has broken my bones. He has besieged me and encircled me with bitterness and travail. He has placed me in darkness like the eternally dead. He has walled me in so I cannot escape; He has weighted down my chain. Though I would cry out and plead, He shut out my prayer. He has walled up my roads with hewn stones; He distorted my paths."

"My soul despaired of peace; I have forgotten goodness."

"It is good to hope silently for Hashem's salvation. It is good for a man that he bear a yoke in his youth."

"For the Lord does not reject forever; He first afflicts, then pities according to His abundant kindness. For he does not torment capriciously, nor afflict man."

I feel guilty for relating Eicha to this situation of mine when it was created to talk of much worse situations. I understand that Bnei Yisrael were literally kicked out of their land. Their Temple was destroyed; compassionate women boiled their own children or took food and refused to give it to their children- instead, eating it themselves. I know that Eicha is about national destruction, national turmoil and true exile, but I have to say that when I was in shul hearing those words, they spoke to me on a personal level, not on a national level.

I know the pain I feel is small and like nothing in comparison to what everyone else has suffered and is suffering, but there it is. It's how I feel. I feel like God has given me this test for reasons I don't understand and I'm not sure yet how long I will be living with it. I feel walled in, besieged and encircled. I hope God will help me.

FSD in DSM-V

So I read in The New York Times (article link here) that Female Sexual Dysfunction is being added to the DSM-V, the psychiatric manual.

The weird part is, they seem to be defining female sexual dysfunction as having a low libido or lack of desire or not being able to reach orgasm. First off, I'm a bit confused as to why that's a psychiatric disorder. Much of the time, there are actual reasons for why people feel that way (ranging from anxiety/ abuse to hormone issues and so on). Although I guess you could argue that depression is also at times just a chemical issue. But what I don't get is- what about the female sexual dysfunction that people like me are experiencing where we actually have physical reasons for what is going on with us? True, taking a pill won't fix us, but it would be helpful for it to be considered a real thing that insurance would cover therapy for, even if it's just talk therapy.

The Toll It Takes

So my husband and I have done a pretty good job of selling you the idea that though we have our ups and downs, in the end of the day we're committed and we're sticking together, no matter what. And while this is the ideal, I just wanted to speak to the toll that all of this has been taking on our marriage.

When my husband and I got married, we were very much in love. All you have to do is look at our wedding video (or have attended the wedding) to see proof of that. We're beaming, totally joyous and radiant. We just look super happy on every level.

As I mentioned when I started the blog, the wedding night itself was fine because we didn't even try to have sex- my husband could see that I was scared and so we refrained. But every night after that meant that we were suddenly part of a highly stressful, highly disturbing and unpleasant situation. We said things to each other that we shouldn't have said. We fought and we blamed each other.

Eventually, we achieved some sort of measure of treatment through the Center for Female Sexuality and the dilation kit. But while that helped me to consummate my marriage, that didn't take the pain away. We got to the point where I was totally avoidant when it came to intimacy and sexuality. I would avoid my husband physically and more importantly, emotionally. I emotionally shut down.

And the thing with this emotional shutdown is that it's not easy to see. Anyone who would be invited to our Shabbat table would see a glowing couple happily setting out cholent, kishke, kugel and the likes. It's not that we are trying to give a credible impression of happiness; it's that doing those non-threatening things, we actually ARE happy. But when it comes to any deep emotional intimacy between the two of us, we've each retreated to our trenches. We've pulled away and it's gotten to the point where we need to actually invest a lot of work into fixing it.

I've chosen to get therapy to work on these issues. I really feel like my husband and I have been living in a war zone. It's just that instead of being under fire from bullets, we and my body have turned into the enemies and aggressors. And it got to a point where it was just easier to retreat from one another than to try to turn this situation around.

I am still hopeful and I think that if our marriage is meant to be and meant to last, we will be able to see it through. But I just wanted to be straight with you about the costs of being in this relationship. It's not easy is the understatement of the century.

It's dark in my corner of the woods but I have hope that there's a lantern on somewhere.

Challah & Vajayjays

So apparently the tests I took at Dr. Goldstein's office came back showing that I had a "light growth of yeast" and thus must be treated for a yeast infection.

I don't know about you, but the very terminology strikes me as funny. When I think of yeast, I think of challah baking. So basically I'm imagining fizzy water and flour somehow getting it on down there. Hey, at least somebody's having fun.

Anyway, apparently there are many causes that can lead to getting yeast infections, ranging from poorly controlled diabetes (scary) to illness, stress and/or eating too many sugary foods (that's something I'm definitely guilty of). I've also heard that sometimes women who bathe in the baths provided at the mikvah (something I do) can get yeast infections that way.

