On learning to give my body some grace

Of all the carnal counsel that Samantha Jones shares with the rest of the Sex and the City crew, the lesson that’s stayed with me the longest is among her most subtle. While the quartet chat over brunch, Miranda explains to a scandalized Charlotte that doing Kegel exercises “helps you stay tight down there.” Samantha then calmly gives Charlotte instructions on how to perform the secret strengthening workout. “I’m doing mine right now,” she smirks. 

Every time I watch that scene (an occurrence that likely numbers in the dozens by now) I have the same familiar Pavlovian response: I, too, must do my Kegels, right then and there. When the episode came back up in my queue a few months ago, I was surprised by the presence of a new feeling alongside the familiar amusement. For the first time, my immediate response after instinctively doing a Kegel was to feel grateful. 

Early last year, I was diagnosed with secondary vaginismus. Vaginismus is a condition defined by the persistent, involuntary contraction of muscles surrounding the vagina. The simpler, cruder explanation is that it feels like being condemned to a life of reflexive Kegel exercises so strenuous there’s no space for any other function. People generally experience the pain associated with vaginismus (known as dyspareunia) most acutely any time penetration is attempted, whether that’s inserting a tampon or trying to have sex. 

For me, the pain started at a miserably inconvenient time. In the fall of 2021, I was very newly (and very unexpectedly) dating a man I wanted to be having sex with constantly. I grinned myself to sleep the first night we slept together, preemptively exhausted but giddy at the knowledge that we’d have sex at least once more before sunrise, bringing the final tally that night to four. The lustful delirium continued apace for the next few weeks, until suddenly, as if out of nowhere, my body seemed to shut down—at his touch, yes, but also alarmingly at my own. 

At first, we tried to work around this confusing new barrier to intimacy. Perplexed but determined, we took things extra slow, adjusted our angles, familiarized ourselves with even more of each other’s bodies. It seemed to work for a little bit, but by the end of the year, I was exhausted by the sheer amount of work it took to even have a chance at being physical in the ways I most deeply wanted. The months preceding my diagnosis were a cold, seemingly unending flurry of trips to urgent care, appointments with multiple gynecologists, full-panel STD tests, unyielding stirrups, itchy gowns, transvaginal ultrasounds, and so, so much pain. 

I was desperate to regain control of my body. Urgent care had given me nothing but co-pay charges; appointments at my gynecologist’s office had yielded no answers. Every test came back negative, every painful probe emerged inconclusive. In the dark, contemplative days between Christmas and New Year’s Eve, I felt myself coming undone. Having luxuriated in those first few weeks of simple, blissful intimacy before the onset of this strange affliction made the dissonance between my desires and my physical capacities all the more maddening. What’s more, I knew I felt safe. My body wasn’t reacting to present danger. Every time a clinician asked if I might be having issues with arousal, I wanted to scream. No, I’m not having libido issues because of my anti-depressants. Wellbutrin is just fine, thank you. I promise you we would be having sex all day if I could manage it. 

The interrogations were part of what made each new appointment so demoralizing. At each juncture, I had to answer an exhausting litany of questions about my sexual past. I was asked to describe, in detail, anything that might be considered a “trauma.” I cringed internally as I responded with deflective jokes that tumbled, unbidden, out of my mouth. I cringed externally as I shared fragments of a story I never recite in its totality. 

Prior to my own diagnosis, I’d had only a cursory understanding of what vaginismus is, most of which I gleaned from a BuzzFeed essay I read back in 2014. I had no clue that vaginismus could be “secondary,” meaning that it can develop even in people who’d previously had no issues with penetration, much less any real sense of what could have caused it to manifest for me at 30. It wasn’t until being referred to a pelvic pain specialist that I ever got any real answers. As I sat on the exam table in a Midtown Manhattan skyscraper, eyes welling with tears of gratitude simply because the paper-covered surface was heated, I listened to the doctor explain that she’s been seeing exponentially higher rates of vaginismus cases since the onset of the pandemic. The stress of everyday life—no matter what someone’s backstory is—can affect the body in ways both unexpected and profound. Sometimes, cognitive behavioral therapy can be enough of a broker between a tense body and a willing mind. Other times, as in my case, regimented work with a pelvic floor therapist is required. 

To calm my palpable anxiety about the discomfort ahead, the specialist prescribed me a topical Valium cream. I found myself wishing the salve came with its ingestible counterpart; I couldn’t isolate the physical pain from the fear that began to accompany me outside the bedroom. 

Sitting in that office, and later on an exam table with the first pelvic floor therapist she referred me to, I was forced to internalize that I can’t rush my own healing—and that lust, no matter how intense, couldn’t propel me out of years’ worth of pain. Nor could the comfort I felt with the man who’d since become my partner, in life as well as in making sense of this dilemma. I could cry or pout or complain all I wanted, but no matter what I tried, I wouldn’t be able to will myself out of a dysfunction that my body wanted me to feel, or out of the message it wanted me to hear. It took staring at a plastic reproduction of my own anatomy for me to accept that being gentle with myself meant abandoning a stubborn timeline of my choosing and allowing my body to lead me in figuring out what I needed. 

The pelvic floor therapist ended our first session by recommending at-home exercises. Gone were the days of instinctively Kegel-ing my way through SATC episodes. Instead, I had to focus on things that would help the strained muscles relax. First, a series of “restorative” yoga moves. Then, slowly reacclimating myself with the feeling of nonthreatening penetration by gently—she repeated it three times—gently trying to insert a silicone dilator about the circumference of a pencil. I resented the prospect of having to ease into using a dilator thinner than a tampon—yes, I had answers now, but I didn’t like them. As the weeks passed, I got over myself. I was willing to let my pride be the casualty here, but I wasn’t willing to sacrifice my sex drive. So I worked my way through the set of dilators, eventually able to look at the box without feeling my chest tighten. These days, it collects dust somewhere in the morass of my bedroom closet. 

Sometimes I’m reminded of the pain and jolted back to the frightening early days of this saga. More often, though, I’m left with a complicated sense of gratitude—to myself and to my partner, for taking my body’s needs seriously. It’s not lost on me how rare that is. And on some days, when I don’t have the energy to think much at all, I’m just really, really glad I never have to place another order for vaginal Valium.