[Image description: Photo is of dark purple flowers spilling from a white hanging basket.]
Content notice: In this post, I’ll talk about virginity, my journey with pelvic pain, and medical treatments that I’ve pursued. I hope that this epistle will help people to understand one kind of pelvic pain and get a better understanding of what to expect from treatment if they have that kind of pain.
By some people’s standards, I’m a virgin. Why? Because I’ve never received vaginal penetration from a penis. Most of the time, I think that’s hilarious because I’ve had several sexual experiences and consider virginity a very silly social construct. I like to joke about how I could be sacrificed to the Kraken to save a kingdom. A knight would be pleased to rescue me from a dragon. Funny how those scenarios would involve me being imprisoned and subject to pain or death.
In reality, I haven’t had “penis-in-vagina” sex because I have a chronic pelvic pain condition called vulvodynia. More specifically, my issue is called vulvar vestibulitis. That means that the vestibule, an area surrounding the vaginal opening, is inflamed and sensitive to pressure. This makes vaginal intercourse difficult and painful. I seem to have had it at least since puberty; I remember not being able to insert a tampon when I first started my period as a teenager. A little embarrassed but not aware that it might indicate an issue, I just thought “Well, I guess I can’t use tampons. *Shrug.*”
As I developed sexually, I discovered my clitoris and learned how to have lovely external clitoral orgasms, but I never much bothered with trying to penetrate myself. In hindsight, that seems odd to me. I wonder whether I tried it once, felt like I was hitting a wall, and decided not to try again. At the time, any desire for penetrative sex wasn’t on my radar. Even when I became sexually active, I didn’t go to the gynecologist; I had heard horror stories of gynecologists in my hometown who didn’t care if their exams hurt their patients–when I mention that to people, they have their own stories to share. I hope to learn more about why that is soon.
Fortunately, when I did finally see a gynecologist, referred through a routine STI testing appointment, I found one who was compassionate and understood pain. She also happened to have a divinity degree, a big plus for me as a divinity student. A female nurse and a male medical student also attended the exam. The student was nice but clearly didn’t expect to interview a queer, sexually active patient who couldn’t receive penetration. I had a bit of fun watching his reactions as I explained that I have a very fulfilling sex life sans PIV, swinging my bare legs as I sat there in my oversized cloth examination gown. I can be a little emotionally sadistic when it comes to teaching people new stuff.
The gynecologist was very kind. She listened as I explained my inability to be penetrated and then attempted a vaginal exam, flanked by the other two. Oddly, I didn’t feel embarrassed by the three lab-coated figures looming like angels at the foot of a bed; I just thought it was nice to have a team of people who wanted to take care of me. When I said “Okay that hurts” and started to shrink back, she stopped. It had felt like sharp pressure. She said that my hymen was intact and referred me to a pelvic pain specialist. I left the appointment emotionally wrung out but relieved that I was finally taking a step to help myself feel better.
When I visited the pelvic pain specialist a few weeks later, she also attempted an exam, briefly penetrating me with one finger. It burned. She explained that my vestibular inflammation and pelvic muscle tension had created a feedback loop: chronically tense muscles aggravated inflammation, which increased tension and pain, leading to a dread of penetration and more inflammation. Vestibulitis can have many possible causes, she explained. For some people, yeast infections (which I did have as a child) lead to greater pain sensitivity. Some people experience an unusual proliferation of nerve endings. Some have a history of sexual abuse; tensing and guarding is a protective response to the trauma. For others, contact dermatitis from irritating soaps, pads, or underwear materials is the main culprit. I would add that anxiety and socialization in a culture that teaches vulva-owners to expect pain with intercourse compounds those issues.
I’ve become a lot more mindful of my feelings in the past few years, but I wonder how long I experienced chronic tension in my body before I had the language to explain it. I was a sensitive and anxious child who never got in trouble at school. Adults in that arena either didn’t notice my anxiety or didn’t see it as a major problem, as long as I was ‘mature’ and ‘well-behaved’. I wonder how much of the tension I experience was carried from childhood into adulthood without my awareness.
In any case, the specialist and I attacked the problem on multiple fronts; while I might choose never to have PIV sex, decreasing muscle tension and inflammation was a worthy goal in itself.
She prescribed a hormone cream, recommended dilators and physical therapy, and suggested some lifestyle changes. I marched out of CVS that afternoon armed with Shea Moisture Soap, cotton period pads, and unbleached Seventh Generation toilet paper. Of course, before I did that, I had a very quiet crying fit in the Panera Bread–it had been hard to endure the searing pain of the exam, to feel betrayed by my body’s self-protective processes.
As a cis woman, I didn’t feel inferior about not being able to have intercourse, but I did feel dysfunctional as a human being. In reality, people of every gender can’t have or don’t want to receive penetration for many reasons, and that’s okay. It’s not shameful. But I had to remind myself of that.
The treatments are helping; I have been using a high-quality set of silicone dilators, and that process is gradually getting easier. Read this post to learn what I use and how. (Please note, dilation isn’t always a linear progression; some days are easier than others, and I do get frustrated with it sometimes or even skip it for weeks at a time.)
At my follow-up appointment, the pain specialist* managed to do a full exam. As she pressed on different areas, I was able to focus and distinguish different sensations. For example, I could breathe and notice that one area didn’t hurt at all, while another, tenser area felt irritated or sharply painful. The pain hasn’t gone away, but I understand it. I know that I can make decisions about how to respond to pain without judging myself for feeling it.
I might like receiving vaginal penetration some day. I might not. But fortunately, no matter what society thinks about the status of my body, I’m not actually a sacrificial maiden. I get to have as much or as little of whatever kind of sex I want, and I get to nurture my body. In a way, I’m grateful for the pain, as much angst and inconvenience as it has caused; it’s taught me how to find many avenues for pleasure and reminded me to treat my body with kindness when it’s hurting. That’s all for now, but I will continue to write about pelvic pain and share resources.
*I swear, I’m going to have to write an erotica called “The Pain Specialist” now.
More on Pelvic Pain and Treatment:
- Scarleteen article “What’s Pelvic Pain and What Can I Do About It?” – Great introductory article to many kinds of pelvic pain, causes, and treatment
- Sex Out Loud podcast episode: Dr. Ashlie Crewe-Campitella on Understanding Pelvic Health – “Pelvic health physical therapist Dr. Ashlie Crewe-Campitella talks about how she became an expert in her field. We’ll talk about pelvic pain, pain during sex, postpartum conditions, vaginismus, and physical therapy treatment options.”
- Better Sex Through Mindfulness: How Women Can Cultivate Desire by Lori Brotto – A helpful (if cis woman-focused) book about using mindfulness in sex; contains a chapter specifically on “Tuning into Pain”
- “For Men, Stress Often Plays a Role in Pelvic Pain” – While most writing I see on pelvic pain focuses on vulva-owners, people with penises get pelvic pain too. Here’s a little introduction (though, again, cisnormative).