Anyway, the plan is to treat it and then hope it doesn't recur. Vaginas are strange places. I sometimes want to do a Mrs. Frizzle - like trip where I could go on the Magic School Bus and explore mine; maybe then I could become more friendly with it.

Misdiagnosis

I am SO THRILLED right now.

I am super thrilled. You know why I'm thrilled? Because everything that has been happening to me is all due to a MISDIAGNOSIS.

I don't have vaginismus. 


I have vestibulodynia (which is a symptom, not a diagnosis- we'll get to the diagnosis later on).

I found this out today when I met with the esteemed and renowned Dr. Andrew Goldstein of the Center for Vulvovaginal Disorders in Washington, DC.

Someone called 'Missing Out' emailed me about Dr. Goldstein all the way back on December 28, 2011 but I just bypassed it back then. Then someone else posted a clip of ABC news talking about Dr. Goldstein and his knowledge of vulvovaginal disorders. All things considered, I finally decided to check him out. I should have gone to him a lot sooner than this- in fact, I should have gone to him before going anywhere else (and this will be my new recommendation to everybody).

Here's how his office works: You fill out a seven-page questionnaire about your pain and everything you are experiencing. You bring this with you to your first appointment. At the first appointment they take a urine sample (to check if you have yeast infections or anything else), blood (to check if you have hormonal imbalances or anything else), speak with you for a long time and also do a thorough medical/ internal exam.

I started out simply talking to Dr. Goldstein about everything I had tried thus far and how I had been told to use the dilators, had tried pelvic floor therapy and I still always had pain. Just looking at my descriptions of pain on the sheet before even examining me, he told me he was skeptical that I had vaginismus. Nevertheless, he would wait till the internal exam to determine that for sure. After talking everything through, we went to the exam room.

I got up on the chair (it was a regular chair like you might have in a gynecologists office, except the place to rest your feet were lined with fur so they were comfortable). The really cool thing is that he hooks you up to a camera so that you can see everything he is doing or touching on a large screen while he does it, so that I could follow along with him. Before he even started looking at my vulva and vagina, though, he tapped on my stomach and asked me if I felt any pain or just pressure. I said pressure and that it was ticklish. Then he took a Q-tip and touched my bellybutton and asked if it was sensitive. I said it was. That's when he moved on to the vulva.

With his Q-tip, he swabbed the mons pubis, clitoris, labia minora, labia majora, perineum etc and asked me if I felt any pain at all. I said no. Then we got to this dividing line inside of the small lips/ labia minora which is called Hart's Line. When he was outside of the line just touching the labia minora. As soon as he was inside of it with the Q-tip I was tensing up and in a lot of pain- and that was just with a Q-tip!

We soon discovered that this entire area was causing me pain. This area is called the vestibule. However, when he would insert his finger through the hymen to the vagina and thrust it in and out, everything was great. There were no problems whatsoever- I felt no pain. It was only when he was touching the vestibule that I felt the pain.

He then had to spray the entire vaginal area with vinegar because that would turn problematic areas white, but nothing turned white so I don't have those sorts of diseases, which is good.

Then he took me back to his office (after I had gotten dressed) and walked me through the following explanation. He showed me this picture:

Please click it to zoom in. The purple part is the part where I have pain- called the vestibule. What I have is therefore called vestibulodynia. The thing is, that is only a symptom, not a diagnosis. It's like if someone were to have chest pain. That could mean any number of things- not just a heart attack.

He also explained the origins of the word. Odyne is the Greek goddess of pain. Dynia thus means abnormal pain response. And vestibule is the part that is having the abnormal pain response.

There are a dozen different causes of pain in the vestibule (he goes into depth about them here if you scroll down, but I am going to go down the list he gave me in terms of my personal pain).

1. Atrophy- Thinning due to decreased estrogen and testosterone because of taking oral contraceptives. The one I am on, Yasmin, is the worst for causing this.

2. Tight pelvic floor, also called vaginismus- I do not have this. This is because if I DID have this, I would only be having pain in the lower part of my vestibule, but in fact I have pain in the entire vestibule.

3. Congenital Neuroproliferate Vestibulodynia- You are born with too many nerve endings in this area. Some women have up to 30x (3000%) the normal number of nerve endings. The types of pain that I was describing- burning, cutting feeling like a 'hot knife' is associated with this diagnosis. Hypersensitivity of the belly button is also linked to this, because the same tissue that comprises the vestibule is the tissue left over in the belly button.

