The Pros and Woes of a Too-Tight Pussy
Written by Lori S., Pleasure Pie contributor. Graphics by Nicole Mazzeo.
Look, I’m not trying to romanticize this crap. Pain sucks. Sometimes, when it feels like I’ve been jinxed with the ability to pee sulfuric acid, or my clitoris is in no-chill, angry-like-the-Bride-in-Kill-Bill mode, I curse whatever vengeful deity is messing with my genitals.
But as much as I’d love to completely indulge in hyper-cynicism, I have to admit that dealing with pelvic pain has, in some ways, made my life better. And yes, that includes my sex life.
Senior year, college. It was 3 o’clock in the morning. There was half an inch of urine in the red Solo cup. I stood in my dorm room, underwear around my ankles, holding the cup between my thighs. Lately, the nighttime urges to pee had become so frequent that it no longer made sense to walk down the hallway to the bathroom every time I had to go. I bore down, breathed hard. I concentrated. After fifteen seconds, a teaspoon more of liquid trickled out. The burning was so strong, it felt like the urine might melt out the bottom of my makeshift plastic bedpan.
I wiped myself, shuffled back to bed, and waited for the next urge. My urethra was on fire. My clitoris felt like a screw someone was straining to tighten with a pair of pliers. Two minutes later, I was up again, Solo cup in hand. It would be another long night.
And so it went. For most of my senior year, I was unwillingly and miserably nocturnal. After hours of straining to pee droplets at a time, exhaustion would finally overtake the pain and grant me a few hours of desperate sleep.
During the day, I carried the pain around with me, squirming in my seat during class, steadying my voice when I spoke, and envying those people lucky enough to merely be bored during a lecture.
I was also on a steady diet of antibiotics. My PCP, determined to treat my symptoms as a urinary tract infection, was prescribing me a marathon of meds. I ended up being on antibiotics for eight weeks straight. But the pain remained.
In the meantime, she sent me to a urologist. This man, after prodding me with catheters, urethral dilators, and various other devices, began medicating me for his diagnosis of bladder spasms.
But still, the pain remained.
I couldn’t have intercourse anymore, either. Before my symptoms started, rough, hard intercourse was one of the many flavors I comfortably enjoyed as part of my sexual diet. Now, it felt like my partner’s penis had suddenly been wrapped in sandpaper, and my vagina was having exactly none of it. Even the most cautious level of gentleness, preceded by extensive foreplay, was too uncomfortable to handle. I couldn't even let my partner enter me.
As if that wasn’t enough, my clitoris – my once trusted sidekick, the source of (what used to be) my greatest pleasure – was now too painful to touch. Even during non-sexy times, my clit felt like an open wound someone was holding a lemon juice-soaked cotton ball to. And oddly, sometimes it was just the opposite, like my clit had switched off and was unable to feel anything. (It’s disturbing when you realize that you’ve gotten to the point where you’re grateful when your clit is numb.) Orgasms, if they came, were like my favorite song being blasted through a megaphone up against my ear: an odd, unsettling combination of a little familiar pleasure and intense, sickening pain.
As someone who loves physical pleasure, this forced celibacy and inability to feel good were heartbreaking. And what was worse, my doctors didn’t seem to have any solutions. I felt exhausted. Damaged. Confused. And trapped in a body that hated me.
But, finally, finally, finally the proverbial clouds and labia parted: I found my “vagina guru.” Not only an OB-GYN, but a vulvo-vaginal specialist at that! After half a year of swallowing pills, gritting my teeth, and spending about as much time in the doctor’s office as the receptionists did, I lay down on her examination table, not daring to hope. This goddess (and I don’t use that term lightly), spent one minute with her fingers inside my vagina and pronounced confidently, “Phew. Your muscles are in crisis mode. You need physical therapy.”
She diagnosed me with pelvic floor muscle dysfunction (I’ll call it PFMD). The kind I have is hypertension—too tight. You know those Kegel exercises that Cosmo cheerfully guarantees will make your sex life the envy of all your friends? Well, my vagina, for whatever reason, was in a constant state of Kegeling, and instead of giving me a porn-level ability to cum, it was wreaking havoc on my nerves, my bladder, everything.
