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I've often been told I overdress for situations, something I take as a compliment, now naturally pelvic floor therapy would be no exception. Though I had spent the last week dreading my first appointment, I walked in wearing a silk blouse, oxblood Bally heels, and a full strip lash.
Now, I love a silk blouse, but I had also brought a change of clothes, as instructed, something comfortable and easy to move in. I had decided to make a day of it. After the dreaded visit, I told myself I could walk around Neiman Marcus and go to a nice lunch. My physical therapist is in the center of Chicago, which I don't live particularly near, but I chose a practice inside my larger medical care system so that all my doctors could share charts if needed and possibly make communicating a little easier. I had my first 16 weeks scheduled. I knew I wouldn't be doing the full production every time, but for the first one I wanted something nice.
I walked in, met my physical therapist, and we went straight into breathwork, during which I was informed I was breathing incorrectly. Very cool. We proceeded to spend the next 30 minutes working on my breathing. She explained that I wasn't expanding my belly enough, something that instantly made me uncomfortable, and we started to have a conversation about why.
It was because it made me feel like I looked fatter. For years, pretty much since I was a young child, I was told to suck it in and avoid looking larger at all costs. And during all those years, it was likely that this kind of incorrect breathing had been quietly working on my pelvic floor muscles. So there I was, half an hour into my first appointment, having to relearn how to breathe.
There are a million and one reasons why someone might enter pelvic floor therapy: pre or postpartum, urinary issues, post-surgery care. But if you're anything like me, it's sexual intimacy. I have a very complicated relationship with sex. Intimacy for me is easy, but sex is far more complicated. I have a lot of sexual trauma that, well, sometimes I feel like I've worked through, but other times I still feel very much bewildered and overwhelmed by. To add to it, I write about sex (brag and plug), so I suppose sometimes I worry that I have to seem like I've got it all figured out, like I just have this incredible, amazing, wild sex life. Which, no. I have good sex, but it's complicated.
Penetrative sex has been painful for as long as I can remember. My first time was when I was 18. It was prom night, the person was far too old and a total loser, and we were in a hotel near the airport. Real classy shit. It was painful, but I told myself that was normal for the first time and that eventually it would get better. Except it didn't. As I got older and had different partners, penetration continued to hurt. The pain would cause me to tense up, which, unsurprisingly, only made everything worse. Eventually I started avoiding penetration, and admittedly still do. But I found other forms of sexual intimacy that really fulfilled me, mostly through kink. Which, in part, is one of the many reasons I love kink. I can still feel all those feelings and have that connection to my partner, all the good, without the pain.
I wish penetration were the only issue. I've had a difficult time with just about anything related to my vagina (millennial core?). Pap smears are absolute hell and take months of back-and-forth with my OB-GYN, prepping her that this is going to be like a "thing."
And now that I'm in my 30s and thinking more seriously about having a child, I've had to confront another uncomfortable truth. Part of the reason I've always imagined using a surrogate is because I'm terrified of childbirth. I don't think I can physically handle it. Children are still a few years away for me, but suddenly this thing I had mostly learned to work around felt like something I actually wanted to understand.
Which is how I ended up on a table in the center of Chicago, being told I breathe wrong.
The second half of that first visit consisted of more of an internal exam, though I'm not quite sure they would call it that. And once again, I was on my back thinking of all the times I had failed partners and medical professionals with what I deemed my difficulty. My rational brain knew that this was her job and that it was to be expected, in fact welcomed, something perhaps as normal to her as a barista running to the back to replace the milk. But the very irrational part of my brain was so tremendously disappointed with myself. Why couldn't I just be easy and carefree? Why couldn't I just get over whatever the fuck was going on with me? Why was I making everyone's life, or so I felt, so difficult?
Naturally, she's a professional and was very much not weird about anything at all. She was reassuring throughout the process, kind and empathetic. Afterwards, we discussed a bit more about treatment and she sent me off with homework. I switched back into my "cute clothes," reapplied my perfume of the day, Ethereal Wave by Liis, and made my way out. I spent a good portion of the day completely ignoring what had happened and decided not to deal with any emotions surrounding it until the next week, because I honestly just didn't wanna deal with it.
