Relationships

“I Didn’t Have Sex for the First Two Years of Marriage.”

Essay on pelvic pain: I Didn't Have Sex for the First Two Years of Marriage

I had been a married virgin for three months when…

…my first physical therapist broke up with me. Actually, she told me that I should “see other people” and that she’d “keep my chart open,” but I knew what that meant: she couldn’t help me anymore.

At the time, I’d been seeing my physical therapist for just over two months. Every week, I lay back on the crinkly paper of her exam table and made awkward small talk while she pushed against the walls of my vagina with gloved fingers, trying to teach my pelvic floor muscles to relax so that I could have sex for the first time — ever — with my new husband.

I knew before I got married that I probably wouldn’t be able to have penetrative sex. Although my husband and I were both raised Mormon, a religion with strict rules about sex before marriage, I’d messed around with a previous boyfriend enough to know that something was up, and not in a fun way. My first attempts at penetration with that boyfriend made me feel like I was being scraped. In response, my pelvic floor muscles spasmed, shutting down entry entirely. I’d expected sex with my boyfriend to be a little painful, since it was my very first time (which is a super damaging myth, by the way!), but it hadn’t just been painful; intercourse was impossible.

Doing some research, I learned it could be that I had vaginismus (the involuntary contraction of muscles in the vagina, which, check!). But I didn’t understand how that overlapped with dyspareunia (a more general term for pain during or after intercourse, which, also check!), nor did I have the first idea how to get it treated as a twenty-year-old without insurance. When I tried explaining my experience to a gynecologist, her medical advice was that I — a teetotaling Mormon virgin — should just try to relax. Drink some wine.

Then I met my husband. Falling in love with him was easy, and I hoped that sex would be, too. But we couldn’t have sex on our wedding night… or the night after that. Still, our honeymoon was practically perfect. We kissed in front of Notre Dame. We went skinny-dipping in the Dordogne River. We got to know each other’s bodies, had a number of orgasms, and in this way tried to tell each other that it didn’t matter, sex could mean lots of things! But beneath the c’est la vie surface there was a huge amount of loss and fear, an unspoken question: would I ever be able to have sex? I called a new gynecologist on our layover home.

Here is a partial list of the treatments I tried: I bought an expensive workbook and four “dilators” — basically, uninspiring dildos of increasing size which I struggled for weeks to insert. I got my thyroid tested, spread estrogen cream on my vulva, and went on anti-depressants (I can’t remember the reasoning — maybe my vagina was depressed?). I went to three physical therapists, one of whom practiced biofeedback therapy. Practically, this meant that every week she put a small electric wand in my vagina. I was supposed to squeeze this wand with Kegels (my pelvic floor muscles) while I watched a line on a screen rise and fall with the pressure. The goal was to get the line to match another line — the world’s most boring, hands-free video game. No matter how many times I played, though, or how many other things I tried, nothing worked.

When I tell this story, people often want to know how my husband handled it all. I get that — social stereotypes about men and sex run deep, and I know there are lots of women whose partners don’t handle sexual difficulty well. In my case, though, our situation affected me much more than my husband. I’m the higher desire spouse, and I’d had more sexual experience before we got married, but it was more than that: It was my body that was keeping me from doing what I wanted to do, and that made me feel broken and unfeminine. I also had this bizarre feeling that I was lying to everyone, that everyone would assume we were having newlywed sex all the time. If I could have, I would have worn a sandwich board that said “STILL A VIRGIN, ASK ME HOW!” Instead, I did what I always do when I need help processing something: I talked to everyone I could.

I asked my girlfriends, my aunts, my cousins, did they ever have painful sex? Did they know anyone who did? Turns out, they did, tons of them, and nearly all of them had experienced the same roller coaster of doctors and treatments, of initiative and inertia. This affected so many of the women I knew, and no wonder: as many as 30% of women experience persistent sexual pain. But none of us were talking about it.

Recently, several books have come out discussing how women’s health in general is taken less seriously by healthcare professionals than men’s health (this is especially true for women of color, trans women, disabled women, and other women with marginalized identities). There is shockingly little research into women’s sexual pain, and though this is slowly improving, there’s a lot of catching up to do.

A year and a half after my first therapist broke up with me, I found a pelvic pain specialist. I’ll never forget the relief of that first appointment. Where most doctors hemmed and hawed at best, or blamed me at worst, this doctor took me seriously. He diagnosed me with vulvar vestibulitis; basically, cells at the entrance to the vagina become inflamed, causing pain, which triggers further pain. He recommended surgery to cut out that tissue. After several more months of my own hemming and hawing, I went for it.

I had intercourse with my husband for the first time two years and two months into my marriage. Like many first experiences with intercourse, it was fine! A little awkward, a little tender. It was also perfect.

Since then, I’ve had a lot of conversations about sexual pain, and I generally give the same advice. First, you know your own body, and you know when something is wrong. You don’t need to drink wine, to relax, to use more lube. You need a doctor who takes you seriously; I recommend starting with a pelvic pain specialist.

Second, dealing with the medical industry is exhausting. Finding someone new, managing insurance, doing research — it’s all a terrible merry-go-round, so assemble your people. Do you have a friend who’s great on the phone? Another who’s a research whiz, or has a gift for understanding insurance? Put them to work. Every vagina takes a village.

Finally — and this is the most important thing — dealing with sexual pain doesn’t make you any less feminine, or adult, or attractive. You are not broken, and regardless of whether or not you have a partner, you are never alone in this.

I’ve been a person who can have penetrative sex for over seven years now, long enough that sometimes I forget I ever couldn’t. What I don’t forget, though, is how difficult — how humiliating, exhausting, stressful, expensive — it was to get to this point in the face of a largely indifferent medical community. Things are getting better, but it’s still way too challenging for women to get the care they need. Sex should be silly, and fun, and pain-free, and getting doctors to care about that shouldn’t be so hard.


Dr. Haylie Swenson is a writer and educator living in Austin. Having recently earned a Ph.D. in English studying animals and environments in literature, Haylie now writes about lots of things, especially bodies, mental health and living with the natural world.

P.S. Scheduling sex and 15 great reader comments on sex.

(Illustration by Alessandra Olanow for Cup of Jo.)

  1. KG says...

    I have saved this post bc I have vestibular vestibulitis too. It feels like if you name a solution, I’ve tried it. I’ve had it for about 4 years now and I finally found something that works for me for now. I’ve been doing acupuncture treatments for about 6 weeks now and it seems that it’s helping immensely. I have also been applying estrogen cream (dr suggestion) but I really believe it’s the acupuncture that’s working. I wanted to mention it in case someone wanted to try it.

  2. Anon says...

    I feel broken and like I’m not allowed to feel sexy because I can’t penetrate myself vaginally. I have other ways I play with myself, including anal, but strangely, the struggle with vaginal stuff impacts my body image. :( I just feel so ugly and unsexy… I have a high sex drive despite this. I can’t see a gyno at this time and am too scared to order/buy dialators myself. Is there no hope for me? What if I just never want vaginal stuff? Is that acceptable? I’m at a loss and upset, and I’m not sure this article made me feel any better to be honest… it just made me feel worse. :(

    • Heidi says...

      You aren’t broken- please keep trying to find what works for you. And find a urogynocologist. They specialize in these conditions!!!

    • michaela says...

      Hi Anon, thank you for sharing this. I’m so sorry you’re feeling this way. When I realized I have vulvodynia (with vulvar vestibulitis like the author), I also felt broken and unsexy and unfeminine. I think you’re doing one really great thing already by focusing on the kinds of sexual pleasure you are able to enjoy. I know it’s scary to reach out for help (it took me four years), but I have seen tremendous improvement in the year that I’ve been working with a pelvic floor physical therapist. You could try ordering some dilators on your own, but I think they would be most helpful if you could work with a PT to develop a program and track progress.

      Another option that sounds like it might be useful to you is to talk to a therapist who specializes in sexuality and sexual dysfunction. I was able to have a session with Jessa Zimmerman (https://www.seattlesextherapist.com) and she really helped me to start dispelling some of the things I had been telling myself about how I was broken or unsexy. She offers online sessions but also has a lot of free resources on her website. I know the app Talkspace is also a low-cost option for therapy, so you might want to look into that too.

      This is so personal and different for everyone, but I found that I needed a combo of physical and mental treatment before I really started seeing progress. There are so many emotions bound up in our sexuality, and the anxiety and fear I was holding about not being able to do something I felt everyone else could was only adding to my physical pain.

      Side note, yes, it’s acceptable and totally okay if you never want vaginal stuff! We all get to choose what sexual activities we want to participate in or not, and vaginal stuff is not the totality of human sexuality. It sounds like you might want this though, so I really hope you can explore this further. Be well and take care!

    • A says...

      Maybe it’s simply OK to not like vaginal stuff? I didn’t like penetration for years, but one day, when I felt very loved and trusted my Partner, who was also very Patient and calm, it simply clicked. I don’t think that’s the path for everyone but that was my experience. I’m gay and I’m currently with a woman who only rarely wants to be penetrated but I don’t consider that as being “less” in any way. I love what we do together. People’s bodies are all different and the purpose of sex, in my opinion, is to listen to each other and do something that both parties like and enjoy. We have sex roughly 3-4 times per week (oral or using Hands) and I’m very happy with our sex life. I think my Partner is too.

  3. Cami says...

    Thank you so much for this post. I went through this process feeling broken and isolated, with the “drink wine and relax” and “do you really feel comfortable with your partner” comments that made me feel like it was all in my head. It wasn’t. It took a gynecologist switch after moving to a new city to say – hey, it may take time, but this can be fixed, I have a patient who just did – and I cried on the spot. No one had ever said that to me. I finally had hope. I didn’t even know pelvic floor therapy was a thing and that I could benefit from it. I ended up moving to the Netherlands for work, and the therapy approach was very different and “hands off” (funny moment in the first session when she said “no you can keep your pants on” haha) but after I left the first session, I had a huge breakthrough – all day every day I was keeping my pelvic floor muscles tense and I had NO idea. When someone said relax, I thought I was. It wasn’t until I did muscle isolation exercises (one example is with abs, pelvic floor, butt – try tensing everything then relax one section at a time. Or try to just tense up one without the others. It’s hard!) with the Dutch therapist, which at first I thought was a waste of time because it was not the manual stretching they did in the US and I didn’t feel anything noteworthy during the session, that I left the office and it all clicked just walking down the street. I could tell my pelvic floor was tense and then I was able to relax it, at least for the most part initially. Takes practice to truly relax. The first day my muscles were tired from forcing them to RELAX every time I realized they were tense again. My mind was blown that the fix could be so “simple” as opposed to a therapist manually stretching things and feeling like no progress was made (plus the US visits were expensive, which made it even harder as a broke student – my Dutch visits were fully covered by my insurance as many times as I needed to go). It still took a little time, but instead of just trying to reduce the symptoms, I was given a key to the root cause. It was such a relief. The therapist even told me to make a point of not sticking in my abs/stomach and to basically manspread while sitting when I could and to just focus on relaxing everything to start changing this deeply set habit. With maintenance exercises and stretching and a bit of time, I now feel in control of those muscles I didn’t even know I was holding tense all day, every day. It took a couple of very long years before I would meet the gynecologist that would lead me on the right path, and like other commenters, I have been lucky to have a supportive and patient boyfriend now husband. Thankfully we were able to work through the moments of frustration. But it’s such a hard thing to go through, and even when I started speaking with my close friends about it, not one of them had experienced an issue like this (which in the height of things no matter how nice they were just felt more unfair – why me? What am I doing wrong?). This article and these comments would have been such a comforting gift when I needed it most, and I hope my comment/story adds to that. Good luck to all of those with whom this article resonates. I hope you find your solution soon, too.

    • Laura says...

      Cami – Thank you so much for sharing this!! I have the same symptoms as the author and have tried the dilators and lidocaine, but nothing has helped much. I’ve noticed that I’m always tense ‘down there,’ even when I’m about to fall asleep. I’ve wondered if that could be the root cause. I did ballet for years when I was in elementary/middle school, and we were always taught to basically suck in our stomach and butt—I think this maybe created the habit. I’m going to do some research. THANK YOU so much for telling your story,

  4. Jean says...

    Thank you thank you thank you for posting this. In tears. This topic needs So. Much. More. Attention.

    Like so many of your posts, I’m saving this to refer back to when I’m in a dark place, as I deal with similar issues, and need it most .

  5. Kate says...

    Thank you for posting this, and for fostering the wonderful, encouraging series of comments that follow! As someone dealing with this and just starting to work toward a solution on what seems like a long road ahead, I’m grateful for the positivity of all the women who’ve shared their stories here. It makes me hopeful!

  6. Stephanie says...

    Thank you so much for posting this. I’m in tears reading the essay and the comments. I’m turning 30 next month and I’ve been sexually active for 12 years — I still haven’t had penetrative sex. I realized I had vaginismus when I was 20 or 21 and it’s been a difficult journey since then. No doctor has known was it was when I told them, and I’ve even experienced psychological trauma and the hands of nurses and doctors who don’t understand and make comments about it during really difficult pap smears. I’ve been so afraid of going to a pelvic pain specialist but this feels very encouraging. I’m lucky I have such a supportive and loving partner and finally found a doctor who encourages me and listens to me. The worst part is the shame, which is compounded by never discussing it or hearing about it. So, again, thank you.

  7. Laura says...

    Wow, I can’t believe I wasn’t the only woman dealing with this but maybe on a milder level. I remember as a teenager it always hurt to put a tampon in and never liked them and couldn’t understand why it was so hard for me. Then when I met my husband and got married, I realized sex was incredibly painful and took several attempts for him to penetrate and sometimes he didn’t get in at all. If and when he did finally penetrate, the sex was very painful and not enjoyable at all. I remember feeling very guilty and alone and it depressed him too. I kept thinking something was wrong with me. Believe it or not, it wasn’t until I had two kids vaginally that that finally fixed the issue. I don’t know if having kids loosened everything up but now I can have sex without a problem. I’m glad to know I wasn’t the only woman out there who had this issue.

    • Lisa R says...