4-9. Dermatologic conditions - I don't have these which he can tell because he did the vulvoscopy with the vinegar today.

10-12. Vaginitis- some kind of inflammation or infection- I don't have this either.

The thought is that either I have #1- the atrophy and thinning because of the birth control pills that I am on- or #3 - the congenital neuroproliferate vestibulodynia where I have too many nerve endings there because I was born this way.

The Treatment


I need to stop taking birth control pills and need to apply a special estrogen/ testosterone cream that he prescribed to me twice daily over the entire vestibule, digging deep into all the nooks and crannies (so it is going to hurt). Then, in three months, he will reevaluate me to see how much pain remains. If we are lucky, it will all be gone and I will just need to find a new contraceptive method.

If the pain is NOT gone (and he suspects it will not be due to my description of it, the fact that I haven't been married or on birth control pills for very long and because my belly button is sensitive), then we will have to consider a surgery called a vestibulectomy that will have to remove some of the nerve endings from that area. Of course, ideally we are hoping that just taking me off the birth control pills will make all the difference.

I talked to the doctor about women in the Orthodox community in general. A prominent Hasidic Rebbe actually sends all women who are experiencing painful sex directly to Dr. Goldstein, and apparently Dr. Goldstein has also worked alongside Talli Rosenbaum and he has given speeches and lectures in Israel on this topic to very Charedi crowds. He says that most times when Orthodox women think they have vaginismus, they really don't and it is a misdiagnosis. In contrast, he has seen a prevalence of Indian women presenting with real vaginismus.

He also said that if I can get together qualified people in New York who would like to learn from him about different types of sexual pain, disorders and potential treatments, he would be happy to speak about it (which is awesome).

He also gave me a free copy of his book, which is AWESOME (and really helpful at explaining everything). It is called 'When Sex Hurts: A Woman's Guide to Banishing Sexual Pain.' If you are in the same boat as me, you MUST MUST MUST read it and own it. It is so helpful.

I also learned from the doctor that there is an International Society for the Study of Women's Sexual Health, which he is part of. Who knew?

I am just SO HAPPY because he stressed to me that my anxiety is not what caused this or brought this on, this is not a psychological issue, this is not in my head and this does not reflect the fact that I don't care about my husband or anything like that. It is purely a medical issue. And it is treatable.

I'm so happy!

Clinical and Torah Perspectives on Intimacy & Fertility

It seems the Orthodox Union and the Puah Institute are going to be addressing fertility and intimacy issues (link). I am pleased to see that they will be discussing dyspareunia (painful intercourse). Anyone who is Jewish and who either has these issues or wants to learn more about them should attend. It is taking place Sunday, April 29th.

I'm not sure if they've done this conference in the past or if this is the first time. Does anyone know?

You can see the flyer and information and pre-register/ sign up here.

Fifty Shades of Grey

You may have heard about Fifty Shades of Grey by E. L. James. It's making the rounds in America right about now. It's been labelled 'Mommy Porn' and is considered to be erotica that leans more to the kinky side (as it involves BDSM). It was originally published on the Internet as fanfiction starring Edward Cullen and Bella Swann, then was changed to a book about Anastasia Steele and Christian Grey.

The book itself is poorly written, bizarre and the characters (especially Anastasia) are often bland and boring. It does, however, have very steamy sex scenes. It's not the sex scenes in and of themselves that have me thinking, though- it's the semi-brutality and focus on pain and punishment that's expressed in the book. The backdrop to this is that Christian Grey is screwed up because he grew up in an abusive family, and somehow this predilection is a means of therapy for him.

Like a typical Beauty & the Beast story, Anastasia is going to be able to save Christian (we don't see it in this book but there are two more books in the trilogy). What bothered me in the book was how much of the sex was about sheer animality rather than love. I was really moved by the parts where Christian did forfeit control/ go outside of his comfort zone in order to try to give love to Anastasia and help give her the 'more' she was asking for. I like Christian better than Anastasia, but I don't like how domineering and controlling he is. I think he is just on the side of abusive personality himself.

I was trying to figure out why so many people like the book. I know the reason that I (semi) liked it had to do with the character of Christian. I am a sucker for people who are in difficult places undergoing difficult things and who are trying to go outside of their comfort zone in order to be better (in this case, for him to love Anastasia in a way that doesn't mean he also hurts her). Some of the sex scenes were hot but some of them just were too brutal/ animalistic for me. I see sex as an outlet for love, not an outlet for animality. The book as a whole actually made me reflect on what Jewish values of sex are vs. secular values. And I think that there *could* be Jews who would do the stuff that Christian and Anastasia did in a loving way, but it was clear that he was doing it in a punishing/ domineering/ controlling/ possessive/ scary way.