Over the next few weeks, we found a rhythm. Sometimes the visits were easy and consisted of me working on breathing, stretching, and trying to better connect with my body. Other days were more difficult and included internal exams, cupping, and using dilators while tensing up. It isn't the most glamorous or fun, but it did force me to learn more about the ways my head and body have become misaligned over the years, how I compartmentalize so much of my own emotions just to kinda get through. Things I admittedly didn't think would necessarily come up.
During internal exams, we talked about everything from Meta's Cambridge Analytica incident, Chicago restaurant group drama, Lamy pens, the Duggar family's weird religion, tech layoffs, and even Tom Cruise's famous coconut cake. Which I'm dying to try, I might add. Tom, if you're reading this, I promise to take back everything nasty I've said about Scientology, and I'll stop bringing up the time Leah Remini wouldn't play hide-and-seek with you!
Throughout the weeks, I tried my best to convince myself that it was just a physical issue. That surely it could be fixed with 16 to 20 weeks of physical therapy. And I showed slow signs of progress. I was growing more comfortable with her. My pelvic floor started to feel a little stronger. I even noticed small things like having to use the restroom less, or being able to hold kegels longer. When I worked out, I felt more engagement with my core and felt like I could hold some types of movement longer.
But my internal stress around the issue was mounting. I think I secretly knew it wasn't just physical, and I quickly became frustrated with my lack of progress. I felt like such a failure.
Near the end of one of our appointments, after about two months, I asked her to rank me. I asked if she could tell me where I fell in terms of difficulty compared to her other patients. I have no idea what prompted it besides needing some type of affirmation or confirmation that my pussy and pelvic floor weren't total failures. Like, hey, could you just go ahead and violate HIPAA to affirm me? Unwell.
I have to say, I appreciated her firmness and curtness in shutting it down. She reminded me that not everyone has the same starting point, or even the same goals.
I came back the next week only slightly embarrassed. But after talking to her and to my therapist, it became clear that if I wanted to reach my goals, sex therapy would be abundantly helpful. Yes, there was some weakness in my pelvic floor, which honestly was showing improvement from physical therapy combined with Pilates classes. But I would also tense up anytime she, or for that matter anyone, attempted to insert anything. I'd relax momentarily once I felt comfortable and distracted (see above, re: Lamy pens and coconut cake), and then tense up again the second I remembered where I was and what was happening. My pelvic floor was getting stronger. But strength was just a part of the issue.
I spent a few days kinda just feeling a little pissy for myself. I was frustrated because I really thought I had moved past most of my sexual trauma. Intellectually, maybe I had. My body, apparently, had some additional notes. I wish so badly my body wasn't responding this way, that I could be cool and effortless and sexy. That sex for me, sex in the very traditional sense, didn't have to come with all these caveats and mental preparations. That I could just strike a match and fucking go. Being seen as hot and sexy is important to me. I know for some people it isn't everything, and I really fuck with that. But I, for better or worse, love being seen as hot and sexy, and this was definitely the summer of feeling like a deeply unsexy loser with a weak pelvic floor.
Now, I have to admit that throughout this process I've found out just how disconnected from my body I was. I'm not ashamed of that truth, but I'm not happy about it either. That disconnection meant I wasn't nurturing my body, checking in with it, or challenging it. I ignored cues I probably shouldn't have while also not giving my body the credit it deserves. Now I'm paying attention to what spikes in energy are telling me, when I need to actually take a beat in the gym, when I'm not sleeping well. Pilates has helped more than I expected, all those small isolations forcing me further into my own body, plus the core work that's been quietly strengthening the pelvic floor along with it.
I don't know yet whether any of this gets me to the thing I said out loud earlier, the one about childbirth and the surrogate and not believing my body could handle it. That's still a few years and a lot of appointments away. But I notice I've stopped assuming the answer is no. I'm also now in even more of a sexual conundrum, one that requires work with a sex therapist.
I don't have a clean, wrapped-up point for this, but I will say that if intimacy is difficult for you and you've managed to make it this far, most of us were never given the skills to advocate for our own pleasure, or even the ability to ask for help when something hurts. I don't know your experience, but I think it’s worthwhile to try the hard things. Just keep trying things until something makes you go, wait a minute, what's that? Do what ya gotta do, babes.
And so, for now, my adventures in pelvic floor therapy continue, and I get to add adventures in sex therapy to the list. Aren't I a lucky woman?!
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