      I had the exact same experience as you did! I’m glad this issue is finally being talked about. The worst part is feeling shame and embarrassment.

  8. Sadie says...

    THANK YOU FOR THIS POST. I have vaginismus as well and struggle so much with feeling alone, like I am lying, and like have I have such a huge secret. I also struggle in dating. When should I tell the guy? how will he take it? Luckily my current boyfriend is very understanding, but it is still me who has to battle feelings of embarrassment, and frustrations with not being the full person I want to be. Luckily I also found a pelvic PT who has helped me so much that I was finally able to put in a tampon pain free for the first time in my life (im 26). It makes me so sad that the health industry doesn’t talk about this, therefore women don’t talk about this. It is such a taboo subject for women and because of that I went so long thinking this pain was in my head and that maybe if I drank more or smoked more I wouldn’t feel pain when engaging in penetrative sex. Thank you for sharing your story, and I hope in the future more women (including myself) can share their story.

  9. A says...

    I’m so grateful that this topic is finally being discussed and talked about openly! When I tried to have penetrative sex for the first time at age 16, it simply would not work. It felt like it was hitting a wall and it was incredibly, incredibly painful. I was so ashamed and embarrassed about this that I didn’t tell anyone. I didn’t know that it was a thing that actually happened to people, and when I finally talked to another woman who had had the same problem, I felt so much relief and so much less alone. In my case it wasn’t a result of a condition that can be diagnosed, but rather I believe I hadn’t been taught enough about my body and the way pleasure works and what the process should be like for a woman. When I was finally able to have sex a year or so later with a different partner, everything felt different because I had given myself the opportunity to explore my body and figure things out on my own without being fed all the things that society tells us about what our first time is supposed to be like.

    As the article mentioned, a lot of these issues arise from actual medical problems that need to be physically treated. I think it’s also important to bring up the fact that as women, we have been taught that we should give pleasure to men before we even think about our own pleasure (and, in fact, it was somehow ingrained in me that pleasure is shameful and shouldn’t even be discussed) and I think at least for me, part of my struggle to have sex had to do with the fact that I wasn’t focusing on enjoying myself and focusing on my own pleasure but rather was anxious about how my (male) partner felt and whether I was “enough” for him. And I think this contributed to a lot of my sexual anxieties.

    P.S. Long time reader, first-time commenter. This blog is such a special, nurturing, lovely place.

  10. Jess says...

    Thank you, Haylie, for writing and thank you for posting, coj! I had vaginismus ten years ago and felt so alone and struggled to find answers. I’m so very happy to see this shared in such a well-read space. I hope medical professionals will become more sensitive and aware and that women will find the answers they deserve.

  11. Anonymous says...

    Amazing to see this story on COJ. A couple years ago I struggled with VVS and like many of you went to many doctors who did not validate my pain. I spent so much time researching my symptoms on the internet and worrying I would never be back to normal. Eventually I went to see a specialist in NYC (he also has an office in DC) and found that my condition was caused by birth control. Using a hormonal cream for several months and getting off the pill helped tremendously. <3 I wish I had this story (and all the comments) two years ago!

    • Sqd says...

      Can you share the doctors name/info?

  12. It’s so amazing to see this article here! I am recovering from a vestibulectomy as I read this (for the record- not as bad as I thought it would be!) and I wish I’d read something like this years ago. I only found the Dr. who would get me the diagnosis by listening to NPR’s bodies podcast after years of struggle and knowing something wasn’t right.

    So many gynecologists dismissed my issues or recommended wine or estrogen- sometimes without even examining me. It was a roller coaster and often the doctors and physical therapists were out of network which added another layer of stress that I see a lot of people here are also dealing with. I am so lucky that my family could help me out with some of the steeper bills, which is a luxury that I know most people don’t have.

    I’m so grateful to the doctors on here pledging to listen to women’s pain and much love to everyone out there dealing with these issues and still searching for an answer. Thank you for sharing Haylie!

  13. Alex says...

    My story: I was never able to insert a tampon and never had a proper ob-gyn check (‘can wait until you have sex’). Me and my husband waited with sex until marriage but meanwhile he was never able to insert a finger. I suspected there might be something wrong but thought we will be able to have penetrative sex when we try in earnest. After wedding and many failed attempts, my gynecologist told me it was probably a thick hymen issue so I had my hymen surgically cut. After more failed attempts I was diagnosed with vaginismus by another gynecologist. He offered no real treatment, just told me to relax and have some wine. Again, failed attempts, so I started to look for answers myself. First, I bought dilators and realized it’s possible to insert things although it was still very painful. Finally, I found out that there are people called pelvic floor physical therapists.

    During several months of therapy I went from crying in pain to bearing quite well whatever my PT does to my vagina. Still, it’s a long way to go before I’m able to have sex.

    It’s ironic that we – as a society – know and talk so much about sex and yet we don’t speak about conditions that make it impossible to have sex at all. Topics like contraception, infertility, when to have sex for the first time are often discussed but when it comes to not being able to have sex you just don’t know where to look for help. Even physicians don’t know much about pelvic floor pain.

    In all this I am fortunate to have the most loving and supportive husband. Like Haylie, I am the one more affected by the situation and I feel like it’s my body that is preventing us from having sex. Although we are a rather low-libido couple, it’s hard to accept that this special sphere of intimacy is out of our reach. But my husband never allowed me to feel any less loved because of that.

    Sending love to all people dealing with pelvic floor pain.

    • Sadie says...

      SAME GIRL. thanks for the comment. it is so helpful to read this and know there are other people with the exact same story. it helps me to normalize myself and to be more forgiving with my body. I am currently in the same boat as you. The dilators are making a slow improvement. Praying for both of us to continue to train our muscles to enjoy moments with our SO in the future!

  14. Lucy says...

    I teared up at this, it isn’t something I’ve experienced but reading 30% of women do struggle made me wonder if there are women in my life unnecessarily struggling. I want to share this with EVERYONE!

    • Liz says...

      Lucy, you sound like a very kind person! Hugs!

  15. T says...

    I lost my virginity during a sexual assault, and have experienced painful penetration ever since. That was 6 yrs ago. I took 2-3 year break from dating and have am now officially dating someone I feel comfortable enough to want to be intimate with.

    It’s hard. I felt very very broken for a long time…none of it due to my own fault. BUT it is my responsibility to get help. I’m back in regular pelvic floor therapy, with dilators and biofeedback. it’s working. my doctors are encouraging me to start trying to have sex. I can feel relief coming.

    Stay up and be honest and askkkkkkkk for help. I know I deserved great sex lol especially with such a f*cked up start to my sexual awakening.

    • Summer says...

      I’m so sorry to hear about the assault, T. I am SO impressed by how you’ve handled yourself since. Go get’em, girl! ;)

  16. Pat says...

    Thank you for sharing your story. This is something that is not talked about and like you, I too suffered. My case was a little different, I went from being able to have sex to suddenly one day, I couldn’t. It was like a light switch turned off. My husband who was my boyfriend at the time patiently sat by my side as we tried to have sex, then it would end in tears. It felt like my body put a wall up and wouldn’t let anything enter it. I did a lot of research, and one day read about Vaginismus and saw the symptoms (fear of pregnancy, not sure you love your partner, sexual abuse). All of that terrified me. Those are all things I had never thought of before. Made me question everything…. Then every time we tried to have sex all of that was on my mind making matters worse. This went on for about 2.5 years, then one day, I can’t even remember the day or where I was, I remembered a trauma that happened to me as a child. I was molested by my own father. It was clear as a day. Then another day I remembered another molestation by a neighborhood kid. I was in denial. I didn’t want to believe my own father would do that. Maybe I wasn’t remembering correctly? These memories circled my brain almost every day, and every time we tried to be intimate. Eventually, the fear of pain during intercourse made me give up entirely on intimacy. I told no one about my memories. I held everything in. I was jealous that other women could have sex, and here I was, completely broken. With terrible memories that I didn’t want to believe. During all this, I had gone to my OBGYN who thought it was hormonal, so we tried new birth control, lube, estrogen cream, blood tests. No one thought it was vaginismus, not once. Not until I had an exam with a new doctor six months ago, and this time it felt like the worst my vaginismus had ever been. The exam hurt. The insertion of the tool hurt. Immediately, she said she was certain that was what I had because she saw my muscles spasm. She asked me if i had been abused, and I was too scared to say yes, so I said no. Saying the words out loud meant it was REAL. After telling my husband what happened at the doctor, and finally admitting to him what happened to me, he urged me to get in therapy. So I did. I started with a regular CBT therapist – she wasn’t so great – then I went to a sex and trauma specialist who is fantastic. After a few months of therapy, meditation, and learning to relax my body, I am happy to say I am now able to have pain-free sex. I am still going slow and making sure I am comfortable, feeling safe, and relaxed, but I am so happy. I have a lot of work to do still. But am so grateful. I am so glad you shared. This should be an open conversation. We are not alone and this disorder can feel so isolating and sad.

  17. Tash says...

    I’ve been following Cup Of Jo for 9 years and this is my first comment. Never has an essay touched me like this one. It meant so much reading someone else’s similar experience. While struggling with the pain it seemed like everyone else was having glorious honeymoons and I was hurting both mentally and physically. Haylie nailed it when she said “It was MY body that was keeping me from doing what I wanted to do, and that made me feel broken and unfeminine.” I, too, can finally have penetrating sex but I’ll never forget that first season of marriage. Thank you for sharing this!

    Also, kudos to our husbands who were both patient and supportive during this time.

    • Sadie says...

      YES! Kudos to husbands and boyfriends! But also, kudos to us for learning and working with our bodies to a path to recovery. I am still working with my PT and dialators and seeing slow improvement. I hopefully that I will one day be able to enjoy penetrative sex. Thanks for your comment!

  18. Anon says...

    Beautiful post!
    I’m in my mid-twenties and have met a great guy and we are interested in sleeping with each other (I’ve never had sex, he has). Pap smears have been incredibly painful for me (but I did get them done) and it didn’t help that during my first one the doctor said I was tight and men like that. So inappropriate. Anyway, do painful paps automatically mean painful sex? Looking for some insight :)

    • Michaela says...

      Anon, I’m not a doctor, so please take with a grain of salt, but I would say…not necessarily. Being in an exam room for an unpleasant routine procedure (with a doctor making gross sexist remarks, no less!) is a very different environment than being with someone you trust and want to be intimate with. You may have been tensing up more than usual in that situation.

      When you and your partner decide to have sex, communicate your worry beforehand, try to take things slowly, and make sure you’re feeling comfortable. It might help to discuss what you might experience and how you two would handle it before, too, just for your peace of mind. I have vulvodynia and my partner and I have an agreement that if I need to stop or do something else because of the pain, it’s okay that we stop. I know that sounds like it’s a given in a consensual relationship, but establishing that ahead of time outside of an intimate moment really helped me feel that I could advocate for my body without worrying about relationship consequences.

      If you do find that you still feel tight and are experiencing pain, I would recommend bringing it up with your doctor again (hopefully a different one)! Good luck!

    • Anonymous says...

      I also find paps to be incredibly painful every time (I’ve had many by different docs) and in no way find sex painful! Hope that helps ease your mind.

    • Cat says...

      I’ve had four children and still find paps very uncomfortable, so I wouldn’t necessarily link it. Just follow your body and your heart and don’t do anything before you’re ready.

    • A says...

      A tip for pap smears that sometimes helps me: wiggle your toes while it’s being done. Somehow this works for me! You can also ask them to use a virgin speculum. I find paps painful but do not find sex painful, I second all these comments.

  19. Shana says...

    Thank you for writing this intimate and so totally relatable and normalizing piece about women who have pain during sex. I tried so many mental and physical treatments and its comforting to hear that I am not the only one.

  20. Anon says...

    I’m working through vaginismus RIGHT NOW. Got married as a Mormon virgin a little more than a year ago, and knew before I got married that sex would be tough, because having a pelvic exam at the gynocologist was extremely painful (and caused cramps and bleeding for days afterward). Took six months to see a doctor, then an OBGYN, then a pelvic floor therapist to start working through it.
    It’s such a difficult problem, but one thing helps: I keep telling myself is that I’m healthy and have a wonderful, functioning, body. My vagina is just very overprotective of me :)

  21. Jill says...

    This is incredibly interesting. Thank you for sharing.

  22. Anon says...

    My story:
    Married as a virgin, did not have penetrative sex for 8 years because of vaginismus. It was very hard on my marriage. I tried many of the therapies listed, and was also told to drink wine and relax. Another time a Dr googled vaginismus in front of me:). I had two children via IVF. 4 years ago, I met with a new sex therapist, and it clicked. There was a learning curve, but I really enjoy sex now. I am so glad I didn’t lose my marriage. My husband didn’t respond perfectly, but we were working through it together and both doing our best with a situation that we knew nothing about. There were some very dark days. I’m so grateful for this article- hoping it helps give hope. There absolutely is hope. Eight years is a looong time. Don’t give up hope.

  23. Rita says...

    Haylie, this is a beautiful essay. I’m so glad you got to the other end, and that your voice and bravery are helping so many others.
    Joanna (and all the team), thank you for creating the space and encouraging these voices.

  24. A Reader says...

    Thank you for sharing your story. I’ve been struggling with GYN issues also, but have yet to find that provider who will take me seriously. You’ve encouraged me to keep looking :)

    CoJ, as a daily reader for as long as I can remember, I haven’t liked the trend towards click-bait headlines recently. Your community is here for you!

  25. This is SO GOOD to hear I can’t even tell you!! I had vulvar vestibulitis and while I could have sex it hurt like hell for about a year shortly after I got married. We had great sex for 3 months after we got married and then all of a sudden it started to burn. I had to see so many doctors until FINALLY one diagnosed me with the right diagnosis. I had the surgery mentioned above and after waiting the recommended 3 months after surgery it still hurt for another id say 5 months after that. I would never have orgasms but I’ve been married 5 years now and that terrible time is a distant memory now. Thank you so so so much for sharing! I’m so sorry for what you had to go through!!