I like the idea of a passionate person who can be controlling or possessive, but not in the way that the characters of Edward Cullen or Christian Grey are. I really like the love story between Chuck Bass and Blair Waldorf on 'Gossip Girl.' I think they are good examples of this kind of relationship. Chuck learns from his mistakes, is aware of when he goes too far and in the end wants the best thing for Blair (which is why he pays for her dowry). His focus is on what is good for her which is why he even lets her leave him for a relationship with Dan Humphrey. And I think that shows real love more than the whole Christian consistently making Anastasia come back to him does.

Melancholy

Pesach was beautiful. We had some friends and family over at our seder. It was wonderful.

I sit here now and listen as the sound of piano music wafts up the stairs. My husband is playing. It's very beautiful and melancholy.

Every time I deny my husband sexual relations his eyes look at me and they look so sad and hurt. If I had feelings left that I could feel, I would probably be pained. But for some reasons, they've drifted so far away from me. I've gone into protective mode and this is also a selfish mode.

I need to figure out a way to get who I really am back.

Fight

So we had sex recently. I had to prep for it by using the smallest dilator, then the middle one, then the largest, then the dildo. It sucked. I hate using the dilators. I cried when I shoved the large size and the dildo in.

It did prepare me for my husband, though. He went in pretty easily. He was all happy and excited about getting to have sex where it wasn't a struggle to fit him inside. I was detached, spending most of my time watching the ceiling and waiting for it to be over. I was also upset because he was being all tender (sweet chaste-like kisses) and I want him to be passionate and excited and exciting, not all tender. Tender doesn't turn me on. Anyway, he was looking forward to my continuing to use the dilators on a nightly basis and thus alleviate pain. I didn't say anything the night we had sex because I didn't want to burst his bubble.

But then I was extremely sore and in pain the whole day after we had sex. And I decided that I don't want to do the dilators, even if he says that long term they are somehow going to help. You try shoving big painful pieces of plastic inside of yourself and see how you feel.

I was upset at him for pushing me away and always putting distance between us. I said that wasn't helping us on an emotional level. So then he said: "You can't feel loved by your wife if she can't have sex, even if it's not her fault." This hurt my feelings. What about this couple?  Why can't my husband be like the husband in that story? Can't love go beyond the physical?

I know that if I don't want to do the dilators, I have to see some kind of doctor or therapist to figure out if there are any other solutions. Maybe I can try Botox. And I don't think this one fight means everything is over between my husband and me. But I do think it means that this is messing up my marriage and that he is being mean. It's mean to say that just because I don't want to be in pain that means I don't love him, even though I get that he is hurting and in pain, too. I guess we're just both being mean to each other.

Let Me Feel My Feelings

Sometimes I want to scream: "Please just let me feel my feelings!"

It is not helpful that every time I say or write something that is socially not the correct or appropriate response or not what you would expect (such as, for example, I feel violated when my husband approaches me and wants to have sex with me) so many commentators jump on me and tell me that either a) I should get a divorce or b) I have serious psychological issues.

It is entirely logical that someone whose experience with sex is that it is ALWAYS PAINFUL but who simultaneously craves and yearns for a loving intimate relationship that is sexual in a positive way feels miserable that the only way her husband can get release sometimes is via non-vaginal penetration. Every time my husband wants to get release in a sexual way, that reminds me of what I consider to be my failure as a woman and as a wife. Since I am currently being avoidant, I try to avoid feeling like a failure (that might also be a kind of coping mechanism). This leads me to not want to engage in sexual activities that are non-vaginal. I also feel used when my husband cums outside of me because it makes me think of myself as part of an I-it relationship (namely, as an object that excites pleasure) rather than an I-thou relationship (the two of us together engage in some sort of sexually blissful experience). Granted, my husband doesn't intend to treat me like an object and he does love me, but that doesn't change how I feel.

It seems sometimes like people who comment here are more uncomfortable with this whole situation than I or my husband am. I think you're uncomfortable with all the concepts involved- a non-traditional marriage/ relationship where sex is not playing the major role, the fact that sexual dysfunction exists in the first place, the fact that sometimes I feel violated even though my husband has good intentions etc. To this I say: Too bad that you feel uncomfortable, that this wouldn't be the relationship that you would want to be in and that for you this would end in divorce. My story doesn't have to end that way. Just because our life is somewhat tragic right now doesn't mean we have to exaggerate the tragedy by ending the marriage completely. 