Apparently, all those “bladder infections” I had been treated for were really just healthy, normal levels of naturally-occurring bacteria in my urine. But if it acts like a UTI, it must be one, right? Right? And my so-called “bladder spasms” were just a shot-in-the-dark diagnosis by my urologist. I learned it the hard way: some doctors just throw pills at you if they can’t figure out what’s wrong. And their patients suffer for it.
It also doesn’t help that PFMD is severely under-researched in the medical community. Even though nearly 1 in 4 vagina owners will experience symptoms of it in their lifetime, most doctors don’t know jack-crap about it. And getting insurance for the specific kind of physical therapy needed is another pain-in-the-pussy (pun intended). Since this problem usually affects those with biologically female genitalia, you can thank good ol’ patriarchy for that one.
To be clear: if you’re experiencing any of the symptoms I was, it actually might be something that requires a prescription: a UTI, an STI, or something else. So get it checked out. But maybe drop the words “pelvic floor muscle dysfunction” during your visit, just for kicks.
So I started physical therapy (PT), which I still continue today. This involves a very nice woman (whom I’ve now grown to love) poking, pushing, and massaging the inside of my vagina with her magically-expert fingers. If that sounds like it would be awkwardly erotic, trust me, it’s not. First of all, sometimes it hurts (and not in a yeah-baby-slap-me-again hot kind of way). And second, being surrounded by all the trappings of a standard doctor’s office (sanitary paper on the mattress, latex gloves, and beige-colored everything) takes the sex right out of the situation (for me, at least).
She explained to me that because the bladder, urethra, vagina, and clitoris are so close together in the body, sometimes they act like four babies in a stroller: if one of them freaks out, they all start to freak out. Hence, my vaginal tightness messes up my bladder function, and my bladder pain is being referred to my clitoris (like how heart attack pain is sometimes referred to the left arm).
She taught me to use a dilator (imagine a very skinny, desperately boring dildo) to massage the trigger points inside my vaginal canal (like when you get knots in your back muscles). She also stretches the skin around my clitoris to free it up, and taught me how to “roll” my skin so I can do this to myself at home.
She taught me core exercises to do too, to reduce the overall strain on my pelvic muscles. I debated whether I should include some images of these exercises, but I’m not going to, because sometimes, an exercise that is therapeutic for one person will exacerbate a problem with another person. So, if you’re experiencing PFMD, it’s best to base your exercise routine on the advice of a PFMD physical therapist who knows your body.
My core exercises were picked specifically for me by my PT based on the positions in which I was least likely to clench my particular pelvis. There was a lot of trial and error involved, including performing these exercises at varying intensities with my PT’s fingers inside my vagina so she could feel when and to what exact degree I was clenching (imagine going through a Pilates class with someone’s fingers inside you!). This fingering-Pilates experiment helped us determine that I should only perform these exercises at 25% intensity; any more than that and I end up tightening my muscles and am in more pain afterwards.
She also taught me to “belly-breathe” into my diaphragm, which stretches my pelvic floor, and to let my pelvic floor “drop” throughout the day.
Finally, she constantly underlines the importance of taking care of my mind in order to take care of my body. She taught me specific yoga poses to stretch my hips, thighs, and butt, and encouraged me to seek out “Yin” or “Restorative” yoga to keep tightness at bay and improve my mental health. She assigned me short daily meditations, too.
After months of PT (and some help from a prescribed numbing cream), I began to be able to have intercourse again. But sex for me these days isn’t the rough, wild stuff of my yesteryears. Now it’s tentative, slow, and still, at times, impossible. My clitoral function wavers from (almost) back to fully functioning to distractingly painful even during non-sexy times. I’ve regained the ability to pee decent amounts again, and sometimes, it feels fine. And sometimes, it still hurts like hell.
Yeah. It all kind of sucks.
So, why does this happen to me (or to anyone)?