  26. Anon says...

    If it’s minor at this point then going slowly and having a few options that don’t hurt is probably the best way to train your muscles out of that involuntary spasm. When I was struggling with this, I read somewhere that the longer in between intercourse the more you’ll tense up again so at least once a week over the course of several months can help reset things. It worked for me. But I recommend you try to sort out the orgasm thing first.. if you can be having fun without Intercourse then you’ll probably feel more patient working on that. Fingers and tongues can be a better place to start and not try to combine with intercourse for now.

  27. Melanie says...

    Wow, thank you to the author and cup of jo team for sharing this. It is for me, unfortunately, all too familiar. I was 16 when I first went to see my gyno about pelvic pain and I, too, was dismissed. At 24, I was finally diagnosed with endometriosis (by a different gyno, a lovely and caring man in Hollywood, Florida if anyone needs a rec). Not only did he care about the pain part, but he also deeply cared about my self esteem and the impact the disease was having on my relationships. He urged me to have surgery, but I had just started law school and didn’t feel I had time (we tried various treatments in the meantime). Throughout law school, I did the pelvic floor therapy described in this article (dilators, stretching, biofeedback, the whole shebang) and incorporated yoga to deal with the pain (my PT also had me doing some yoga moves at my sessions – in particular, happy baby pose) — but by 25, I could no longer put off the surgery and had the laparoscopy — it was only then that the doctor could see my endo had developed to stage 4. It had affected not only my uterus; there was also endo tissue on my bladder, appendix (which was removed), sacrum and traveling towards my kidneys. I will spare you the details of recovery.

    5 months later, I graduated law school, but My doctor put me on Lupron to kill off the remaining endo that was too engrained to be manually removed by the laparoscopy. Ladies, please do your research about Lupron if your doctor suggests this. It is an intense hormonal chemo drug that will put your body into an— albeit temporary — menopausal state. I was on it when I took (and passed) my state’s Bar Exam and while I don’t regret it, it was extremely difficult.

    All that to say, my pain has subsided significantly and I finally feel for the first time in my life “normal” — there is hope!!! Im 28 now, and the first time I was able to be intimate without excruciating pain made it all worth it. I included all the details here so that others may not feel so alone and also know there are effective treatment options out there. Good luck and DONT GIVE UP!

  28. Mari says...

    Thank you so much, Haylie. I struggled with related (though less severe) issues and always felt guilty when people made suggestive comments about “newlywed life.” I felt like I was missing out and depriving my husband and thought he probably secretly resented me. (He didn’t!)

    A question for those who have struggled with sexual pain/discomfort: did you try going off hormonal birth control, and if so, did it help?

    My story: I’m 24 and have been married a year. I’d never been sexually active before then, and it took us about six months to successfully have PIV intercourse. The perfect storm of small problems– tense muscles, my tilted uterus, and his curvature– made it really difficult to have sex without it feeling like he was hitting a wall. We’ve FINALLY figured out a few positions that work, and my muscles have relaxed somewhat over time.

    However, I’m still feeling mild discomfort and have never had an orgasm via any means. I’m not sure whether this is a *big problem* stemming from some kind of hormonal imbalance (I’ve read so many awful things about hormonal BC! even though I haven’t experienced any other side effects?) Or maybe it’s just something that we need to work up to that will come with time/practice? Thoughts?

    • A says...

      Hi there,

      I do not struggle with sexual pain BUT I just wanted to address what you said about not having an orgasm via any means. I am 26 and have been sexually active for a decade. I have always enjoyed sex and thought I had few hang ups about it, but until a year ago I had never actually had an orgasm. And I thought I was broken. I hid it well (very well), and even though I am usually an open book it was something I didn’t know how to talk about with anyone — not even my lifelong best friend or therapist. I have been with the same man for over four years, and didn’t start having true orgasms until three years into our relationship. It made me feel so so small and unfeminine. When I finally figured out my own body and my own deeply suppressed discomfort with my own sexuality, I finally had a breakthrough. All of this is to say, that while you work through finding what is right for you and your body, learning to have an orgasm can be HARD under any circumstances and it should in no way make you feel less than or broken. One of the things I found most helpful was to remind myself that sexual pleasure doesn’t have to be measured in orgasms — it can be measured in vulnerability, in laughter, in cuddles, in just generally feeling good even without achieving the big O.

      Best of luck as you keep pursuing your own sexual health. Fight for your vag girl!

    • Anon says...

      Ps. Nothing was better for my sex life than ditching the pill. I never fully realised how much it affected me until my husband and I decided to have kids and I went off it. I never went back on. We used condoms with no issue between pregnancies and now that we are done having kids, he got a vasectomy. Best thing ever. We joke it was his most romantic Valentine’s gift!

    • Jennifer says...

      Oh, Mari! Hang in there. I had similar symptoms—feeling like he was hitting a very tender wall every time we had intercourse was the worst—and my doctor finally diagnosed me with polycystic ovarian syndrome. It was easily treated with Metformin, a drug typically used to balance blood sugar in people with diabetes. It took about a month and sex became fun again. I have no idea if this will help you, but I wanted to throw it out there just in case. Best of luck to you and everyone else here struggling with body issues and hard choices.

    • E says...

      Yes! I had the worst experience with hormonal birth control, and if you’re having pain issues I would urge you to try going off of it for just a few months to see what happens. I was diagnosed with vulvodynia and the first four years of my sex life were extremely painful both physically and emotionally. After trying just about everything (lubes, numbing creams, antidepressants etc.) I finally went off of birth control because sex was just too painful, and taking a daily pill was such a cruel reminder of the sex I wasn’t having (plus I was a broke college student before it was free.) Well shortly after getting off the pill my symptoms cleared up and I was able to have sex again, so I went back on the pill and started the whole vicious cycle again. It wasn’t until the third time I went off and back on birth control that I made the connection. My doctor told me that there was no correlation between the pain and the birth control, but just because there haven’t studies about it yet doesn’t mean the link isn’t there. Anyway, I desperately wanted to believe her so I tried a fourth, different hormonal birth control and the pain came back quickly but stopped almost as quickly when I went off it. I’ve been off hormonal bc for almost ten years now and i haven’t looked back. I still have minor discomfort occasionally but it’s rare and never the constant excruciating pain I felt while on birth control. It was such a lonely and isolating experience and no one in my life except my ex who lived through it with me knows about what i went through because it felt too shameful and embarrassing to talk about. Thank you COJ for this and much love to anyone out there suffering, you are not alone.

    • K says...

      Hi Mari,

      just wanted to jump on here to say that getting off the pill was the best thing I could have ever done for my sex life.

      Sex used to be so painful for me, but as soon as I went off the pill, all the pain was suddenly gone and I was able to enjoy every minute of it.

      I would definitely look into getting off the pill if you can.

      Hang in there! <3

  29. Susannah says...

    Just wanted to share “Ohnut” a “revolutionary wearable that allows couples to explore comfortable penetration depths during sex”:

    https://ohnut.co/

    It’s also an awesome woman-led, NYC-based company. Three cheers for open minds, open dialogues, and everyone feeling exactly the kind of pleasure they want to!

    • Olivia says...

      This looks really interesting, thank you so much for sharing!

    • Ella says...

      These look amazing!!! Thank you for sharing!!

    • Beth says...

      Thank you!!

  30. Laura says...

    Very very related: I recommend ‘Vagina’ by Naomi Wolf.

  31. Eleonora says...

    Haylie, that’s an incredible story and I am happy you found a way out! Have you considered getting in contact again with some of your previous doctors (including the first one who said go see others) to explain your diagnosis and the treatment that helped at last? This can be a way to spread awareness in the medical community and make a strong call for “take us seriously!!”

  32. Emily says...

    Thanks so much for this brave essay! As a Women’s Health Nurse Practitioner I see women such as you and am lucky enough to have amazing pelvic floor PTs that I can refer my patients to. In fact, just this morning I had a 17 yr old come in w/ complaints of pain and inability to have penetrative sex. After the amazingly brave 17 yr old patient left, the nurse practitioner student who is working with me right asked “do you ever read CupofJo? Did you read it yesterday?”

    Yes I do! Yes I did!

    Thanks so much for this essay Haylie!

  33. Luana says...

    Any tips for me? When I was younger it was ok, but I often had UTIs and felt a bit raw after sex. After having kids it got almost unbearable. I dread it now! It feels like horrible sandpaper during, and crazy painful burning afterwards! UTIs EVERY single time after sex. No sex for a year: no UTIs nor burning. My doctor just prescribed estrogen cream, which did not do anything. Please, anyone here like this? Any tips??? This discussion is so so important, thank you Joanna!!

    • Emily says...

      I’ve had fairly chronic UTIs for years (I’m pretty sure I even had them occasionally as an early teen, way before I was sexually active). I finally started seeing a specialist after a particularly bad year. She had a lot of potential ideas, including estrogen cream, as she said the fact that I’ve been on hormonal birth control since I was 12 could be a contributing factor. However, she also ran a urine test to determine if I had a ureaplasma infection. This apparently isn’t something they normally test for in a typical UTI test, but it’s a kind of bacteria that most people have at some level. On some people, these colonies get out of control and cause exactly the same symptoms as a UTI. They can also increase the chances of getting a UTI. I was given an antibiotic specifically designed to target this bacteria, and as it’s something that can be transferred between partners, my doctor was able to give me a second prescription for my boyfriend as well. It’s been about 4 months, and I haven’t had any UTI symptoms since . This may not sounds like much, but it’s probably the longest I’ve gone without symptoms in years.

    • Twyla says...

      Could you be allergic to latex or semen?

    • Erin says...

      Not a doctor, but have you ever heard of interstile cystitis? I would look into it. I thought I got UTIs a lot and would treat with lots of water, probiotics and cranberry (so often didnt go to the doctor or have a positive bacterial test), and since I’ve found my triggers life is a lot a lot a lot better. Finding a sympathetic doctor was also crucial. Your symptoms sound like this might be it. As it predominantly effects women it’s also understudied. There are tons of homeopathic treatment options, too.

    • Hannah G says...

      Hi Luna,
      I know continuous UTI’s can be a pretty vicious cycle to break! Reoccurring antibiotics can throw off the good bacteria in our vagina and make it hard to fight infections. I would find a care provider with a holistic mindset: once I was free of an infection my CNM had me go on a yeast free diet for 4 weeks to help build back the good bacteria, and also recommend these lubes https://greengoohelps.com/collections/southern-butterintimates (I believe they have water based ones as well). I would also highly recommend seeing if you’ve possibly developed vaginismus and getting referred to a pelvic floor pt! Best of luck, I hope you find some answers!

    • Luana says...

      Thank you so much for your comments, Emily, Erin, Eleonora, Sala and Hannah G! I will look into everything you commented, and give it a try. So thankful for this!

  34. Annie says...

    I love this essay so much, and could have used it myself a few years ago! I agree that the talk about the pain of virginity was awful, and I think set me up for failure. I could have sex, but it was so terrible, so I ended up self-treating with a dilator kit (I know, it doesn’t work for everyone, but the kit and the book that came with it were life-changing for me.) And for me, having a baby actually helped even more. Now sex is amazing, not painful in the slightest. Bravo for posting this, and good luck to everyone who is still struggling.

  35. L says...

    I went to bed fine one day 8 years ago and woke up the next day with vulvyodnia and life as I knew it seemingly ended. Like the author, I’ve tried countless therapies, including the same surgery. Getting doctors to listen, insurance to cover treatment, people to understand that it’s Important and not all in my head has been almost as hard as the devastation and physical pain it’s caused. I’m still fighting for insurance to cover another surgery I know I need, and I know that if something similar were happening to a man, it would be covered. I wish I could scoop up all the women living with pelvic pain and sexual dysfunction and give them a big encouraging hug. It’s so hard to remember that we are still women with value. Thank you for posting about such an important topic.

    • Tabitha says...

      L, I’m so so sorry. I’ve had Vulvodynia for the past 5 years– mine is oxalate-based and has improved a lot by consuming a low-oxalate diet, taking a few supplements, and yoga, but it’s still a daily thing I have to deal with. It’s so frustrating when doctors seem to know nothing and you feel like you’re just fighting to be taken seriously. Anyways just wanted to let you know you’re not alone and you are so loved by me and all the other women here!!! I hope that you will be able to find some healing soon. Sending a big encouraging hug right back to you!

  36. Nigerian Girl says...

    Thank you for sharing this important story. Sending hugs, strength and healing to anyone dealing with chronic pain.

  37. K says...

    I’m so thankful for this community. I too suffer from pelvic floor disfunction. It is intermittent, years with no pain, pain that comes and goes…in the beginning, thinking I had yeast infections and UTIs, etc etc etc… I’ve been lucky that vaginal dialators and biofeedback helped, and even sex helps as my muscles respond well to the experience (often relaxing during and after with a patient partner), but I can’t wear tight pants, stockings, non-cotton underwear. During flare ups even sitting can be uncomfortable. I hear all of you amazing women. If you’re struggling, know there are good medical professionals. I’ve seen the best and the worst. I’m in a good place right now. I still have flare ups, but I seem to have it under control (pelvic floor exercises, meditation, nightly boric acid suppositories to ensure ph stays good and doesn’t cause tension and flare ups). I needed this conversation so many times in the past though and I just wanted to express a little bit of my experience to say, yes. This is real. This needs attention. Women’s pain needs attention. Thank you all for sharing. I hope that all of these voices and experiences can offer insights to those still looking for treatment.

  38. Emily says...

    “Every vagina takes a village” made me lol because, yes, that has 100% been my experience. I figured out I had vaginismus about a year ago after years of frustration, self-doubt, and heartbreak. Finally getting to pain-free sex was such a process, but I’m so grateful to women like Haylie for sharing their experiences or else I would never have put it all together in the first place.

    I’ll shout out here resources that helped me put my sexual health puzzle together: the Pelvic Power episode of Call Your Girlfriend, the Gynecology and Sexology episodes of Ologies, the vaginismus forums on Maze Women’s Health’s website (https://www.mazewomenshealth.com/forums/forum/vaginismus) and the Jen Gunter NYT article linked in Haylie’s piece. Also, finally finding a team of doctors I liked and trusted and preparing really specific questions for them. I also really liked the episode of Sex Education that covers vaginismus, and just love that that episode even exists.

