Part IV: Physical Therapy for Vulvodynia, Continued

I probably should have explained why I was so prolific earlier this month. I had a week off from work, which is why I was able to write daily. Now that I'm back at work, I don't have nearly as much mental or physical to write. I'm also coming off a crash from about a week ago. I'm fighting a sore throat, low grade fever, and extra weak muscles. Bleh.

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.

I go to physical therapy about two to four times a month -- which amounts to once a week to every other week. The entire staff at the pelvic health center is made up of women, so I feel comfortable going. My physical therapy utilizes a combination of biofeedback, physical therapy, and relaxation techniques. I'm sure there's much more involved, but this is the only way I know how to explain it. I see two different people at the pelvic health center -- a biofeedback specialist and a licensed physical therapist. I meet with the biofeedback specialist more often than the physical therapist.

I am not a doctor or researcher, so I do not entirely understand the mechanisms of biofeedback. I am going to explain my therapy the way I see it. I apologize in advance if anything I say turns out to be incorrect. Here are some articles about biofeedback for vulvodynia that include history and research.

The biofeedback specialist inserts a probe into my vagina, which measures the activity of my pelvic floor muscles. I am able to see my muscle activity charted in the form of a continuous line graph on a computer screen. The specialist walks me through a series of kegel exercises (usually used to help people with urinary incontinence), which allows me to view my muscle activity on the screen. I can "see" the contraction and relaxation of my pelvic floor muscles.

I am supposed to focus on how I feel when my muscles are relaxed and work on keeping them that way all the time. After the kegel exercises, the biofeedback specialist will often play a relaxation CD so that I can focus on relaxing my entire body including the pelvic floor muscles (which, if you'll recall, I was constantly contracting). Between the relaxation CD and watching my muscle activity on the computer screen, I am somehow able to make my pelvic floor muscles relax even more. It's pretty amazing.

The physical therapist focuses on my whole body. She makes sure my pelvic floor muscles, head, neck, back, and legs are all aligned and working properly. If there is tension in a particular area she will massage the area and/or give me specific stretches or exercises to do. When she works on my pelvic floor muscles, she inserts a gloved finger into my vagina to massage and stretch the muscle walls. The procedure is uncomfortable because of the stretching. There is some pain involved, but the therapist is careful to use less pressure if I can't tolerate it.

In addition to the biofeedback and physical therapy, I also have a set of vaginal dilators that I use at home. They come in sizes XS, S, M, and L. The idea is to start at the smallest and work up to the largest as I am able. When I first start a new size, it can be very uncomfortable and involve some minor pain; however, as I have progressed in biofeedback and physical therapy, I have been able to do better with the dilators.

I have been in therapy for about two months and have made significant progress. During my last period, I was able to use the largest tampons without pain. While this is something many women take for granted, I consider it a major milestone.

In my last post about vulvodynia, I'll write about the nutritionist and psychologist the pelvic health center recommended for me.