Let me feel my feelings. Even if my feelings scare or bother you, even if they include wishing I was single or dreaming about other imaginary sexual partners. If my own husband isn't scared by my feelings, non-traditional or out-of-the-box as they might be, why do you need to be? Why do you need to judge? Everyone has ups and downs. I have good days where I love my husband and want to express that love sexually and I have other days where I am in the dumps and dreaming about never having sex again. People have to learn to let things be, to let people grow at their own pace, to let them feel their feelings. Obviously, you don't have to agree with all my decisions or points of view, but to be such Debbie Downers and spend your time informing me of the mental issues you think I have or deciding I ought to get a divorce- well, you should be ashamed of yourselves. What you should be doing is rooting for me and my husband to move on, get through this and become an even better and more loving couple together. We want to beat the odds and end up together. You should be praying that that happens for us too.

I was thinking how so many of you, if your kid said they were gay would be all like "Oh Lady Gaga Born This Way, Rah Rah Rah, Gay Pride Parade, Hurray' and you would let your kid feel his feelings, no matter what they were. Why are you kinder to someone who has discovered he's attracted to members of the same gender than you are to someone who is trying to figure out how to cope with something which is basically chronic pain in the sexual department? Would you tell a woman who was incontinent and peed herself when she laughed or had sex that it doesn't matter and she should just sleep with her husband anyway, even if she's really embarrassed because she might urinate? Wouldn't you comfort her and say you understand how ashamed she feels and how hard things must be for her? A lot of you are not getting this point: Just because there's something that to you seems to be the logical solution doesn't make it the right thing to say or the thing that the person on the other end of the conversation needs to hear. 

I want to get to the same place that you guys want me to get to, where I have sex with my husband and he's happy and it's not horribly painful for me. At the least, I want to be able to get him off without feeling upset or miserable. Telling me that I'm a bad wife, have psychological problems or should get a divorce isn't the way to get me to that goal.

Hypnosis

I hired a hypnotist to try to help me manage the pain of penetration but it seems like I don't like to be hypnotized and that I just can't mentally get into the space where it works. So although he was able to help another woman before me, I don't feel (unfortunately) like he was helpful to me.

I had sex with my husband and it hurt a lot. This is largely because I had not primed myself with dilators and suchlike.

Before that sex part, we had some bad nights where my husband tried to approach me sexually and I felt violated and angry that he was trying to get me to get him off with my hand. (I think my main irritation came when he actually took and positioned said hand.) I felt used and yelled at him that I didn't want him to touch me and that I was tired. I just don't like feeling like it's my responsibility to give him some sort of sexual release, even though on the other hand I get that things are difficult for him.

I guess I am back to having to start creating a routine of using the dilators several times a week if I ever want sex itself to be not so painful. It's so frustrating that the dilators, which are the only thing proven to work, still hurt me nearly as much as a penis would. Inflicting pain in order not to feel pain seems backwards.

I wonder sometimes about what it would be like to live a fulfilling life as a single woman, unmarried, not having sex at all and yet being very happy. I worry when I wonder this that I jumped the gun in getting married and that I got married just to find out what the sensation of sex was all about, which makes it all the more disappointing that I'm not getting to have that. (This meaning I would still have married my husband, just maybe have waited a few years rather than insisting that we should get married right away in part due to my curiosity about sex). I also entertain the fantasy that this condition might not exist if I only had sex with a different partner. Maybe if I could sleep with some other guy, I would suddenly not feel pain. (Of course, I will never know because I'm an Orthodox Jew and adultery isn't okay).

I'd like to be a happy single. Or blissed out with some guy with whom I wouldn't feel the sexual pain. Something other than irritated, snappish wife with a host of responsibilities that include the chore of sex.

Vaginismus in Deborah Feldman's Memoir!

Everyone's talking about that book that's been in the New York Post, on The View, etc, called Unorthodox: The Scandalous Rejection of My Hasidic Roots by Deborah Feldman.

Honestly, the story itself isn't what interested me. What interested me is that this woman was brave enough to put her entire sex life (or lack thereof) on display for all her readers to see. Her sex life meaning her lack of knowledge about sex and her VAGINISMUS.

Yeah.

She did that.

She wrote about her vaginismus in her memoir.


I would put all the quotes from the book online except I think that would be a disservice. I think women suffering from sexual pain should buy the book and read it. So I'll just put some teasers up for you:

P.168- Finally he pokes, I think, in the right area, and I lift up to meet him and wait for the obligatory thrust and deposit. Nothing happens. He pushes and pushes, grunts with the effort, but nothing seems to give way. And in fact, I can't see what should. What is expected to happen here?