    So happy to see others sharing their stories and the resources that helped them here, and so grateful to this blog for creating that space. :)

  39. Rochelle says...

    Having these types of stories and discussions is one of the many reasons Cup of Jo has been such an important part of my life the past 10 years. Thanks for sharing and bringing this to light.

  40. Daisy says...

    This is such a timely article. I have been struggling with low libido, spouse who blamed me for not giving him the sex he needs, going crazy and wondering whether I am asexual/lesbian. Atleast in my case there was a lot of shame involved with pre-marital sex, not knowing anything about female orgasm which just put me off sex completely. I am very Thankful for this article.

  41. Sasha L says...

    As someone who’s worked in women’s health (birth doula), I thought I understood pretty well that our medical system didn’t meet women’s needs very well, understand women, or commonly treat women with compassion. But after reading this post, and all of the comments, I’m just so sad. We deserve better. The bright light for me is that like Dr Swenson, many women have this unfathomable perseverance and just don’t give up and find their own answers and solutions. I wish it didn’t have to be that hard though. Let’s please all keep sharing about our bodies (and especially our reproductive health and experiences) so that we can help each other be well. Let’s please share our pain and troubles so others know they are not alone. Thank you, from the bottom of my heart, to COJ for creating a space where this is happening. I can just feel the healing flowing out from this post.

  42. Jessica West says...

    As a physical therapist, I am so sorry that your PTs weren’t able to direct you better. They should have directed you to a pelvic pain specialist when their treatments weren’t helping. I’m so happy you found a physician who could help!

  43. Laura says...

    Thank you for sharing this post. I saw a doctor about a similar, but not so severe issue. Though the doctor was a woman, she told me it was psychological. So, I’ve lived with it. And I’ve blamed myself. Now, I’m rethinking everything.

    • Michaela says...

      A sad statistic my sex therapist told me: on average, it takes seeing seven different practitioners before a woman’s health concern is addressed and treated. I’m sorry to hear about your experience with this dismissive doctor, and I hope you can find a provider who listens to you and helps you.

  44. Parikha says...

    I *see* all of you and understand your pain. I have been there. I too have vular vestibulitis.

    My story in a nutshell:
    – virgin when I married, went on Nuvaring which my doctor believes started this, could not insert tampons, could not have penetrative sex, could not have a Pap smear, tried anti-depressents, biofeedback, dilators, was recommended surgery, used lidocaine. I have been through the whole rigamarole just like the rest of you. I am also high-libido and struggle a lot with this.

  45. Vanita says...

    This post brought tears to my eyes. So much of Dr. Haylie’s story was reminiscent of my own. The first doctor I saw about my pain told me I simply needed to practice having sex more. I didn’t have money to see another dr for almost 2 years. Luckily the nurse practitioner I ended up seeing was wonderful and right away validated everything I shared and set me up with physical therapy. My physical therapist was wonderful and helped me immensely but I still had non muscle pain. Years later I went to a specialist who prescribed me a special lidocaine salve and it helped enough for my husband and I to start having sex that wasn’t as painful. This was 7 years into our marriage. I still have pain but it is not as painful as it used to be and it’s been such a crazy journey… Thank you so much for writing about it so beautifully here.

  46. Parikha says...

    Yes! I too have stayed away from surgery for similar reasons. I saw the leading doctors in the DC area. The only things that worked for me are biofeedback and the dilators.

  47. Robin says...

    Thank you COJ for sharing important stories like this! I’d never heard of this, which is crazy, especially since I actually worked as a peer sexual health counsellor as a teenager. Even with the training for that job (thank you planned parenthood- everyone should be so lucky!) and a liberal upbringing there’s still so much I don’t know or am afraid to talk about. Thank you so much for hosting these conversations.

  48. dana says...

    Reading articles of like this and seeing how much this blog touches so many women makes me wish I could call Joanna’s mom and be like, “Do you have any idea what kind of women you have created…?!?!” She must be so proud.

    • Joanna Goddard says...

      oh my gosh, dana, that comment is so incredibly sweet. thank you!!!

  49. alida says...

    Thank you so much for your words Haylie!! And thank you Coj, as always, for reaching us with such interesting and powerful content!
    During a visit at my gynecologist, when I was asking help about experiencing pain during intercourse the doctor explained it as a natural lost of attraction due to a long term relationship.. ugh

    • Jess says...

      Oh no, that’s such an insensitive and probably inaccurate response from a medical doctor. I’m so sorry. :( It’s a fact that women’s issues pertaining to pain are often dismissed, but I think we know our bodies best. Can you find another doctor?

  50. Lindsey says...

    I had essentially this exact diagnosis (vestibulodynia & vaginismus) and surgery to help it a couple of years back. I was incredibly lucky that my gynecologist’s office happened to also be one of the leading group of physicians specializing in the conditions and treatments in the country.

    I’ve wanted to shout it from the rooftops ever since my surgery, it’s been life-changing and a thousand times over worth it.

  51. mb says...

    Thank you for sharing your story. I finally have decent health insurance again and have been waiting to see a gynecologist because for the past 3 years sex hurts in ways it never did before. It used to be fun but now I get on edge just thinking about it.

    There’s only one position that doesn’t hurt—I’ve tried doing some basic googling and found nothing. (Thanks for the resources! I’ll be reading them)I then thought it might be psychosomatic but it’s been long enough that now just the thought of sex makes me feel like such a shell of a human being. I feel like my body is failing me, it can’t do what it used to do and therefore I feel like I am failing at my relationship as well–this whole thing has really hurt my self-esteem.

    I am hoping that I get a step closer to figuring this out soon.

    • sally says...

      might be endometriosis, which I have – worth checking into if you have not already :P

  52. Sarah says...

    While it is of course wonderful that you have had years of pain-free sex possibly attributed to the surgery, can I offer some balance by sharing that I’ve heard from multiple women for whom the surgery did nothing, and even added to their pain?

    Firstly, like many commenters, I’m ecstatic to see this topic discussed. Reading the article was an eerie experience, as the story was so similar to my own that I could almost have written it myself. I, too, had seen a whole slew of physiotherapists, been given dilator sets (glass and plastic), had biofeedback, was given pelvic floor exercises, prescribed antidepressants (had NO effect and the side effects were awful) and topical creams. I was examined by countless doctors and physios in two different countries and a gynaecologist who actually claimed it must be because my vagina was “just too small”. (I have since seen other doctors who gawk at the nerve/naivety of this damaging statement).

    Another gynaecologist, one who supposedly specialised in these issues, told me my last hope was surgery. In the same breath that he admitted modern medicine doesn’t understand vulvodynia/ vulva vestibulitis, he said that cutting out a section of your genitals sometimes gives positive results. Does this not strike anyone else as absurd? If you research the pelvic floor you come to understand the importance of paradoxical relaxation, trigger point therapy and muscle behaviour. It’s not because you cut out the ‘inflamed’ part that you solve the problem: the local pain is often caused by tension in a trigger point elsewhere.

    I said no to surgery, and I’m so glad. It’s years later and I’m not cured; I still have flare-ups. That is typical of pelvic pain syndromes. But I’ve also had really long periods of pain-free sex. The dilator sets were the best of the treatments actually prescribed to me but you need to find what works best for you and use it consistently.

    • Veronica Asence says...

      Thank you so much for your balancing comment and perspective. I think Dr. Swenson’s story is one that needs to be shared, and to help inspire empowerment and self-efficacy related to our health. I’m so happy this treatment ended up working for her. But I do caution the potential bandwagon-ing effect this article could have – not that it will, but could. Everyone here is wise and well-read. I don’t mean to sound condescending in any way. I tell my patients that every body is different. We’re our own intricate variants of a general template.
      Cheers to you, Sarah, that you found the right solution! And to all the women searching for reasons behind there pain, I’m rooting for you. :)

  53. Kristin says...

    Thank you so much for sharing this story. We need more conversations like this. I feel so many of the things you describe dealing with infertility. Especially the feelings of unfemininity—the feeling that you can’t get your body to work as all women appear to be able to. People love to say “oh you can just do ivf” or “oh you can just adopt” without acknowledging how incredibly difficult it is to get to that point, and to have to jump through all the medical hoops you aptly describe. I am glad that you broke through, found a solution, and that your marriage stayed strong along the way. That’s what it’s all about!

  54. I know it sounds strange but I am so glad I read the godfather at a young age. There’s a character in it that has an overly loose vagina and is horribly insecure about it. Eventually she gets diagnosed with a muscle issue that is surgically repaired and all is well again. But it always stuck with me that issues down there happen, are normal, and can be treated. Definitely a weird take away from the godfather but it’s helped me whenever I have any issues or concerns. There is definitely too much stigma and judgement when it comes to pain and issues with our bits.

    • Anne says...

      OMG, I too read The Godfather when I was 15/16 and that woman’s situation (her initial shame about it and then its resolution) is something that has stuck with me more than any other thing in the book. I think about it regularly!

  55. Evan Mead-Brewer says...

    Bravo, Dr. Swenson!

  56. Emily says...

    Haylie, we were friends in California, about 10-11 years ago. You helped me move into my new apartment. I read your name and thought to myself, I know her! I was Emily Thomas when we met, now Emily Honeycutt. I was excited to read this article. I love your honesty and willingness to share your life experiences. You are amazing as always!

    • Emily! Oh my gosh!!!! Of course I remember you. I can totally picture your apartment. So awesome to hear from you! <3

  57. Kate says...

    In the past 3 years, I have gone from being a 33 year old virgin who thought she might be asexual to meeting a wonderful man and beginning a long term monogamous relationship with lots of great sex(!) I also got on hormonal birth control for the first time in my life, and my body absolutely rebelled. Itching, weird discharge, pain during and after sex, and on and on. It was frustrating having physical symptoms and having a doctor tell me it was normal. Was it a yeast infection? Was it BV? Was it another complicated but very, very normal issue that happens all the time that many doctors either dismiss or blame as BV or a yeast infection? Or was it a combination of physical symptoms that combine with shame, self esteem issues, a religious upbringing with absolutely NO sex education, and some disconnection from my body and all these new changes?

    Symptom tracking, communication, and a whole lot of research and education has made all the difference for me and my partner. I now know so much about my vagina! And so does my partner! :) I’m not saying things are perfect, but I am able to have a healthy, satisfying sexual relationship with my partner. Here are some resources that have been incredibly helpful to me:

    Our Bodies, Ourselves. The classic and for good reason! https://tinyurl.com/y2zf7w43

    The V-Book. This is from 2008, and I’m hoping she updates it soon. It is so incredibly comprehensive yet approachable and I think most of my conversation with my boyfriend revolved around “Did you know *vagina fact*!?”
    https://tinyurl.com/y4gw8c36

    What’s Up Down There. Funny but also informative. This was a good first book to read before really digging into the topic. https://tinyurl.com/yxwak874

    I also adore Dr. Lindsey Doe, who is the force behind the YouTube channel Sexplanations. She’s a licensed sex educator, and while not all of her videos connect with me, she approaches sex education in a fun, informational, non-judgmental way. She was the sex education I never got until my mid 30s.

    • Michaela says...

      Thanks for sharing these resources, Kate! I keep a running Evernote document of anything helpful related to pelvic pain/vulvodynia/vulvar vestibulitis I encounter, I’m going to add these!

      I added my current list of resources earlier in the discussion thread.

  58. Emily says...

    Thank you, thank you, thank you for sharing this story. I wish that stories like this were being told 15 years ago, when I first realized something was not quite right with my pelvic floor. (At the time, all I knew was I couldn’t wear a tampon and my doctor, after a failed attempt at giving me a pelvic exam, said “I guess we’ll just have to wait until you’re not a virgin anymore.”) I’m so grateful for my therapist, my wonderful husband, and the helpful doctors I eventually found. But geez, knowing that I was a part of a large community of women who struggle with this sure would have been helpful.

  59. Jamie says...

    This is such an important conversation! I lived with pelvic pain for two years, and doctors had no answers. Not only during sex, just constant excruciating pain and I initially thought was a urinary tract infection. I finally found an article of a woman having the same symptoms as myself and was diagnosed with overly tight muscles. I took matters into my own hands and massaged the area until within 3 days I felt no pain. My husband will occasionally help if sex becomes painful. I can not describe the hopelessness that comes with being in this type of pain, and in every crazy deprivation diet that I tried for some non existant resolution. Just like excercising to tighten muscles, we need to have conversations about loosening them as well, or the pain can be unbearable.

  60. Sam H. says...

    Brava CoJ — reliably adding high quality stories to the internet and helping to keep minds open and stigmas out of the club.

    Also, wishing it was easier to reply to every single comment — they are all so interesting and I just want to tell all the people in the comments that I see you!

    • EXTREMELY SAME, Sam. <3

  61. Libbynan says...

    This article and all the comments just make me happy and proud to be a woman. We are so strong and courageous. We persevere in spite of all the obstacles the medical community puts in our way. Of course, it also makes me angry enough to scream that women’s pain isn’t taken seriously. I can’t put into words how much I love all of the women who have just pushed and struggled through anyway. Bless you and keep fighting for what you need.

  62. Jenny says...

    I’m sharing this article and comment section among my medical school friends because it is so important to hear your voices. I promise to take my patients’ pain seriously in my future career— hopefully as an OBGYN. The Painful Sex episode of The V Word Podcast (by the two rad-est OBGYNS at StNford Med!) was really great: https://www.stitcher.com/podcast/the-v-word/e/55560810

    • Joanna Goddard says...

      that’s so, so wonderful, jenny! thank you!

    • Peggy says...

      Best wishes to you Jenny! My daughter is an OBGYN and I passed this COJ posting on to her. The comments tell an incredible story.

  63. bethany says...

    This is an amazing post and so important. Thank you so so much for writing & publishing.

