Pain with SEX? Let's get intimate!

This valentine's day, people everywhere are thinking about one thing. Love! It buzzes in the air as you walk through the department store and see the heart shaped chocolates, red teddy bears, and roses on every corner. I have spent the last couple weeks trying to search for the perfect gift for my FIRST VALENTINE EVER (my husband, Coleman). This got me thinking about how just a year ago love, romance, intimacy, and specifically sex seemed very distant and very scary. Not just because of my christian upbringing (which taught me the importance and sacredness of sex), but because for over a decade all my vagina has been is a gateway to pain.

Tampons? Painful! Internal ultrasounds? Painful! Pelvic physical therapy? Painful! Therapeutic pelvic wands? Painful! Casually living my life? PAINFUL!

When I started dating Coleman it became clear very early on that I could be dating the man I would marry and share a bed with... forever. And that would mean there would be expectations of me, that I felt completely unprepared for. How would I ever be able to be a participant in intimacy, if not only penetration was agonizing, but the very thought of it increased my anxiety because of all the pain and trauma I had experienced in the past? I mean from the time I was 12 years old men (doctors) were poking, prodding, and cutting into my pelvis. Everything associated with my vagina was associated with pain and medical intervention.

Now, it took time, but I was able to become more and more confident that I was prepared for my wedding night. And most of that feeling came from becoming comfortable with Coleman, communicating with Coleman, recommitting to my pelvic physical therapy, and just learning to love myself deeper... to love that 12 year old girl inside me, who is lying on a plinth screaming bloody murder because it felt like my ovaries were stabbing me.

I have extensive personal experience with pelvic pain, pelvic physical therapy, psychotherapy, etc. But I also have professional experience working in multiple pelvic physical therapy offices and as a doctor of physical therapy student. So, I know a few things about pain science, coping, movement, and pelvic dysfunction. More than too many "experts" will say that to solve all pelvic floor dysfunction kegals are the gold-standard exercise. But that is not true. They can be important in SOME people's therapy programs, but for most they need to learn to breathe, relax, and connect with their pelvic floor wayyyyyyy more than to strengthen these muscles.

Pelvic pain and specifically pain with sex, is COMMON! You and I are not alone, but just because something is common does not mean it is normal. And despite that a significant percentage of men and women deal with this issue, we don't talk about. And if we don't talk about an issue we cannot find solutions for it. I have been blessed with the experience and the knowledge that allows friends and acquaintances have felt comfortable confiding in me about these issues. I have had more than a handful of people approach me, this year, expressing they were having this type of issue and asking for my advice and knowledge. And among these people include men and women; most of which are in their 20s and 30s. Below I have complied 5 of my top tips for anyone dealing with these issues!

1) Get a medical dream team and make sure it includes a Pelvic Physical Therapist! When I was 14 I saw my first pelvic physical therapists and it was HELL on earth. There were actual physiological things wrong with my reproductive organ and the therapist I had pushed me wayyy too far, too fast. This made me extremely hesitant to see another one. But on my first hysteraversary I decided it was time to try again. I was still having pelvic pain and there was absolutely no more ovarian cysts and it was very unlikely any other pathophysiological issue was present. So, I was left with pain due to the trauma, guarding, and anxiety that I was still holding in my pelvis. I remember laying on that table and my therapist doing a pelvic exam. And for the first time in my life, I didn't want to scream when she did it. It was barely uncomfortable. I was finally in a place to work through these secondary issues to my pain. I share this story because it may be that you have seen a therapist before and it didn't work. Or that you are afraid of therapy leading to more pain. But the truth is that you should shop around for the right medical professionals for you. Find one who challenges your body (because we need stress to grow), but who doesn't push you to what is uncomfortable. OR maybe your body just needed time and that is ok too. It is always ok to try again.

2) BREATHE!! Just a take a moment to breathe and think about how and what you feel? Does your chest rise? Does your belly expand? Do you feel breath in your pelvis and back? Do you feel calm or restricted? Breathing is vital for calming the nervous system and allowing the body to relax. EVERYONE should take a few minutes a day to deep breathe where they breathe in, hold, breathe out, hold slowly. During this they should feel the breath growing in all directions; allowing their belly, ribs, back, and pelvic floor to relax and expand. This is a good thing to practice during intimacy if someone is starting to feel pain or anxiety, but also throughout the day to help the body live in a more quiet, calm state.

3) Keep realistic goals for you! Penetration does not have to be the goal! Orgasm doesn't have to be the goal! It is easy to get caught up in wanting your partner to "get what they want". Now that doesn't just include making your partner feel good. In the beginning, I knew all Coleman wanted was for me to feel good and that pressure was difficult. That goal was set too high for me. I had to start with tolerance and over time as my nervous system calmed down things that were so painful became pleasurable. But we both had to be patient.

4) Communicate with your partner. Make sure that you are letting them know when things feel good, when things are painful, or even when things are overwhelming/anxiety inducing. You can trust someone wholly and love someone unconditionally and your nervous system may still go into panic mode when faced with sex. It is emotionally and physically vulnerable. Coleman knew about my past with pelvic pain since our first date. And it was only a few months into our relationship when we talked about what intimacy would look like with me. I, a sweet innocent christian girl, was sitting there telling him about different lubricants, positions, options etc that would be apart of my sex life; at least, at first because my experience (with pelvic physical therapy), had taught me that these things were apart of my future. He was way more receptive than I ever expected. And from early on he did his own research about how best to comfort me when I was having a flare up and how to approach any level of intimacy without increasing my pain. Letting him be apart of all my life, including my pain, allowed him to prepare himself too for being yoked to a women with pelvic pain. Most partners want to be apart of the journey and as a pelvic pain sufferer it is so easy to endure in silence. Heck, for the past decade, I had been dealing with this issue by myself. This was my burden to bear, but as I prepared to marry this man I had to learn to share everything with him, including this trial.

5) Don't avoid intimacy instead explore alternatives and options to help make it enjoyable for your partnership! Intimacy is sacred and a vital part of a strong relationship. Again, the goal does not have to be penetration or orgasm, but taking time to be physically and emotionally intimate with your partner is necessary. And overtime will work to help you reduce your pain and anxiety associated with sex. There are also toys, lubes, positions, coping tools, etc that can be incorporated into intimacy and I can attest from personal experience that different kinds of each of these can effect pelvic pain in different (good and bad) ways.

I know this blog post may be awkward for some, but that is what makes it so vital. There are women and men throughout the world dealing with pelvic pain that is negatively effecting their sex life (by the way in the medical world sex is considered a Basic Activity of Daily Living and something that is necessary part of normal function). This is way more COMMON than we think because it isn't talked about. But this isn't NORMAL, even if countless people experience it. I am here to tell you there is hope! Start with these strategies and call your local pelvic health expert to talk about how you can specifically find relief. I suggest pelvicguru.com to find a provider near you!