Well, no one really knows for sure, but I know some things. It’s partly biological: the way my skeleton is aligned. It’s partly physical, too: some of my muscles are too weak, and some too tight. But it’s also a manifestation of mental strain: a combination of stress, anxiety, and PTSD from past sexual traumas. Mental issues can cause different physical symptoms for different people: migraines, ulcers, hives, digestive problems, etc. Maybe you clench your jaw when you’re upset. I do too, except the “jaw” I’m clenching is between my thighs.
So, what’s the upside to all this?
A list, for your reading ease:
My pelvic pain is like a health drill sergeant. If I don’t hydrate enough, my urine burns more. If I hold my urine, I pay for it later. If I skimp on sleep, my pain increases the next day. And if I ignore my mental health, I make it that much less likely to have pain-free days. So, I drink water. I go to the bathroom (a lot). I get as much sleep as I can. And I go to a therapist.
2. I have a greater appreciation of my mind-body connection.
About a year ago, I was in a bad relationship. I finally worked up the nerve to end it, and the next day was the first day in two weeks that I was pain-free! I was stunned. All that earthy-crunchy talk about how the mind controls the body? It really is true sometimes. But reducing subconscious stress? That’s damn hard. Which is basically why I’ve still got these issues.
3. I am a more compassionate lover.
Simply put, when your own genitalia tends to crap out, you learn not to take it personally when your partner has technical difficulties too.
4. I’ve learned to see the beauty in “boring” and savor the subtle.
If I have a day when my clitoris isn’t throbbing in pain, it’s a good day. The sun seems brighter; the sky seems bluer. When I pee and it doesn’t hurt, it’s like finding a twenty dollar bill. And when a boring old piss has the ability to lift your spirits, it’s oddly peaceful.
Sometimes I compare my sexual sensory ability to a bloodhound’s ability to smell. There are plenty of times when I wish I couldn’t “smell” so well. I do miss the thrill of having my men rub my clit with abandon and pound me as hard as they could. At the same time, however, my body is so hyper-sensitive that now, just my boyfriend squeezing my thigh can make me wet. Our sex is slow, connected, teasing, forbidden, and, sometimes, intensely erotic. And our high level of bedroom communication has brought my lovers and I closer together.
5. I’ve destigmatized my body and its functions.
You know all that stuff that “ladies” aren’t supposed to talk about? Favorite sex positions? Orgasms? Peeing? Pooping? Just saying the word “clitoris” used to make me blush. Well, I’ve had to describe all of those things, in shocking detail, to too many strangers to count over the years. Hell, I have (basically) a stranger probing my vagina, butt, and clit once a week, while asking me unabashedly how my last masturbation session went. My GYN and physical therapist don’t bat an eye when I tell them my most intimate details, and so I’ve learned not to either. I’m no longer embarrassed by my sexuality. In fact, I now delight in inviting my lovers to examine my genitals up close in all their fleshy glory. So far, I’ve had two men tell me that my unapologetic attitude about my own genitalia has inspired them to feel more comfortable with their own bits and pieces too.
6. Finally, I’m a better advocate for myself in bed.
I am now the queen of detailed instructions when it comes to sexy time, because now, my body demands it. I demonstrate to my lovers exactly how I need to be touched at any given moment (my needs change often). I don’t have sex until I’m very naturally wet (no fast-tracking with spit anymore; that doesn't work for me). And during intercourse, I control the positions, speed, and depth of thrusting. And you know what? The men I hook up with can totally dig it. I’ve even become comfortable masturbating in front of my male partners, something that I used to shy away from for fear of bruising their egos. But now, I don’t care, not just because f*ck that, but because I deserve what pleasure I can get, and usually, only I can please my temperamental little button.
Let me be clear— as gratifying as all these truths have been for me to discover, there is no lesson important enough to justify chronic physical pain. If I had a choice to live without pain, I would. I think I would have learned all these lessons on my own with a fully functional body …eventually …probably.
But I would be lying if I said that I haven’t gained anything from my pain either. I’m more proactive about taking care of myself. I’m unashamed of my body and its needs. And best of all, I have more feminist sex.
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