    I also want to touch on another part of this that Swenson seemed to be alluding to in the post, which is that young women who grow up in conservative religious communities may have an even harder time with caring for our sexual selves because of purity culture–the cultural belief that people should abstain from sex until married. This was true for me, the teetotaling Baptist virgin who got married at 21. I had never masturbated (because it was sinful), had never used a tampon, had never watched porn, nothing. I had kissed my boyfriend and enjoyed some over-the-pants action and that’s it. I barely understood what turned me on, and didn’t know how to ask for what I needed. I did experience pain during intercourse, especially in the beginning, and I do think there is a correlation between that pain and the anxiety I felt about sex for a long time. Some of my friends did have vaginismus and other vaginal pain diagnoses and it took them years to even ask for help, because talking about it wasn’t normalized or encouraged at all in their families or friend groups. I’m 31 now, and I still struggle with the shame that was engrained in my psyche, but I’ve found things that have helped me relax and enjoy my sex life: finding friends to talk with about sex, therapy, EMDR, erotic fiction, learning to masturbate! I’m grateful I found a path to healing.

    If anyone else here is recovering from purity culture like me, there are great resources out there, but here’s a good start:
    – #purityculture hashtag on twitter
    – Impurity Culture: https://twitter.com/ImpurityCulture
    – No Shame Movement: http://noshamemovement.com/

    • Sam says...

      Bethany thank you SO MUCH for mentioning purity culture! It was going through my mind as soon as I started reading. And thank you, for sharing your experience.

    • Becca says...

      I 100% empathize with this comment. It is only now, after leaving my faith and my first husband, that I am able to experience sex with pleasure and without pain or guilt. I am sad that it took a crisis of faith and a dissolution of a marriage, but happy to have found sexual liberation. Life is unexpected, isn’t it?! Also – COJ, thank you for normalizing something I felt really alone and ashamed about for a long time!

    • Kate says...

      I did not grow up in purity culture, but my very religious Lutheran parents did not have sex before marriage and they sent me to a very conservative religious grade school, where there was absolutely no sex education. And at home, sex just wasn’t discussed. That in and of itself was and is a challenge–just being completely in the dark and feeling very hesitant to bring it up. I can’t growing up in a culture worse than that. I salute you all and the work you’re doing to heal.

    • Michaela says...

      Bethany, thank you for this comment. I love that you phrased it as “caring for our sexual selves.” That is something I’ve had to learn how to do in adulthood. When I think about it, it makes me so angry that this culture I grew up in has contributed to so much of my mental anguish and physical pain—from feeling guilt about receiving pleasure, to feeling like it was normal for sex to be painful for me, to feeling like I was missing out on some promised-land sexual experience when penetration was excruciating for me, to even just a basic lack of knowledge about my physiology because talking about anything even tangentially related to sex was taboo…there’s a lot to unpack there. Up through my early twenties, my mom insisted I didn’t need to see a gynecologist if I wasn’t sexually active, and there was so much stigma around sex that I didn’t want her to think that I was having it if I went to the doctor on my own (I wasn’t.)

      Another book on this subject that I’ve been hearing great things about is Shameless by Nadia Bolz-Weber. I haven’t read it yet, but it just became available off my holds list at the library!

    • bethany says...

      Thanks to everyone that responded to my comment! Kate brought up another aspect of this that I forgot to mention, which is the deliberate lack of sex education in conservative religious communities. My parents wouldn’t let me or my siblings attend any sex ed courses in school, but they also didn’t teach us sex ed themselves or enroll us in a class that might have met their religious standards. The lack of education is a common problem for people who grew up in conservative religious communities and just adds another complicated layer to learning about/caring for our sexual selves and bodies. It’s a wonder that any of us have fulfilling sex lives at all. My love to everyone who is going through the process of educating themselves about all of this as adults! It’s hard and important work. <3

    • Marcella says...

      Yes I totally thought about purity culture – I grew up Catholic and went to Catholic school all throughout high school and grew up thinking I was going to wait until marriage, then I met my boyfriend sophomore year of college (lol). We had abstinence-only education in middle school called “Worth the Wait” and in highschool our theology teacher would tell us about how “Planned Parenthood is the devil” and how birth control was literally unnecessary because “modern medicine has already solved all those issues people go on birth control for” or some shit. Since I had NO legit sex education and my mom never talked to me about it I never doubted it until I went to college. I had SO much guilt about having sex, disappointing my parents if they found out, hiding the fact that I was on birth control by buying it without my mom”s insurance, etc. It’s still something I think about a lot and definitely want to do differently with my kids.

    • Catherine says...

      Thank you! Sex, bodies, periods, masturbation, all of it, was deeply shameful and sinful growing up and did not warrant conversation about it other than, “it is wrong – unless you’re married, end of conversation.” I grew up Catholic. I’m middle aged, married for 18 years with four children and that shame follows me every time my husband and I have sex. Strict Catholicism damaged that part of my life (not just sex, but womanhood, our natural bodies, etc) so deeply in ways I’m only just beginning to understand now in my early forties. I’m angry and left the church long ago. Sadly, it has not left me so easily. Fortunately I figured this out before I let it affect my children who are learning healthy attitudes towards their bodies and sex and sexual identity.

  64. michaela says...

    Dr. Haylie, thank you so much for writing about this. I see almost my exact story mirrored here. It’s taken me years to realize that something was medically wrong that could be treated and to untangle the years of shame, guilt, and apprehension around sex.

    Thankfully, I’ve had an extremely supportive partner and a wonderfully helpful pelvic floor physical therapist, and I’m starting to see the light at the end of the tunnel. It has also helped me to see a sex therapist (just talk therapy! But with a specific focus on sexual relationships and intimacy) with my partner so we could begin to redefine what our intimate relationship looks like and how we can separate my medical progress from our physical intimacy.

    For anyone who recognizes themselves in this story, I’ve been compiling some helpful resources, listed below.

    * The National Vulvodynia Association (Good informational resources and recommended provider lists)
    * Center for Vulvovaginal Disorders (Comprehensive definitions of different pelvic floor disorders)
    * When Sex Hurts by Dr. Andrew Goldstein
    * Call Your Girlfriend podcast, Pelvic Power episode
    * Bodies podcast, Sex Hurts episode (Bodies also has a Facebook group; Dr. Goldstein occasionally comments)
    * https://pelvicpainrehab.com/blog

    • KR says...

      Screenshotted your resources! Thank you!!!!

    • Emily says...

      +1 to the two podcast episodes you recommended! Pelvic Power changed my life.

  65. Abesha1 says...

    It’s maddening when women’s pain isn’t heard, or believed.

    Once, after a tooth removal followed by antibiotics (which I believed were a bad idea, but the flippant oral surgeon basically said, What’s the worst that can happen?) I developed a yeast infection that developed into *endometritis*. This is a low-grade uterine inflammation (like any other
    -itis) that can cause pain during intercourse, among other symptoms.
    After a short course of a targeted antibiotic prescribed by a GYN who gently listened to my mortified self explaining exactly how it hurt during penetration, it cleared up completely. But several years later I had both a nurse and GYN imply it doesn’t even exist… needless to say, I didn’t go back there.
    If I had not been blessed with that particular doctor at that time, who knows what could have happened. Dr. Vander Pol in Oregon, thank you.

  66. Naomi says...

    I’ve read every article for years but this is my first appearance in the Cup of Jo comment section! I’m 27, divorced, and a virgin; in some ways a similar story to above, but with a porn-addicted husband and a devastating honeymoon. If I try having sex again it’ll be after getting remarried and I find myself worrying a lot about what might be wrong with me: was it the wedding night trauma? Something else psychological? Something physical? Not feeling safe? Will I be having honeymoon sex this time around? Will I be going to the doctor asking for referrals? Will they tell me to have a glass of wine and try to relax, like last time? Anyway, I just wanted to say thank you so much for this post: it’s given me so much more hope and I feel like a part of the weight has been lifted. And if there’s a Kickstarter for those sandwich boards, someone send me the link!!

    • Joanne says...

      I’m not a regular commenter either, but wanted to say I’m rooting for you! Be your own advocate, and I’m wishing you the best. Why not visit a new doctor sooner rather than after a potential future marriage? (Also, “have a glass of wine and relax” makes me want to punch someone SO HARD.)

    • Kate says...

      Naomi, I’m sorry that all of this has happened to you. I’m glad this post gave you some hope, and I hope those feelings continue for you.
      As someone who has had to unpack a lot of sexual issues, I just wanted to say that there are wonderful sex therapists and doctors out there who could be a great person to work through these very thoughtful questions you’re pondering. These questions are also questions that you can start pondering now, before you’re at the point of entering into a new relationship or marriage. I follow a YouTube channel called SexPlanations with Dr. Lindsey Doe (who is a clinical sexologist and sex educator) and while some of the videos might be really not what you’re looking for, she has a great series of videos on sexual trauma, regaining a healthy sexual life, and how to choose a professional to talk with when you’re to that point.

      I hope I’m not overstepping by suggesting these things, but again, I hope good things come your way.

  67. Maia says...

    I got married 4 years ago to a man I loved. He was not very interested in sex, which is something I didn’t learn until such time we were actually married. This minimal interest continued to be on the decline and combined with his refusal to go see a doctor or therapist to address his issue, we are now staring at a divorce, a couple of months from now. I still do not know if it is a physical problem (Asexual? ED? Impotency?) or a mental one (he unexpectedly lost a parent when really young and has never really been bound to any relationships since), but I guess I will never know. It’s been 3 years since there has been anything physical between us – no sex, no touch, no hugs. Nothing. This man is so consumed by whatever demons are eating him up, but would rather let go of our marriage, than to find the courage to face up to his problem and fix it.
    I know my comment is unrelated to the topic at hand, but I had to share this. I wish our world was more open and accepting of people that have sexual issues and there were better ways to help address this.

    • Mel says...

      Maia, I’m so sorry you’re going through this. I have a friend whose fiance was going through something similar after discontinuing medication he had been taking for a while. She finally talked him into getting a physical and having his testosterone checked. Turns out it was incredibly low and after 4-6 weeks he had his drive back. I don’t know if this helps, but just wanted to put it out there in case it does.

    • Cady says...

      Maia, I’m sorry your relationship has this struggle. My husband has low sex drive and it’s done a number on my self esteem, bc the way we talk about sex is so aligned to the ‘sex hungry husband, acquiescing wife’ trope. Intimacy is much larger than intercourse but I hope your partner is able to open himself up to a bigger, more intimate relationship with you. Thank you for sharing.

    • Meg says...

      Maia, I’m so sorry. I went through something similar in a relationship, and it ate me up. It was a mental problem in my ex’s case, and he eventually worked to overcome it (we’re friends now), but not until I’d left him and he was required to really face it. Just know it’s not you and that you’re not selfish to need more.

  68. Sue says...

    Thank you so much for posting this. I never knew that it was something that happened, up until I got married at 23 and sex wasn’t just uncomfortable- it was impossible. And I had no idea what to do. I didn’t know it was a problem that could be solved because I didn’t know that it was a definable problem – I thought it was something I was the cause of, or I was doing wrong. Thank goodness for the internet because it was desperate googling that eventually led me to ‘vaginismus’, and then reddit forums, and then a very weepy and awkward conversation with my GP who listened, took me seriously and gave me a fairly strong muscle relaxant that I had asked for without fighting me on it. I’m forever grateful to her for that, and the NHS prescription, because while it didn’t totally solve it it set me on a path to know that the issue was fixable. All I can hope is that the more women and girls know that this is a condition the more it is easier for those who suffer from it to get quick, effective help for themselves without feeling broken or inadequate or ashamed.

  69. Tracy says...

    Oh my goodness! This is exactly my story, except I didn’t get diagnosed with vulvar vestibulitis until I’d been married for over ten years! All my previous doctors just said “sometimes it hurts a little”. It’s not something I commonly talk about except with very close friends, but kudos for this woman sharing her story. Well done Cup of Jo for making me not feel like I’m the only one who has this story.

  70. Jill says...

    I have never heard of this! Ever.

    So glad women can be more open in today’s world than we could be in the sixties.

    Because now I’ve heard of this! Thank goodness!

  71. cupofreader says...

    What a great read. I didn’t suffer from the same issues, but I went through a period of a few years – yes, years – where sex was just NOT happening, and I was previously a pretty sexual person. I wish I could say one magic thing fixed it, but I can’t – but I did eventually start having sex again. One nice thing about being in a long-term relationship is accepting that sex drives ebb and flow. Some encounters may be shorter or longer or involve penetrative sex or not, sometimes one person gets off, sometimes neither do, sometimes both do. And that’s all ok over the long term (obviously there is an issue if one person or both people never have an orgasm).

    • Annabelle says...

      Thank you for this comment.

  72. Julie says...

    I love this article. I went to docs, PTs, specialists, all the above. Half of which would also suggest wine/calming down/its in my head. It took a great deal of personal research to find a cause and solution and now I can get back to relatively- pleasant sex. Talking about these things lessens the despair that these sorts of things cause and I love that were all starting to talk about it <3

  73. Samantha says...

    Thank you for sharing your story. It is so true that many issues that primarily affect women are overlooked or minimized by doctors. I have lichen sclerosis on my vulva that makes penetration painful. When I tensed up for a pap smear one time the doctor said “I bet sex is painful if you tense up like this!” Gross comment that made me feel abnormal (even though I shouldn’t have let it. I should have just gotten up from the table and walked out the door!) Anyway, as someone who has explored treatment through creams, gels and even lasers…the whole process to figuring out how to engage in sex that includes penetration, which I used to really enjoy, is hard and expensive! Not to mention what it does to ones sex drive.
    I am all for more open discussion about these fairly common issues that no one seems to talk about!

    • AJ says...

      Thank you for sharing, Samantha. Me, too. I was diagnosed with lichen sclerosis after two years and many doctors visits. I felt so isolated and ashamed until I knew what was going on — I was in my early 20s and couldn’t understand why it was nearly impossible to have sex and why I was so uncomfortable and in pain. I was miserable, and was so grateful to find a doctor who listened to my concerns, validated my experiences, and was committed to helping me work through it. I’m trying to make peace with the fact that this is something I will always need to manage, but it helps to know there are others out there who have experienced this. Openness would have helped immensely when I was first trying to figure out what was going on.

