My first PAP smear was a disaster.
After being told about the procedure, I’d steeled myself for a manageable discomfort. The same discomfort that accompanied a pair of tight heels or a scratchy sweater with the added benefit of not lasting as long. That is what I’d heard from my mom, from my friends, from magazines. PAP smears suck, but only a little. Then it’s over.
So I expected to leave my gynecologist feeling awkward but distinctly more adult, having endured a trial all of us with vaginas are expected to go through. Instead, I left in tears, bleeding and in pain.
My gynecologist told me that we could try again in a year, but we didn’t. I put off an encore event until my birth control was held hostage by the exam. This time my gynecologist (a different one than the first) used smaller tools and a nice nurse held my hand. The pain was still there, but I got through the exam this time. I also got a diagnosis: vaginismus, a condition where vaginal muscles involuntarily contract when touched, making any kind of penetration difficult or totally impossible. It’s considered one of the most treatable sexual conditions there is, but the treatment has been as discouraging as the condition.
But I’m getting ahead of myself. Before I ever had a PAP smear or attempted sex, I tried and failed at using tampons. It wasn’t a huge deal at the time, and I didn’t think anything of it. I continued to think nothing of it when I attempted to have sex for the first time and that also went badly. Having been told that first time penetration was supposed to be painful (it’s not actually), I thought I’d have better luck later after conjuring up more cooperative vaginal muscles or having penetrative sex. I just knew my body would simply fall in line with what an average twenty-something woman would want.
When I got a serious boyfriend, penetrative sex remained agonizing, and I wasn’t interested in having it. Cue my boyfriend seeking sex elsewhere and me dumping him. It sounds easy and breezy now, but at the time my self-esteem took a blow from the betrayal and the self-loathing that accompanied the confirmation of what I’d suspected: my inability to have penetrative sex was going to steer potential partners away and to women who could be, and do, what they want.
And do what I want.
I consider myself a sexual person. I love sex, and I’d like to have penetrative sex someday.
Even without it, I’m not exactly inexperienced. Still, it’s strange to move through the sexual world as a twenty-something still considered a virgin by many people’s definition. Despite my best efforts, having this one thing consistently denied me makes me feel naive and infantile, and often totally undesirable, on even the best days.
On other ones, I remind myself through wordy and rambling thoughts that maturity and worth can’t be determined solely by whether or not I’ve had penetrative sex.
There are other ways to have sex that aren’t penetrative (all clearly preferable to penetration for me), but it’s difficult to explain that to potential sexual partners without turning them off with the painfully unsexy tale of my compulsively closing vagina. Unfortunately, guys start feeling a certain type of way after you explain why you can’t have the kind of sex with them that they want to have, or expect to have, or are used to having. That way usually comes down to them deciding they’d just rather not deal with it.
As my ex and a couple of other past potentials confirmed, this was the case even before my diagnosis.
Being able to put a name to, and learning there was a solution for, the thing that had plagued my sex life was a relief. My vagina’s refusal to do what I wished – what it was supposed to do – felt like a betrayal. Was it all in my head? Was I imagining the pain that looked likely to doom me to a sexless existence?
Getting that definitive “no” was immensely freeing, and I went home and cried.
It wasn’t long after that I began physical therapy, and my once happy tears turned into ones of frustration. My therapist was new to pelvic floor therapy, and that could be the reason I was so unhappy with her treatment. My appointments were focused on stretching, breathing exercises, and meditation apps. I knew already that most of my treatment would be on my own, but the vague guidance left me feeling more helpless than encouraged. Then my therapist told me there wasn’t a lot she could do for me without doing an internal exam.
This sounded ridiculous to me, the girl in therapy precisely because I couldn’t deal with an internal exam of any kind. I couldn’t even tolerate the Q-tips she suggested I practice with (which doesn’t make me excited for the eventual use of dilators, a tool people with vaginismus use to acclimate to vaginal stretching). At my therapist’s urging, I tried the internal exam anyway and told myself it was worth it if it meant I’d have a cooperating vagina. But the exam went badly. Lasting longer than my tortuous PAP smear, the pain was unbearable, and I couldn’t go through with it.
Eventually, my therapist said I didn’t have to come to appointments at all unless I felt ready for the exam (she sent me home within 10 minutes at an appointment where I was on my period – and I still had to pay full price for that one).
One of our last email exchanges included her telling me it was her goal we do the internal exam at my next visit. I’d only had a handful of sessions by that time so my therapist making goals, especially ones hugely beyond any I’d reasonably have after such a short time, pissed me off so much I stopped making appointments.
In the months following my official diagnosis and quitting physical therapy, I’ve flipped back and forth from viewing penetrative sex as an inevitability and an impossibility.
Sometimes I’m certain it’ll just happen when it happens, and other times (when I meet someone I’d love to have sex with when my solo attempts at treatment are difficult) I’m convinced it never will. I do the calming breaths and try to envision successful and painless penetrative sex. I do the stretches. I try the Q-tips.
So I stop the breathing and the envisioning and the stretching. I ignore the Q-tips. Then I start up again.
A few months ago I joined a group of other people also dealing with vaginismus, and seeing how they faced the same frustrations, I felt more confident about dealing with them. I even picked up a book about the topic, one with more clarity and sensitivity than my therapist had, and I refer to it for tips on how to keep going.
But it’s a process, and like all processes, it is also slow. Motivation and discipline come and go and discouragement seems a constant companion. Regardless of what I do, this one facet of sex has grown and expanded into a massive cloud that hangs over my sex life, casts a shadow over my vagina and lingers always in the back of my mind.
While I try to work my way up to penetration, I also try to convince myself that it’s not necessary. I haven’t been able to master either one.
But I’m working on it.