P. 172- The days after my wedding, which should be the happiest of my life, become consumed by the effort to consummate my marriage. But as each effort results in failure, Eli becomes more and more anxious, and as a result, his family exerts more and more pressure on us to be finished with it. By the third try, Eli can no longer muster any eagerness from his own body, and I cannot submit to something that isn't there.

(Then there's this weird part where it seems like she has a septum - you know how sometimes people are born with an imperforate hymen or a septum?- which the doctor explains to her as having "two hymens." The other doctor she talks to tells her she has some scarring, which I don't get, because I thought you could only get scarring from having been penetrated and cut/ bruised/ hurt. Maybe someone can explain this?)

P. 179- My feelings are such fragile, scared creatures; they must be coaxed out slowly, and by the time they get comfortable, they are sent into hiding again. Soon I cannot bring myself to reach out to my husband at all, because I dread the day when he will once again reject me...My own body becomes detached from me as well, and I can make it do things without feeling as if I am present.

I really did not like her description of vaginismus, because I think it gives the wrong impression of what is going on and that you can control it, because she describes it as being all in your head- but nevertheless, here goes:

P. 184- The therapist says she can tell from the way I squirm on the table that it's in my head. My head, she says, has more power over my body than I give it credit for. My vagina closes up if my mind wants it to, and no matter how much I convince myself I want it to open, my subconscious knows best, and it is in control. It's called vaginismus. She gives me a book to read about it. I read that the condition is most common in women who grow up in repressive religious environments.

She also talks about how she wrote about her struggle to consummate her marriage on her blog, Hasidic Feminist and how she felt like that was freeing. And she also talks about how she developed major anxiety because of the unconsummated issue and starting throwing up all the time.

Anyway, I'm really glad that someone has written about this in a mainstream and popular book. Hopefully that will raise awareness of the issue, although I'm worried people will think it only happens to people raised in very repressive environments (like the Hasidic community) when it happens to people like me, too, who was not raised in that way.

What I think was really helpful was how she showed her vaginismus connected to everything else. It caused her anxiety panic attacks, it deeply strained (and eventually broke) her marriage and it was also one of the main causes for why she moved out of one city and transferred to Upstate New York. So she showed how this condition can actually impact your whole life, not just the bedroom.

You go, girl! You're giving the whole world a wake-up call and making them a little more aware of what sexual pain means. You rock.

Lonely

Your Eyes Open- Keane

Reading the comments on this blog should make me happy, not depressed. Except, of course, that there are those of you who really have no concept of what I'm dealing with and think that with enough effort of will I can just make it go away or fix it. This is very frustrating because it's really not helpful to read that you think I should seperate from my husband or divorce him. Or for you to tell me that I should just change my attitude and my thinking, perk up and be cheery.

I was just thinking that I feel very lonely and very pressured. I know that other people have much worse things going on in their lives but this is my life and this is the thing that ranks highest in it. I'm in a lonely place and sometimes what people say just makes it worse. What I really need is love and support and sadly the only person who can give me that is the same husband I'm mistreating since it's just him and me in this together. Also because I trust him and I don't trust therapists, especially because (even though this isn't their intent) they give me the ugly feeling that they earn their keep off of my suffering.

Somewhere Only We Know

Somewhere Only We Know by Keane.

Many people have special places. These are places that have impacted their lives in important ways. The place you were when you found out you got your first job. Or the place where you first kissed. Places full of magic and joy.

For some reason this song caught my attention. I feel like my husband and I need to travel to that place, to somewhere untouchable, someplace only we know- in order to get ourselves back together. There's been so much stress on our lives, whether it's due to work, family issues, the sex issue, how the sex issue is sapping away all of our money that I just find myself being avoidant. I don't even want to deal with the sex issue anymore. I just want to leave it alone completely.

My husband's more persistent. He wants me to choose some method of pursuit: continuing with sex therapy, pelvic floor therapy, working with dilators- something. He wants me to be actively doing something, not just assuming everything will fix itself. It's really hard to actively do something when you're trying to just push away, deny or avoid the fact that you even have a problem in the first place.

I like to pretend that the pain will just go away on its own. Then I do a bedikah and just the insertion of the finger or the tampon hurts and I remember that the pain isn't imaginary. It's really there. And I get frustrated and angry. I've even become avoidant with bedikahs. I only do the first and seventh days; I don't like having to do the in between days. (I have no one's psak to do this- it's just something that I'm doing because I don't feel like I can deal with things otherwise.)