  74. CJ says...

    I went through much of the same treatment course as the author- and finally discovered (with the help of a naturopathic doctor) that my pain was caused by inflammation stemming from gluten intolerance. A few weeks after I cut gluten out of my diet, I was finally able to have non painful sex (at age 25). The few times I have experimented with adding gluten back into my diet, the pain has returned. I went to so many specialists and pelvic PTs before figuring this out!

    • Anonymous says...

      False

    • Jeannie says...

      OH my gosh, me too! It took at least a year of seeing a few different doctors and a nutritionist who suggested I might have food sensitivities. Turns out my discomfort was due to dairy and gluten sensitivities. All better now. Hope this helps for others trying to figure out what could be wrong.

  75. S K says...

    I was so glad to see this! I think it would be such a great idea to have a recurring blog post that covers topics like women’s health. Maybe both from a sex-positive, LGBTQ+ friendly OB/Gyn and as well as from women who have experienced a certain problem from their perspective as patients.
    It is so important to have high quality information about the prevalence of pain with intercourse/bleeding (what is cause for concern/how to talk to your doctor) and I think including some medical voices on this topic along with patient stories and comments is SO important.
    There’s definitely so much that science needs to do to better understand and treat conditions that affect so many individuals, but there is some good work being produced that I think would be great to highlight in this blog community.

    • Erin says...

      Yes — I’d also love a way for this community to share practitioners, b/c finding a doctor who listens and is for you is over half the battle it seems.

  76. Tess says...

    Pieces like this are the reason Cup of Jo is such a valuable, wonderful gem of a place on the internet. Thank you, thank you for sharing!!

  77. Amy says...

    Thank you so much for posting about this! It really is sad how difficult it can be for women to get the pelvic floor help they need. When I was in college, stress really started getting to me and I felt the urge to urinate constantly. This especially occurred at night and I could barely sleep. Despite no burning feeling, this was dismissed as a UTI for months. Then I was referred to a urologist who thought the cure would be to “widen my urethra”. That ended up being pretty painful and just increased my pelvic floor stress. Finally I made it to a physical therapist and learned the correlation between stress and my pelvic floor. I too played the wand game and took valium suppositories, but the thing that helped lost was managing my stress. I have been able to manage it much better now, but it was a painful two years to deal with. I had a supportive partner and was sexually active the entire time, but the experience still left me sexually insecure and ashamed for a while and I really hope it doesn’t have to be that way for others in the future.

  78. riye says...

    I can’t believe that doctors still think its okay to tell us that our problems will be solved if we “just relax and have a glass of wine”. None of the men in my life have ever had anybody tell them that!

    Go with your gut ladies. If your doctor doesn’t believe you or won’t listen–start looking for a new one. I just switched primary care doctors because the old one kept telling me how fat I am. I finally called him on it and he backed down but that was the last straw.

  79. Alexandra says...

    Thank you for this wonderful and open article about something that is commonly just not talked about, and it’s time to talk about it. And thank you (and hugs) to all the sensible and brave commenters. I love CoJ so much, a large part of my love being for the wonderful conversations in the comment section. I hope that all of you can find help and are taken seriously by the medical profession. I understand now how frustrating this can be. I had breast cancer, am on estrogen-reducing medication and had a hysterectomy/oophorectomy at the age of 45. I always had a good, satisfying and fun sex life and intercourse with my husband, but after all of the above, it was gone. No sex drive, completely dry, I am crying when I have intercourse because it has become so painful, and it sucks. I have started the medical journey, and am not sure where it’s gonna go, since I can’t take any hormonal help, but your comments give me a bit of hope that there can be help otherwise. I am not ready to give up. Thank you again for sharing your experiences.

    • Nina says...

      Alexandra I’m so sorry to hear what you’re going through. I started intermittent fasting several months ago and this might be something to look into to. Jason Fung has a few books or Delay Dont Deny by Gin Stephen’s. Many people find IF has helped with hormonal issues, increased sex drive and natural lubrication. I hope you find what helps you.

    • G says...

      Thank YOU for sharing your story. Hoping that you find answers and feel better. I am rooting for you!

  80. Claire says...

    Wow- what a way to empower the female community! I work as a pelvic floor therapist to help women through these issues. I am so commonly asked by my patients if they are “normal” and my consistent response is a resounding YES. Lets keep the conversation going to women can be heard and supported.

    • YES! Totally normal. I love this so much. Thank you for this, Claire, and for the work you do!

  81. Dani says...

    This topic is so important to me as I’ve struggled myself. I met my ex at 17 and quickly realized penetration was impossible. I tried seeking help with various doctors who were so unhelpful! I was literally met with “you’ve never had sex? EVER?” in my early 20s from a doctor and promptly gave up. I spent nine years with my ex and never had intercourse. After we broke up, I tried a tampon and was successfully able to use one for the first time. I went to a gynecologist and she was so helpful and told me my muscles were as tight as a rubber band and prescribed dilators and gave me a physical therapist referral. Somehow, some way, around this time I tried sex with my new boyfriend and he helped me make it work. I dont know how I somehow solved my issues without help (I know extreme tightness like this can be worsened by mental issues however which I’m sure played a part), but at 26 I lost my virginity and am happily having sex which I never thought would happen. Theres hope for everyone struggling!

  82. I’m so glad that you’re sharing this! I experienced pain, but for different reasons, and am linking my name with the doctor who helped me when I was living in the DC area (he’s located in Baltimore and was worth the drive). I’m so glad that you were able to get the treatment you need! Thank you for sharing your story.

  83. Barb says...

    This was GREAT!! Thank you for sharing Dr. Swenson!

  84. Elisa says...

    I have never felt so seen and understood. Thank you for honestly telling a story that leaves so many women sitting in silent shame. I’ve experienced my own saga of doctors and failed therapies. I’m only now beginning to realize how traumatizing this roller coaster has been. From the first few lines of this essay I immediately sensed anxiety welling up in my body – a body steeped in shame and guilt from years of feeling broken. My physical response to your words feels like a wake-up call – to tune in and turn on the light, to stop pushing down the feelings of inadequacy and anger that I’ve held for too long.

    Thank you for your truth and your vulnerability. I appreciate it more than you know.

  85. Katherine says...

    What a wonderfully vulnerable and intimate story – one that will no doubt be so helpful to many women. Loved your writing, Haylie, and would enjoy to read more from you! Thanks CoJ for giving women the space to talk freely and openly about that which ails us, things that aren’t widely discussed, and topics that are not taken seriously/all but ignored in medicine. We have a long way to go but honest sharing like this will help us find the support we need and deserve.

  86. RG says...

    How do we nominate you guys to get a Pulitzer? I mean, seriously—I don’t know another group of women so bold, determined, fearless, and LOVING to contribute such honest, raw, RARE topics to the female community. I have a folder in my phone named COJ because, when life gets tough, I remember to refer back and re-read your articles. Another one tabbed. THANK YOU ON BEHALF OF ALL OF US. DON’T STOP WHAT YOU’RE DOING. YOU MAKE US WOMEN PROUD <3

    • Joanna Goddard says...

      oh, RG, that makes me want to cry! thank you so, so much. i just shared this with our team. that means so much to us. (and bravo to haylie!)

    • Jordan says...

      I can’t tell you how many times over the past 10 years I have come to COJ and typed whatever my current life struggle was (heartache, finances, wardrobe slump) into the search function. It’s like a little pep talk and a cozy hug from gf’s around the globe.

    • Candace says...

      Jordan….Exactly that. All the time.

  87. Kate says...

    This is a wonderful essay, and I’m so grateful to CoJ for getting this conversation started. I was referred to a pelvic floor PT when I was having trouble getting through the pap smear (which I thought was nerves from previous poor experiences at the doctor’s), and to my surprise (!), one side of my pelvic floor was much tighter than the other. My PT was great, and got me through what I consider to be pretty challenging therapy, but when I tried to dig more into how I got this way in the first place, she said “maybe you’ve been abused or something, I don’t know.” And I haven’t, and have obviously carried this comment around for years now.

    Also, shout-out to the author and everyone here in the comments who is continuing to raise the issues of equity and access.

    • Amanda says...

      Kate – I had a similar situation. My therapist didn’t suggest I was abused, but I admit I thought it myself! “Maybe I just don’t remember?” I thought. (What a scary feeling!) But then, she said it could be a result of injury. I have a vivid memory off falling onto a balance beam as a kiddo. So, who knows? Maybe it was that? Maybe it’s just how my body is. Regardless, I’m so thankful to that therapist for helping me through it all!

    • Hannah says...

      Hi Kate!
      Just thought I’d add a comment bc I also went through Pelvic floor therapy for vaginismus, and my PT and CNM both said it can be caused by any sort of painful/uncomfortable experience in our pelvic floors (not just abuse, what a discouraging and haunting comment to make!). Mine was repeat painful intercourse due to yeast infections, but childbirth, or totally even just an uncomfortable pap smear can cause this type of stuff. Our minds our pretty powerful and our bodies will go to a lot of lengths to protect us from what it perceives as painful.

    • Kate says...

      Thank you, Amanda and Hannah, I really appreciate both of your responses.

  88. Katie says...

    Thank you so much for sharing your story Haylie. I also have Vulvar Vestibulitis and have undergone surgery so that I could finally have sex without excruciating pain. In fact, I can now have extremely enjoyable sex! My pain was caused by years of being on hormonal birth control when I didn’t really need to be. I completely understand that strange guilt that engulfs you for not being able to have sex and how lonely and hard it is to go from doctor to doctor and not receive a definitive answer about what’s going on. Your vulnerability and bravery is so inspiring!! I wrote about my struggle here: https://medium.com/@kt_b_g/hidden-disorder-a-psychological-thriller-of-chronic-female-sexual-pain-555b672d286a

    • Lisa says...

      I was just diagnosed with the exact same condition, likely due to going on and off the birth control pill frequently for non-contraceptive reasons. Coincidentally, I also see Lucy. Thank god for medical professionals who take this seriously. I’m only a few months into this, but in that short time had two gynecologists give up on me and tell me they were out of ideas before I found her. I’m scared about the future since treatment feels so trial and error, but also hearing stories like yours and the authors gives me hope that someday it could be over.

    • Taylor says...

      I also saw Lucy–had my surgery performed by Dr. Simon. After my surgery I stopped going because I just couldn’t manage the cost, but Lucy is a damn treasure. The most empathetic, comforting person in medicine I’ve ever met.

    • Le says...

      I am convinced hormonal birth control is the root of a lot of problems no one talks about or recognizes, and that it disguises problems we would have known about if it weren’t for the bc. It took me a week to be able to have sex for the first time on my honeymoon and years after that for it to be halfway comfortable. I had chronic yeast infections and elevated liver enzymes while I was on it, but no one linked the two. When I came off it, I learned I had PCOS. Reading this, and the comments, I realize how much more pain so many other women are in. My heart goes out to all of you and I hope you all find doctors who truly listen to you.

  89. Sharlene says...

    “Every vagina takes a village” – this made me laugh out loud in the middle of an incredibly brave and heartfelt piece of writing. I don’t happen to suffer from this problem but I think it’s amazing how, just like with any tough thing, knowing you are not alone makes something so difficult a little easier to bear. And it’s heartbreaking to read the comments from women who need help, but honestly, just don’t have it in them to spend more time and money on it and so continue to suffer.

  90. Tessa says...

    THANK YOU for sharing this! 5 yrs, 1 mo for me. I luckily had a great physical therapist (3 months; expensive with bad insurance) and then THE BEST physical therapist (2 years; relatively inexpensive with great insurance) and a great psychotherapist who helped me through it. Light at the end of the tunnel! This is such a great read and I’m sharing it with all my friends, now that I can talk about it without crying after being “cured”. THANK YOU!

  91. Martha says...

    I went through the same thing. I went to 4 different OBGYNs before I thought to seek out a sex therapist. Me, seeing a sex therapist at 23?? Unthinkable. The only other people were 60 year old males who I assume were having very different issues than me.

    I ended up doing the estrogen cream and the dilators. Those helped me, as well as stopping hormonal birth control (which I know isn’t an option for everyone). Once I stopped that, my sex drive returned and I was able to live pain free. It’s still a little tight, but nothing that some lube can’t fix.

    Thanks for sharing your story, it felt like mine too.

  92. Ella says...

    I could cry…thank you for sharing this piece. For the last several years I have struggled with the pain described in this piece as Vulvar Vestibulitis. I’ve gone to several doctors who have all been completely dismissive and spent time researching to find my own diagnosis of the problem. It is so meaningful to hear someone else’s experience and triumph. I’m glad that you have given a voice to women’s sexual pain.

    • Julie says...

      Praying you find some relief soon, Ella. I remember thinking daily that I would never feel good again and how isolating that can be. You’re not alone… and I hope that you find a day soon where you do too. Xoxo

    • Erin says...

      Ella if you’re comfortable you could share your location and I wonder if someone in this community knows of a great practitioner for you?

  93. Courtney B. says...

    A pelvic floor physical therapist literally changed my life after having scar tissue build up after the birth of my first child. I, too, thought I’d never hae sex again. Now I carry the gospel of pelvic floor therapists to every pregnant, post-partum, and sexually active woman alike.

    Trust your bodies, ladies. Don’t give up. There is treatment. There is hope. There is relief.

    #shepersisted

    • E says...

      HELL YES. I’m in the exact same boat — had to have surgery to remove scar tissue after my first birth. It took 13 months to diagnose and a 12 minute surgery to fix (plus recovery, of course).

      I remember the sheer terror of just wondering if we’d ever have sex again and so.much.shame. I’m now pregnant with our second (surprise! we had sex again!) but I now preach pelvic floor PT as well and have an amazing PT.

      I’m nervous about how another birth will impact this, but the simple fact of having a supportive practitioner decreases by anxiety by about 80%. She’s going to help me and we’re going to make a plan — it’s just so much relief.

      Also telling a woman to “just relax” is some of the worst advice I’ve ever heard, esp from a medical POV.

    • E says...

      I also want to say don’t give up — I did pelvic floor PT initially post-birth b/c they thought it was a tightness/stretching issue and it wasn’t until I went to a sexual health doctor that she looked further internally and diagnosed this. She suggested stretching and dilators (which I’d tried) and I started sobbing. Finally she just looked at me and said: get the surgery, it’s going to help you.

