At just 27 years old, I had been through several major abdominal surgeries already and I had spent the last few years of my life in chronic pain, diagnosed with stage IV endometriosis.
Most people don’t know what endometriosis is all about. I didn’t, before it happened to me.
I thought that women with endometriosis simply had bad periods. Or, more honestly, I thought they were just big whiners. After all, didn’t every woman get cramps with her period?
But endometriosis is so much more than just bad cramps; it’s what happens when endometrial tissue implants outside your uterus.
Those implants then shed and bleed with each and every period, just as the endometrial tissue inside your uterus does. The problem is, the areas outside your uterus aren’t equipped to handle that bleeding and shedding, causing pain, scar tissue and irreparable damage.
Women can experience endometriosis to varying degrees.
Some just have slightly more uncomfortable periods, while others are knocked down by pain on a near daily basis.
As a woman with stage IV, I had endometrial implants well outside just my pelvic cavity. During one surgery, endometriosis was removed from my gallbladder and up behind my lungs.
The pain became crippling at times.
Not just during my period, though that was certainly the worst of it, but on every other day as well.
Scar tissue made it hard for me to digest food without pain, and the inflammatory nature of this condition had even my joints swelling and aching on a regular basis.
I had gone from being a young, healthy, active woman, to someone who routinely struggled to get out of bed.
On top of the pain, I was also losing my fertility quite swiftly to this disease.
It was a devastating period of my life.
And I was one of the lucky ones because just a few years into my diagnosis, I was able to connect with one of the top endometriosis specialists in this country: Dr. Cook of Vital Health Institute. He looked at my records and was the first doctor ever to call me and say, “I think I can help you.”
And he did. Five years later, my endometriosis is kept relatively under control, something I attribute mostly to the three surgeries I had with Dr. Cook.
But it wasn’t just the surgeries I needed. Because it turns out that when you’re in excruciating pain on a daily basis, you tend to clench up your whole body without even realizing it.
And because the bulk of my pain took place in my pelvic region, I had apparently been clenching my pelvic muscles for years.
Those pelvic floor muscles are just like any other muscle in your body: you clench them for too long and eventually they’re going to start in on spasms.
That’s what was happening when Dr. Cook first saw me. Any time he even attempted to examine me, my vaginal walls shot off into spasms and clenched tightly shut.
Hence the recommendation for physical therapy for my coochie — or pelvic floor physical therapy, as it’s more commonly referred to.
That was what I called it: PT for my coochie. I had to laugh about it, because if I didn’t laugh, I was sure I was going to cry.
Dr. Cook explained that if I wanted to get back to a healthy and pain-free existence after surgery, I would need to see a physical therapist once I had healed.
Yes, I was getting vagina therapy.
This physical therapist would use a combination of exercises and massage to help get my pelvic muscles back to a relaxed and natural state. Yes, massage. Of my vagina.
I left his office with a prescription for pelvic floor therapy in hand and called all my friends to tell them I had a prescription for orgasms because joking about it was the only way I could get through it.
Except, I didn’t even really try to get through it at first.
Upon returning home from surgery, I tucked that prescription away in a drawer and pretended I had never seen it before.
I was feeling better, after all. I didn’t need someone working on my vagina. I was going to be fine. I couldn’t even tell that anything weird was going on down there.
And then I entered into a new relationship. He was great. I maybe even thought he was the one.
But as we jumped into bed together for the first time, his hands wandered into my pants and moments later he said, “Um, is this going to work?”
Apparently he could tell, that quickly, that I was completely clamped down.
And there I was thinking I was open for business. That was when I knew I needed to cash in on that prescription.
A few days later, the subject randomly came up at my Pilates class.
Because apparently I had all the telltale signs of a woman with pelvic floor dysfunction, and the universe was sending me all kinds of signals to get the help I needed.
It turns out, pelvic floor dysfunction isn’t all that rare and it isn’t something caused just by endometriosis.
(Yes, if you have experienced a pelvic pain condition you could probably benefit from pelvic floor therapy, but it’s also something most women who have given birth could probably use. Because having a kid wreaks havoc on those muscles.)
Still, even after doing all kinds of research, I was nervous.
I didn’t want some random stranger fingering me in the name of medicine.
And what if I had an orgasm in the physical therapist’s office? How embarrassing would that be?
I walked into that first appointment with all kinds of trepidation.
Thankfully, my concerns turned out to be mostly unwarranted. That first visit, she just had me do a series of exercises — all with my clothes on — to help her assess the level of my pelvic floor dysfunction.
Your pelvic floor affects so much more than just your ability to have sex pain-free or pee without leaking.
It ties into how all your other muscles work, too, so that at the height of my pelvic floor dysfunction, I couldn’t balance on one foot or hop in a straight line.
On my third appointment, my physical therapist pulled out a contraption that looked a bit like a mini-vibrator and said, “Today, we’re going to try something new.”
I had no idea what to expect, and as she explained that I would be inserting this piece of equipment inside of me and we would be attaching it to a computer in order to monitor my pelvic muscle contractions, I almost ran right out of that room.
But somehow I convinced myself to get up on that table. And in it went.
I laid back as she pointed to various numbers on the screen, explaining to me where a “normal” woman’s resting numbers would be, and how much higher mine were.
This was indicative of how tightly I was unconsciously clenching my muscles. All the time.
She then asked me to intentionally clench. And the numbers just barely rose.
So while I was forever in a state of abnormal clench, I had very little control when it came to exerting any more power than my resting state.
Over the next few weeks, we used that machine to help me gain a better understanding of what was happening with my pelvic floor muscles.
Which, in time, helped me to gain more control.
Over the course of my therapy, there was occasionally pelvic floor massage as well, which involved me laying back and allowing my physical therapist to work those muscles into submission. (It never resulted in an orgasm, in case you’re wondering.) Instead, it was mostly uncomfortable both because of the pain I was still experiencing and because… well, it was uncomfortable.
But with each attempt, we would hook me back up to the computer and I could actually see the progress that was being made.
It took over six months before I received a bill of health from my pelvic floor therapist.
In that time, I learned so much about my pelvic floor muscles and how they affect the rest of my body. I still routinely practice some of the exercises I was taught and I’m tuned in enough with my body to actually know what’s going on down there.
Because I often write about pelvic pain conditions, I hear from women who have been given a similar script for therapy and want to know my thoughts.
I almost always tell them to do it.
I get the anxiety and the embarrassment but if your doctor is telling you that you could benefit from vaginal therapy, find a qualified doctor in your area and give it a try. It won’t be fun, but it will be worth it.
No matter what, know that you aren’t alone in your need for coochie PT.
More women than you would ever realize are doing it because life is hard on our pelvic floor. And sometimes you just need a little extra help to get your body back to where it should be.