I just want to run away from myself and from my life. I want to go 'somewhere only we know' with my husband and live in that fantastical in-between teenage/adolescent phase where you have all the sweaty joy of kisses and making out with none of the penetrative pain I know comes after.

I know running away from my problems isn't really a solution. I know being avoidant isn't one, either. But I'm in a dichotomy where what I know in my brain isn't working with how I'm feeling. I feel like if I just avoid the issue, it will go away. Of course it won't and in the meantime my husband (even if, as those of you who are reading have suggested, I pleasure him in other ways) will be really frustrated. Regarding that whole issue of pleasuring my husband in other ways, I feel (unfairly/ wrongly maybe) used when we do that. Like my hand or my body is some sort of object that, if rubbed against, satisfies a need. It leaves me feeling dissatisfied and unclean. I know that none of that is fair and that there's no reason to think that way- and yet that's how I think. This is aside from the fact that at this point I have some sort of aversion to all things sex- the smell, the stickiness of the semen, the rubbing - everything.

Running away is often portrayed as a romantic solution. Go run away with someone you love or elope and that's supposed to be a good thing. In this case, of course, the real issue is to stand and confront the issues, not to run from them. But even though I know that, I have absolutely no desire to do it. I just want to be safely cocooned somewhere in the loving/ warm part of our marriage (the conversations, massages, kisses, touch) and away from everything else I dislike (stickiness, feeling used, pain upon penetration, my body hating me and me hating it back. Like in that Gemara/Talmud where the butcher chops off the hand that accidentally cut him- it's stupid, but it's still what you do when you're mad. You just become self destructive.)

If I had to take my husband 'somewhere only we know' to try to work this out, where would I take him? Where would we both feel safe? I feel like it would have to be someplace in nature. Maybe sitting on the top of a sand dune staring out at the beach. Or watching a sunset from the beach. Or sitting at the top of a snow-covered hill with a sled beside us. I don't know- there's something cozy in my mind about us two together there in the vastness of nowhere- just us, but so much space all around us. Of course, there's only so much that talking can do for us. There comes the point of action and doing and that's where I'm not really motivated. I'm resenting my husband for making me perform these potentially growth-oriented steps even though I know it's for our own good. I guess I'm getting a preview of how kids sometimes feel towards their parents...

Inside

Sometimes, usually deep in the night, when my feelings flow more freely, I find myself overwhelmed by my feelings for my husband.

I love my husband. Love him. He has rescued me, stood by me, been there for me, helped me through thick and thin. He is so patient and kind and his every wish is for my happiness. I feel so humbled by him and so loved. I don't feel worthy of him. He cares so much about me and I worry that I'll never be able to equal that for him. He is an honorable and respectable man and I admire him and I love him.

But when the day comes, these feelings get hidden- or evaporate- or it's like I block them off from myself. In the daytime, I can get irritated with him or act short with him or be not as kind as I want to him. But at night, that's when I feel close to him- usually while he's sleeping and I'm sitting here typing in the living room.

I want to capture these feelings and have them all the time, not just some of the time.

Banana Split

We interrupt our regularly scheduled doom-filled programming to tell you the following....

Cupcakes are DELICIOUS.

I decided I was going to do something to make myself feel a bit more upbeat. So I went to the bakery and bought a banana-split cupcake. It was amazing. I never knew a cupcake could taste like a banana split in your mouth.

I think if I liked sex half as much as I like sweets, my husband and I would be in business.

In all seriousness- are any of you guys reading this blog husbands? I feel like my husband could use some support as well. So dear men who are married or in relationships with women who have pain with sex- how do you cope? What do you do? Is it just a lot of porn and masturbation for you, or have you come upon a more sophisticated method than that? Any and all advice or responses will be appreciated.

Funny or Die

So I read The Camera My Mother Gave Me by Susanna Kaysen. On the one hand, it was a really good and refreshing read in that it's cool to see someone talk about this subject. And her descriptions were right on- describing her vagina as broken or feeling like someone had taken a cheese grater to her. I was a bit depressed by the end of the book, though, because at the end sex and a happy vagina were still not happening for her. So it was a bit of a downer, although realistic, I guess.

The thing that I noticed is that what enables her to write the book is her gutsy, humorous attitude towards everything. She just confronts everything head-on and she makes her misery really funny. While I think that is a great attitude for those who can do it, I think there are also those of us (like me) who don't really have the ability to use humor as a weapon. She still felt like a woman even though a part of her was not working, while I am having issues figuring out my womanhood, sexuality and so on.