      Now as part of my recovery I’m with a different pelvic floor PT and she’s a much better fit for me, and much more experienced.

    • A says...

      I was unable to have penatrative sex after the birth of my first for over 8 months due to scar tissue/nerve damage from a tear. And every time I brought it up to my doctors I was told to use more libe and relax, which was simply infuriating. It decreased my sex drive and was so depressing. I also felt so guilty and insecure about the whole thing…I constantly wondered if I just did not want to have sex so was imagining this pain or exaggerating it. I am now pregnant with my second (due any day!) and hoping it doesn’t happen again. But after the first experience, if I do have postpartum issues, I have vowed to find a pelvic floor physical therapist and advocate way more aggressively for myself this time around.

    • Erika says...

      I had already had issues with pain during penetration prior to my first pregnancy, enough to think something was wrong with me…but not enough to not have sex at all, I guess. I was treated for yeast infections I didn’t have, told it was depression (by my psychiatrist), and honestly thought I was going to go through early menopause. It took not being able to have sex at all after my daughter’s birth (a cesarean) to get me to pelvic floor pt. THANK GOD FOR PELVIC FLOOR PT. It’s still a journey, but it’s so much better- and it turns out it wasn’t all in my head.

  94. Alessandra says...

    Thank you, thank you, thank you for bringing awareness to this condition. Pelvic floor therapy saved me after spending years bouncing from doctor to doctor with no answers. That was 17 years ago, and while I still have flare ups around stressful times in my life, knowing what it is and knowing that I can manage it has helped me to cope with the pain. I wish the same for all of you incredible women out there. There is hope and there are answers! xo

  95. Emma says...

    I’m not sure how quite to voice this, but it seems harmful to me to call only penetrative sex, sex. The title of the article is “I didn’t have sex for the first two years of marriage.” But then I go on to read that on their honeymoon they both got to know each other’s bodies and also had orgasms. To me that sounds like sex! It seems to perpetuate the suppression of a women’s sex life by only calling penetrative sex, sex. Especially since so many women can’t orgasm via penetrative sex. We put women’s health and sex as secondary to men’s when we talk like this! Not to mention sex other than in a heterosexual relationship! Maybe “I didn’t have penetrative sex for the first two years of marriage” would be more productive! Maybe I’m overthinking this, but it seems important!

    • Joanna Goddard says...

      yes, we thought about this, and haylie and i talked about this, but for the purposes of a title (which is by necessity short), we felt it was okay, and she explains in the piece that there are other kinds of sex/pleasure/etc. thank you for your thoughtful comment!

    • I’m really glad you wrote this, Emma. Thank you! There are so many ways to have sex, both in heterosexual and non-heterosexual relationships. To think of sex as only one thing – a penis in a vagina – is rarely accurate or helpful, especially not to women.

    • Thanks for this, Emma! I absolutely agree (and in fact, recently came out as bi–I definitely don’t want to overemphasize the penis!). While writing this piece, I tried to both acknowledge that penetrative sex is not the only sex(!!! for emphasis!!!!) while still giving an accurate reflection of how I felt as I was going through all of this. I really appreciate this comment.

    • Michaela says...

      Emma, definitely! I don’t have a problem with the way the headline was written because of what Joanna and Haylie said, but your comment is spot-on in terms of how we should be discussing sex in general. I grew up in a culture where p-in-v *was* sex, or at least was the be-all-end-all of sex, and it 100% made me feel broken and like I was somehow not fulfilling my partner’s needs (which, ick) when I realized that penetration was extremely painful for me. Even though I intellectually know there’s not “real” sex and then “the other stuff,” it helped me immensely to talk to a sex therapist about this and reframe this for myself.

  96. CAE says...

    I LOVE THIS! Not that you had to go through it, but that you are talking about it!
    When I was a teenager, I physically could not make a tampon work. I thought I was doing it wrong – it literally felt like it was running into a wall. So when it came time to have sex for the first time, I was too afraid! If I can’t even get a tampon in there, how was this going to work?! By the grace of some higher power, a girl I knew confided in me, completely unprompted, that she had recently had surgery because she was having a similar-sounding issue. WHAT?! I was still mortified, at age 19, to have to talk to my mom about it and have her bring me to her GYN, etc… but guess what? My hymen had developed in a way that it just wasn’t going to break or make room, the way it does for many. And there was a simple procedure to address it. I seriously felt so liberated – I was not making it up, and there was something I could do about it. While it actually changed my life, it took me a while to feel okay telling people about it, so I thank you and applaud you (and all you commenters) for being so brave!

    • Katrina says...

      Same!!! I had a hymenectomy when I was 17 so I could finally use tampons. After I went to the doctor with my mom to figure things out, I remember laughing when she told me that if it were medieval times, I would have passed the virginity test and married the prince. 😂

  97. Kelly says...

    Hi Dr. Swenson, I’m living in Austin and I’ve been dealing with similar issues for a while. Do you mind giving me a recommendation for who you’ve been seeing locally? I did 2 years of pelvic PT and I have a gynecological surgeon I love, but I’d love a recommendation is you feel comfortable giving it. I’m also on Twitter if you’re comfortable with DMs.

    And thank you, Joanna, for helping to demystify a really painful subject!

    • Hi Kelly! The doctor I saw was in Maryland, unfortunately, so I don’t have a recommendation for you in Austin. But I’d be really happy to talk about it more. DMs are fine! You can also find my email on my site.

  98. Sarah says...

    I love this! Sex became painful for me after giving birth. My OB gave me some creams (thinking it was from breastfeeding) and told me she had couples therapists she could recommend (thinking it was mental). Ten months after giving birth I finally saw a pelvic floor PT, who immediately said it was due to an excess of scar tissue, which doesn’t stretch. With dilators and exercises, I can finally have sex without pain/bleeding! The lovely PT said she recommended all women see a PT after giving birth (something that’s common in other countries, but not in the US!). Thanks CoJ for opening the door for such an important conversation.

    • rubyshoes says...

      YES! I didn’t know that pelvic PTs even existed; I haven’t given birth but have dyspareunia. My first appointment was a revelation – this was totally normal, not something to be ashamed about, and something that could potentially be improved with exercise (just like working on any other muscle). I wish there was more information readily available that this is a service that exists!

    • Lisa says...

      Through sheer luck I saw a PT after giving birth and I’m forever grateful for her. I’m based in the UK, and for all the wonderful things the NHS does, they really mess up on this. I had been seeing the PT privately when pregnant because I had SPD and because it was pregnancy related, I had to have a follow up when I wasn’t pregnant to make sure the condition had gone away. The birth was traumatic – I had to have assistance as the baby was ill, and ended up with second degree tearing and an episiotomy. Three weeks later I got a bacterial infection and it wasn’t so painful. At my six week check up the doctor focused on the baby, briefly asked how things were and that was it. When I saw the PT two weeks later, she did a full assessment including of my pelvic floor strength, muscle separation and the scar tissue. She gave me exercises and emphasised if I had ANY pain it wasn’t normal, and I should come back.
      I’m now super vocal about women seeing qualified, specialised PTs after giving birth. Apparently in France it’s common, and women automatically get 10 sessions. This should be more common

    • P says...

      I knew I’d found “THE ONE” when my physio specialist in pelvic floor said what was happening to me (post birth) was incredibly common but never is it “normal”. We don’t have to put up with pain. Good luck on your search for your one!

  99. alison says...

    I’m sorry to hear the author had a bad experience with pelvic floor physical therapy, but if someone is suffering from vaginismus (as opposed to the diagnosis she ended up receiving), it can be very helpful if you find the right practitioner. I did the whole lower body stretching/manipulation and dilator routine and it worked – and consequently changed my life. I am so grateful to the author for sharing this very intimate and powerful story and want to second her thoughts about doctors not taking womens’ pain seriously (I was told by more than one doctor at AGE SEVENTEEN to “just have a glass of wine to relax” before intercourse), but I would hate to see anyone dismiss this kind of treatment based on this article.

  100. Megan says...

    YES! YES! YES! Thank you CoJ for doing a piece on sexual pain! My own experience overlaps significantly with Haylie’s. Thankfully I had a doctor who knew to put me in touch with a pelvic floor PT, who helped me immensely. So many good books on this topic as well–Heal Pelvic Pain by Amy Stein was a godsend–but all the other women dealing with this–know you’re not alone. And yes–you are not broken. I struggled for months asking myself that and am so thankful that there are resources to help women through these dark, dark moments.

  101. Shannon says...

    Thank you, thank you, thank you for posting this. I have been married a little over a year and have not been able to have sex due to pain. When I would see doctor’s about it prior to having sex almost everyone told me “oh it’s just because you haven’t had sex yet.” But gynecological exams would leave me in tears because of how painful it was just for them to use a cotton swab. Even when they saw me writhing in pain, I still go a “well once you start having sex it should get easier.” And even post marriage and attempts at sex, I just got told to try new positions. Unfortunately, it did start to have a negative effect on my marriage because of how broken I felt, and, like you said unfeminine. We are Christians and there is a lot of hype around all the crazy fun sex you get to have once you’re married – but no one ever tells you that sex is also not easy and not like the movies! So when it was completely impossible for me, I almost lost all libido and desire for it. I ended up going to counseling to talk about it and help work through some of the emotional trauma of it and my counselor was familiar someone who had gone through a similar experience and had written an article about it. She sent me the article and, similar to reading this, it was like I had wrote it myself! All the symptoms, pain, failed attempts, emotional struggles. Vaginismus! I had a word for it! It was there that I even learned that there were physical therapies for pelvic pain. I booked an appointment with a gynecologist so I could get a referral for a PT. When I went and saw her, I didn’t even have her do an exam, I told her all my symptoms and what I thought it was and she just wrote me a referral. I am now seeing an AMAZING pelvic floor PT who has worked with countless women for similar issues. Gynecologists and doctors really need to not dismiss pelvic pain so easily, regardless if you have had sex or not. I wish one of the many gynecologists I had seen would have been familiar with or suggested I see a PT. But, like you said, you know your body better than anyone else and if something feels wrong, look into it. Also, you have take your health into your own hands and be your own advocate! Again, it really makes you feel less alone reading articles like this so thank you and Cup of Jo for publishing these stories!

  102. Veronica Asence says...

    Hi! First of all, I want to express a boatload of gratitude that this is even being shared and discussed. Huge bonus that it’s in a community of supportive and powerful women.
    I’m a pelvic health PT based outside of Boston, and I just wanted to add a couple thoughts. First to Dr. Swenson, I’m sorry that your experiences with PT weren’t fruitful. I hope you we’re able to learn some good takeaways and self-care strategies. Second, not many women know we Pelvic Health PTs even exist! It’s not for everyone but it can help many people, so to see this even acknowledged and shared is such a blessing. And third, we don’t only treat pain with intercourse. We can see and treat patients with urinary dysfunction (like leaking when you laugh), bowel dysfunction (like chronic constipation or IBS), post-menopausal symptoms (which can include pain with intercourse), cancer patients who have undergone pelvic radiation or bowel re-sections, and post partum/post-op patients! We also see patients with endometriosis, male pelvic pain patients, patients with tailbone pain…it can go on! And while we can’t cure everything, and sometimes, diagnoses fall out of our wheelhouse, we’re here, and we fiercely love what we do.

    • Hi Veronica,

      May I ask what practice you are with outside of Boston? Ive been dealing with pelvic pain for 20 years now and it’s still a constant source of pain and frustration. Ive seen boatloads of PT’s in the Boston area, and still experiencing tremendous pain. Id love to connect.

    • Hi Veronica! Thanks for this comment. I definitely didn’t mean to dismiss PT in general; I have female friends who have found it really helpful! I also have incredibly fond feelings for the PTs who helped my grandparents as they aged. It wasn’t right for me, but I know you folks do excellent work. Thanks for all that you do <3

    • Veronica says...

      Trying to figure out a way to reply to Leah who responded to my comment. Only thing I could think of was to respond to my comment back. I hope it works. Leah, if you’re reading this, I work for Lahey Health in Burlington, MA. I would be so happy to be of help on your journey. What would be the best way to contact you? I noticed your name links to a children’s Scandinavian clothing portal, but I didn’t want to send a random email with sensitive information. Please respond to my comment again, and we’ll figure it out!

    • Joanna Goddard says...

      i’ll connect you two over email! :)

    • megs823 says...

      Leah – if you live south of Boston, a pelvic PT in the Hanover area is named Nadine Adams. I have seen her for diastasis recti and I know she also does pelvic floor PT.

    • Ariana says...

      I am a cancer patient and received pelvic radiation. I just started pelvic floor therapy and am very hopeful after reading all of these comments. I want to be able to have intercourse again!

  103. This is an incredibly brave essay. I’m so sorry you had to go through this. I’m a psychiatrist and have seen women who have been referred for similar concerns. I always tell them to see a specialist because it’s far too common for women’s issues to all be diagnosed as mental. And while it’s important to understand and get help for our mental health, I also believe that we have to make sure there aren’t organic medical causes contributing to what the professionals in my field see. Thank you for sharing your story. I’m sure it will help so many women who have been suffering.

  104. Jackie says...

    Endometriosis ended up being the reason behind painful intercourse for me. A laparoscopic surgery and nutrition (plus supplements) to help rid my body of too much estrogen was the key and the pain is now a thing of the past. As Dr. Swenson noted, it is a long, confusing and lonely road. SO thankful for this piece so women all over can start unlocking their own solutions and know they’re not alone. Bravo Cup of Jo for bringing it up!

    • Eleanor says...

      Same!! I’ve had 2 surgeries and working with a PT now who has saved my life. May I ask about your nutrition plan and supplements? I know it’s different for everyone, but I haven’t ventured into this aspect of endo and am curious. Glad you’re feeling better and THANK YOU to COJ for broaching this topic.

    • Sarah says...

      Hi! I think I might have endometriosis, but sex isn’t painful for me. I’m struggling with infertility. Did you have an experience with infertility before the surgery? Please don’t feel like you need to answer if that question is too loaded.

    • Jackie says...

