Part III: Physical Therapy for Vulvodynia - 1st Visit

Disclaimer/Warning: This post contains a frank discussion about specific female organs and sexual issues that some people may find too graphic, offensive, embarrassing, or personal. If you know me personally, you may feel awkward reading about these issues. Rest assured that if you are not embarrassed, I am not embarrassed. If you have any questions, feel free to ask.

As I mentioned in  Part II: Vulvodynia Treatment Options, I found the idea of physical therapy for my vagina quite odd. I'd heard of going to physical therapy for nearly every other part of the body, but for a vagina? Seriously?!

My wonderful gynecologist talked about physical therapy in a very matter-of-fact way. She explained that what I had was a medical issue that needed to be resolve in a medical way. Though an obvious explanation, it helped me to hear it come from a doctor because I'd spent years emotionally beating myself up over this. The doctor then went on to tell me that she had another patient who had not been able to have sex with her husband of 10 years whom she'd referred to the physical therapy place who was now pregnant.

I started to have a little hope.

I scheduled an appointment for my physical therapy with the pelvic health center my doctor recommended. I had no idea what to expect, but my imagination ran wild. I imagined everything from medieval torture devices to kinky sex toys. Fortunately, my treatment turned out to be something closer to the middle. Their entire practice is devoted to helping women improve or entirely overcome various types of pelvic issues -- from incontinence to vulvodynia, and they treat every patient with understanding and dignity.

My first visit involved a long medical history form and interview with the center's director. She explained the center's holistic approach to therapy. She said that they see many women like me and are usually very successful in treating my particular condition. The director mentioned the same patient my gynecologist had told me about before -- the women who had not been able to have sex with her husband of 10 years who was now pregnant (the woman, not the husband).

I felt encouraged.

Many women that come to the practice are out of balance in some way -- whether nutritionally, hormonally, physically, psychologically, or all of the above -- and they like patients to address all their issues. Interestingly, no one in the practice was surprised to see my long list of health problems. I can only assume that quite a few people with multiple chronic illnesses are patients here.

After I finished meeting with the director, I met with one of the physical therapists for my initial evaluation. I felt a lot of apprehension at this point because I knew this was the time I would have to drop my pants. Evaluation involved (painfully) inserting a narrow probe that would measure my pelvic floor muscle activity and sticking what looked like EKG electrodes to my stomach to measure my abdominal muscles.

Turned out that I was constantly contracting my pelvic floor muscles, which meant nothing was getting in there very easily. The physical therapist was pretty shocked at how strongly my muscles were contracted; she said it was one of the worst she'd seen. She also said they'd been able to help women with as serious a problem as I had.

I started to have a little more hope.

After the initial measurements were done, the therapist recommended I do four things:

1. Purchase a particular relaxation CD. The particular CD's they recommend help women relax every part of their bodies, including pelvic floor muscles.
2. Purchase a particular set of medical vaginal dilators. The kind the center recommends are primarily used in hospitals for women who have had cervical cancer.
3. Make an appointment with a particular nutritionist with the hope that I would adopt a diet that could help my prediabetes and IBS symptoms
4. Make an appointment with a particular psychologist to deal with all the emotional issues surrounding my health.

At first I was mildly offended they thought I needed a nutritionist and psychologist because I thought I was already a pretty healthy eater and was dealing pretty well with my issues, thank you very much. However, I had already decided I was going to follow their program because of all their experience, so I made the appointments. I'm glad I did. I'll talk about the nutritionist and psychologist in a future post.

I knew that going through this process would be a financial investment (i.e., expensive), but my husband and I decided that we would go for it and would put everything on our credit card if we had to. Amazingly, my medical insurance covers most of the costs of my treatment.

Well, it turns out that explaining everything has taken much longer than I anticipated, so I will have to do a Part IV (and maybe Part V) to talk about subsequent appointments. Until then, think good thoughts!