So I feel like I'm more of a dispirited voice (at least in this area) than she is. Less ballsy, less funny-or-die. But I think it's good in that different people cope in different ways. I cope by thinking out loud on this blog. She copes through making the horrible laughable. I've been trying to take some pointers from her and incorporate a bit more humor into my life. It helps a little.

Anyway, when it comes to sex therapy- my insurance doesn't cover it because it's a not-in-network provider. But the bigger issue is figuring out a time when my schedule and my husband's schedule overlap so we could actually go see the person. This is turning into a challenge.

Personally, I've gotten to a point where I feel like I feel like I'm okay with a platonic or celibate marriage (celibate as in non-penetrative, not non-making out). But I know my husband's not. So I guess we have to figure out where to go from here. My issue is that I've decided I dislike everything about sex- the penetration, the pain, the stickiness of the semen, touch that tickles me- everything. Happily, sex is off the table anyway right now because my husband and I are supposed to be reestablishing intimacy (and not sex). I think this is helpful so far. I guess we'll see where we go from here.

Sex Therapy

So my husband and I had our first meeting with our sex therapist. It was in a really lovely little room with swiveling swirly armchairs like you would get in nice coffee shops. We sat next to each other in the swiveling chairs and the therapist sat across from us and we told our long story. It seems like there are a lot of factors (at least in my case) that make it likely that my sexual dysfunction has a psychological component. These are:

-Family issues: Members of my family were not so thrilled that I was marrying my husband. Possibly even though I went through with the marriage, I had a lot of difficulty taking that final step of consummating it or having an enjoyable sex life because of the weight of their disapproval.

-Power issues: Sex in my mind is synonymous with power. Women seduce and ensnare men or men seduce or use women. Because sex in my mind is tied up with power, I am not interested in being powerless and 'submitting' to it as it were. 

-Virginity issues: I was brought up with virginity being really important and anything that could spoil your hymen (tampons, fingers, gynecological exams) was bad. So basically I was told all my life to keep my vagina closed and now I have to switch over to it being open and I'm having difficulty processing that. 

-Emotional issues: I have trust issues in general because people have disappointed me. Maybe these carry over to my man as well and emotionally I can't achieve the intimacy for the sex to work well.

-Anxiety: I was really anxious about my knowledge or lack thereof of sex before my wedding and of what the hymen was and how to do stuff and I now have a body memory of that fear/ pain.

Best of all (I say this sarcastically), there's the possibility (which I don't consider a possibility) that I was abused when I was younger and I just forgot it. I find this very hard to believe because my family was hypervigilant about that sort of thing but my husband pointed out there's always babysitters. I don't think babysitters would do that and I think it's extremely unlikely, but whatever, it's a possibility. 

Anyway, our homework from the sex therapist is to find two hours a week to have a physically romantic and intimate date/ spending of time together with actual intercourse totally off the table. I guess this is probably to take the anxiety out of this experience and for me to develop trust with my husband. 

Comic Relief

I did a bit of research and discovered there are other blogs out there like mine. This is exciting because I think that maybe I can create a sexual pain support group online (even if I can't seem to find one offline). Here are three that seem promising:

-Living with Vaginismus
-"Down There"
-Buaslbutterfly's blog

The things that I really enjoy about skimming through blogs like these are the comical ways people are talking about their experiences. (If you don't life, you cry, right?) Stuff like "My vajayjay is broken" or "Living with Vaginismus: When a Vagina Rebels" or mantras like "Defeat Sexual Pain!" just make me smile. I kind of have the idea of creating a Livestrong bracelet that says something ridiculous like "FSD (that stands for Female Sexual Dysfunction) FTW (for the win)!" Something to remind me to stay strong and that other people are out there dealing with this and that we can make it funny.

I was thinking how jewlry is so expressive. We have jewlry to say all kinds of things- I love you, I support the fight against Breast Cancer, Live Strong etc- why don't we have jewelry about this? There should be jewelry about sexual pain, supporting those with sexual pain and defeating sexual pain.

It occurs to me maybe I should explain why a support group for people dealing with sexual pain would be useful. Well, partially because then we could all help support each other (the comic relief idea where people make it funny) and also because when the only people who know about this are you and your spouse, it's just really hard. And it's easier to relate to someone else having a hard time alongside you rather than your (amazing) spouse who doesn't actually know what the pain feels like.

I also discovered that there's a memoir someone wrote about living with her (seemingly super severe and much worse than mine) sexual pain. It's called The Camera my Mother Gave Me. I'm planning to read it; we'll see if it's any good.