      Hi Eleanor! I worked with a nutritionist here (https://www.weightandwellness.com/counseling/ ps. they do phone consultations too) and it opened my eyes to all the ways an overload of estrogen (through food and our environment) impacts our bodies. It was immensely helpful and really amazing to watch cleaner food and supplements rid my body of excess estrogen and have a positive impact on sex and other symptoms that I’m sure you know all too well. Good luck and yay for finding PT help thus far!! Oh and also (you may have already made the connection but FYI if not!) birth control pills were having a NEGATIVE impact on the endo (making symptoms come back after surgery) because they invite SO MUCH ESTROGEN back into your body. I got a non-hormonal IUD and that also helped.

      Hi Sarah! Not too loaded. I had the surgery before I was trying to get pregnant, but the Dr. who performed it basically said “Have painful sex for years and then come back when you can’t get pregnant. Or just do it now.” Seemed like a no-brainer to me. I had the surgery around age 25 and got pregnant at 30 by working with nutritionist to keep it at bay / not come back / up my chances of fertility. I hope, hope, hope this helps you on your journey and I’d highly encourage you to chat with a reputable nutritionist (I worked with https://www.weightandwellness.com/counseling/ and they do phone too!) to help balance your hormones for fertility. Thinking of you!

  105. My family makes nice, very ethical people with highly creative reproductive systems. Not creative in terms of making lots of babies, but creative like… LET’S PAINT THE LIVINGROOM CEILING CHARTREUSE TODAY! Or WHAT WOULD HAPPEN IF I SET THE COUCH ON FIRE? kind of creative.

    After I Ieft for college, when I finally began to understand that everything wasn’t supposed to hurt that much, I came home and carefully spoke to both of my rather prim grandmothers about their reproductive health. It was the late 80’s, and family medical histories were not public knowledge; your body was private, especially the private parts, and especially where I grew up. Both my grandmothers, I was surprised to learn, had had hysterectomies, and neither was sure why. “Oh, something was growing in there,” they said, as if it were distant and unremarkable. In time I found the words: endometriosis, uterine fibroids, ovarian cysts. My 49 year old body has never given birth, but by gum it can MAKE SOME STUFF.

    What I have learned, like this article says, is that it is right to insist upon the truth of your pain. Being female does not need to come with intense pain. If your menstrual cycle is painful beyond moderate uterine contractions, something is amiss. If it hurts when you have sex, something is amiss. If your doctor does not respect your experience and your pain, you should speak to another one. I found it useful, when speaking to my own patients as a yoga therapist at UCSF Medical Center, to remind them that while we often have intense emotional feelings for our physicians, we are hiring science consultants, not friends. It isn’t cheating to talk to another doctor. And other! And HECK YES for the pelvic pain specialists, bless them.

    It is also important to remember that one person’s great doctor might not be yours. Some people need coolness and some tenderness in their physician or physical therapist’s bedside manner. Some people need to test everything exhaustively, some need a minimal approach. Some people have tissue that wants deep pressure fast, some people need slow, gentle progress with lots of instruction about what is going to happen. Trust yourself. Keep looking until you find someone who can help you. Keep insisting upon the truth of your experience.

    When I was 23, I told my doctor it hurt when I had sex. She told me to relax. 8 months later I said, “Okay, now it hurts when I breathe,” at which point she finally took me seriously because my grapefruit-sized ovarian cyst could be palpated clearly and easily, and sent me for the ultrasound she should have ordered the first time I said I was in pain.

    You are not wrong when you are in pain. Someone CAN help you. Keep looking until you find them.

    I am 49 years old, and after 5 surgeries in 10 years and pain from menarche until a few years ago, I am writing this from my sailboat in Mexico, far from my doctors, with their great blessing. The one who surgically reconstructed my urinary tract (after endometriosis ate it and the first urologist didn’t believe how much pain I was in because I spoke of it so calmly and let things go until I lost half the function in one kidney) said GO! HAVE A GOOD LIFE!

    Keep looking until you find the right help, sisters. You, too, can know less pain, and perhaps be free of it. I am free of pain, as long as I practice yoga and self-massage daily to keep my tender, powerful, and deeply scarred innards supple. My surgeon, who has seen in there, sat me down and looked me in the eye and said HOW ARE YOU DOING THAT? about my active life. You can do this, too. It can get better.

    I know that someone is going to read this and sob. Probably several. Because this is too common, and because I was there. I am headed out to the dock to stretch my scars and I will sing to the universe for your comfort and your freedom from pain, sisters. May we all be free.

    • Joanna Goddard says...

      i love this so much. you are amazing, kristie. you should also be a writer.

      “Being female does not need to come with intense pain.” i love this line. when i was deeply depressed after having a baby, a woman told me, “new parenthood is a lot of work, but you shouldn’t be suffering,” and i honestly was so startled and thought, “i don’t?!!” because i thought pain and suffering was a necessary part of it and that i should just muscle through it.

    • Taylor says...

      I’d like to add……looking for help doesn’t feel free. I believe in the promise that someday, someone will be able to accurately determine what causes my pain–but I don’t have the time, money, or resources to keep looking right now. I can’t go to specialists in another state, and I simply don’t have the leave to go see doctor after doctor and try the next cream, the next gel, the next PT, the next surgery. I “fixed” the biggest issue with a surgery that was not covered by insurance. I simply do not have it in me, outside of me, near me, to spend as much money and time trying to find an answer to the issues that stemmed from the fix. Maybe coming to terms with a steady regimen of advil and never wearing pants is complacency instead of freedom, but I am so tired.

    • Sasha L says...

      Bless you Kristie, I know all this will help someone out there in pain tremendously.

    • Taylor, I hear you. We each have our own experience, and I cannot know yours, but mind is not small. I had level 7-9 pain much of my adult life. I am a healer because of what I learned trying to heal myself. Joanna said I should be a writer — I am; I got halfway through my MFA before healing called me because it asked so much of me. I spent 20 years trying to avoid surgery and then 10 years having 5 surgeries. I was both desperately poor and uninsured and financially secure and well-insured at different points in this process.

      I have been too tired to try anything else, too poor to do anything but go to the free clinic, and so terrified by my symptoms that I have to write them down because my mind will not actually remember them. I have sobbed in more doctor’s office than I can count — and turned a cartwheel in the parking lot of one.

      Of course we each decide how to live. We get to decide what’s okay for us. And there are times where we cannot do anything, for many reasons, even if we want to. But I speak about hope and trying because time brings change, and because I know from my work that people in pain, particularly strong people, come to accept it as normal. It’s so hard to make it go away, and no one believes us, and we just it up and deal. But there are always more options for those who want them, medical and nonmedical, mental and physical, free and costly, in person and online. I am not saying that anyone is obliged! I am saying that there is hope. I’d be happy to speak to you privately if you wish; I almost reached out already when I read your post, it touched my heart so.

      I am sorry you have pain, and glad you have less than once. I hold you in love.

  106. amy says...

    I LOVE THIS ESSAY. thank you, haylie, more than you know.

  107. diana k. says...

    I want to know more about this surgery! It sounds like something so revelatory once you found the solution. Was it just one group of cells freaking out? The rest of the cells remained chill about the whole thing? What was your healing time? More people should know about this!

    • gfy says...

      Not to mention the commentor who said that inflammation from a gluten intolerance solved her problem entirely! Like millions of others lately, after experiencing first hand just how inflammatory gluten is, it seems that should be the first thing to try!

  108. Sarah says...

    thank you so much for sharing your story!

  109. Sandra says...

    Very brave and intimate essay, thank you for sharing !
    I feel wary about the expression « i am still a virgin » when someone wants to say they haven’t had penetrative sex yet. Sex is not only penetration : if you kissed and had orgasms during your honeymoon, you totally had sex !! Thinking about penetration first is a very heteronormative way to approach sex. I don’t want to sound like I criticize the author at all, I just want to offer some perspective.

    • Hi Sandra! Thanks so much for this comment. I couldn’t agree more, and struggled while writing this post on how to express that while also being truthful to my younger self, who really did feel like a virgin (and not in the fun Madonna way!). I definitely feel differently now, and I really appreciate your thoughts.

  110. Sasha L says...

    Dr Haylie, wow, such helpful info. I bet there are so many women who can relate, to the problem, pain, frustrations of dealing with the medical industry, “the terrible merry go round”, all of the above. Thank you for spreading awareness and compassion, particularly for encouraging us to speak up and ask our loved ones for help in navigating.

    Can I just add that I think, based on this post, and the following tweet, that you must be a completely fun and awesome person to know. “I really hate it when people act like having a kid is the same thing as raising a cat. I get it, you love your kid. But it’s just not the same.”
    😂😂😂
    We need more of this lady!!

    • Thanks, Sasha! I have TWO cats now! It’s a struggle, but we’re #soblessed ;)

  111. Tabitha says...

    This brought tears to my eyes. I’m so grateful to Dr Swenson for sharing her story, it helps me less alone! I’ve had Vulvodynia (a chronic painful vaginal/vulval condition) for 5 years now. My condition is related to my body’s inability to process oxalates– those things that cause kidney stones and gout. It feels like I have little shards of glass in my vagina and the surrounding areas. For the first couple of years I couldn’t even wear tights or sit down for long periods of time. I went to 3 doctors who all misdiagnosed it and made it worse by prescribing me antibiotics., and pelvic exams caused the most excruciating pain I have ever felt.
    I figured out my condition on my own by reading forums and stumbling across http://www.thevpfoundation.org. I currently take some supplements that have helped me, and now my daily pain level is closer to a 3 than a 9 like before. But it sucks. I was (and still am) a virgin before I got this condition, and unless it goes away I don’t see how I will ever be able to have pain-free penetrative sex. I want to be married, but I’m freaked out by how a potential partner would respond to me explaining that we couldn’t actually have intercourse, and might never be able to.
    No one looking at me from the outside has any clue how much pain I’m in. They just see a happy, healthy woman and wonder why I’m not married or at least have a boyfriend. I try to remember this when I form opinions about other people based on their public appearance.

    • Sasha L says...

      Wow Tabitha, that sounds really hard. Sending you a hug. Hoping you can find healing. It’s so true, we don’t really know what is going on below the surface, having kindness and compassion toward others is always a good plan.

    • Kelly says...

      Hi Tabitha, I also have vulvodynia (unknown cause but either autoimmune or endo). I’ve been in a relationship for 9 years, and it kicked in (great timing) a few months before my wedding 2 years ago. My Urologist recently gave me a topical gabapentin cream for before pelvic exams that has been a godsend, and I also do daily vaginal suppositories that are lidocaine (pain relief) and valium (muscle relaxer). It took me two years of asking to get these, but they’ve made a world of difference with the pain while we continue to figure out underlying causes. Best of luck xoxo

    • I’m so sorry, Tabitha, and just want you to know that I see you and–while my diagnosis was different–I really understand your feelings, especially around feeling like your public persona doesn’t match your pain. It’s so hard.

    • gfy says...

      Have you ever tried a liver/gallbladder flush? No idea if that would help in your case but it might be worth trying. Andreas Moritz’s book “The Amazing Liver and Gallbladder Flush” is the definitive resource if you decide to try.

    • Tabitha says...

      oh wow, THANK YOU so much for your kind words and support everyone! Sasha, the hug means so much!!! I can feel it through the computer! :)
      Kelly, I’m SO sorry you had/are having to deal with that… but thank you so much for sharing what has helped, that gives me a ton of hope.
      Haylie… thank you. Thank you again for writing this article and for sharing so much of your personal story with us. It was a true gift.
      GFY, I haven’t tried that but I’ll definitely look into it! Thanks for the recommendation!

  112. Taylor says...

    I had a vestibulectomy in May 2017. I was 25, I had a normal, no pain, sex life from 16-23. At 23, I started experiencing the worst tearing sensation during intercourse. OBs, doctors, no one knew what it was. Maybe herpes! Maybe endometriosis! Many doctors told me it was in my head :) After two years of physical therapy and expensive out-of-network visits with specialists, I had the surgery. It fixed the pain during intercourse. Now I have residual pain from the surgery, but hey, I can have sex with the man I love. It’s a brutal truth that ultimately, I would take constant low level pain over the inability to be sexually intimate with my fiance. I wish this wasn’t the case, but it is.

    More than anything, the situation has led me to have a PTSD around most doctors–any time I go a doctor’s office I am terrified they will not take me seriously, I cry and feel sick. This process has made me hyper-aware that women’s pain is not something that’s considered important by medical professionals–whether it be researchers choosing new studies, or those that fund studies.

    Thanks for shining a light on this Jo.

    • Sasha L says...

      Hugs to you Taylor. Our medical system has let so many women down. It’s shameful the way many have been treated. I know it feels lonely, but you are not alone and you don’t deserve your pain.

    • Katie says...

      Reading your comment is like looking in a mirror and I just want to give you a big hug. I can’t even count the number of doctors I went to who had no idea what was going on and would prescribe me a herpes cream. When I finally found a female pain specialist who told me exactly what was happening I burst into tears. My vestibulectomy was the best decision I have ever made for myself. Yay for pain free sex!!

    • Thanks for sharing this, Taylor, and I’m so sorry for what you’ve been through. I’ve only recently realized how much anxiety about doctors I still carry with me because of my experience. I also go into appointments sure they won’t take me seriously and–even after all this–unsure how best to advocate for myself. Hugs to you.

    • M says...

      Perhaps a doula would be willing to accompany you to these appointments. It’s worth investigating. Some doulas have a sliding scale for payment.

  113. Katherine says...

    What a moving, open, sensible piece of writing. I feel this will be helpful to quite a few women-thank you.

  114. Thank you so much for sharing your story! I imagine it will help many women feel less alone, and it helps remove shame and stigma around virginity, sexual pleasure, and communication. I am so glad you were able to find medical professionals who would listen and respect you. <3

  115. agnes says...

    “maybe my vagina was depressed?”
    You’re a great writer and you definitely have a sense of humour! thanks for this very interesting article… I feel things are starting to change thanks to women who tell their stories…

  116. Wow, this is so brave & so intimate — thank you so much for sharing this incredible essay with us.

    I’m immediately going to check out your other work!