“Can I examine you?” #Periodically 18

Covering all bases here, Happy 2018 #Periodically readers! We left off with me on Mefanamic Acid and iron tablets to help with period pain and heavy bleeding, for more details on that read: #Periodically 17. Today however, I have news, good and bad, a diagnosis and a potential solution, but it’s all rather bitter sweet.

TW/Disclaimer: I briefly touch upon mental health in this blog and as serious as I consider discussions on mental health to be, I do approach the subject with a little bit of humour. Making light of something isn’t always mockery, sometimes it’s a brilliant coping mechanism and an even better way to banish demons – even those of the vaginal kind. 

I was going to delve right in and give you the gossip from my gynae appointment last week, but having flicked through my December diary entries, I realise there’s a whole load of crap that needs to come before that, feel free to skip ahead. Warning, moaning ahead.

Just over a month ago we had some snow here in Essex. It only lasted a day but for about four seconds of this particular snow day, I pulled my twenty-seven year old sister two metres across the garden in a sled. The next morning I woke with an excruciating backache. Back pain is something I’ve dealt with for years, especially when on my period, but this was something else. Assuming it was because of the spontaneous sled pulling, I dosed up on ibuprofen and took it easy. A lot of the pain was intensified to my lower back and got particularly bad at night when I was sitting or lying down, at which point it was accompanied by some delightful shooting, tugging and tearing pains across my pelvic area, front and back.

After ten days of my moaning being even more annoying for my family than normal, I went to the doctors to check this wasn’t a womb-related pain. The delightful new doctor I had the pleasure of seeing basically laughed at me for expecting the pain to go away so quickly, and when I explained the fact that “hey, I’m in a lot of pain most of the time anyway and this is a bit much and I think I’m going to lose my mind” he did a nice, patronising head tilt and said, “so how long have you had this tummy ache?” Have you ever wanted to flick someone in the face, Rachel and Monica style?

The pain was quickly accompanied by some intense nausea, which I now believe was caused by the iron tablets. I had some really disturbing nights’ sleep for a while in December, so I stopped taking them for a couple of days and immediately felt better. Since I’ve been back on them it’s been OK, so I think it was just an acclimatisation thing. When the doctor couldn’t do anything for my back my mum insisted I got a sports massage, my first since the good ol’ marathon days. I don’t actually think this helped at all, but it turns out the masseur happened to have endometriosis, PCOS and a one year-old, so it served as an enlightening therapy session, if only emotional. The backache went away while I was on my period curiously enough, it’s back now, but honestly I think I’ve gotten used to it. I am wondering if perhaps it has been caused by the fact I probably carry myself awkwardly because of the pelvic pain and it’s therefore referred elsewhere, but the fact it hasn’t healed like a normal muscle injury does leave me wondering if it is just the next phase of Project Pelvic Pain.

So I started 2018 with my two favourite things; a period and a visit to the gynaecologist – yahoo, lucky me! Going into the appointment I had two things in mind: a) I hope its a female gynae and b) I think I’m going to come out with a prescription for the pill. Well the gynae was a man so that was an excellent start. I’ve never been bothered about having a male doctor for “intimate” situations, it’s more that in Swansea Dr M asked me what was wrong and then interrupted me every time I spoke – all that resulted in was fruitless surgery and a dodgy belly button. I wanted things to be different this time. Unfortunately, things started the same way. He asked me what my symptoms were and the moment I opened my mouth he just started talking over me and before I knew it he was saying, “so we need to get some hormones in you” and I just said “NO.” Happily, he shut up and listened while I explained that this was no longer just a situation of bad period pain. I told him that the pain and the repercussions of it were creeping in my life in serious and unwelcome ways and he finally said the words I’ve always wanted to hear: “can I examine you?” For avid #Periodically readers, you’ll know this is a momentous moment. Read: Why didn’t the gynae look at my vagina? to see why.

This was horribly awkward because I was on my period but also because the chaperone, who is there to make me feel comfortable, got waaaay too close while I was changing. But it turns out, the exam was uncomfortable for another reason.

Reclothed and a little lubey, I sat back down at his desk and he immediately said “OK you have a superficial problem too, it’s not just your internal system”. I didn’t even care what it was at this point, I just wanted to cry about the fact that all it took was a 30 second exam for someone to finally be like “oh yeah, there’s a problem”. He went on to explain that some of my pain, specifically my dyspareunia (pain during sex) is being caused by the uncontrolled clenching of my vagina upon penetration. Yep, I just wrote that #sharingiscaring. This has a name, vaginismus, sexy right? So he starts listing the treatments for vaginismus; “definitely counselling, probably physio and possibly anti-depressants”. I should have been fairly concerned at this point, but instead, my mind immediately went to Charlotte in Sex and the City… 

I’m not surprised, given the difficulty of pelvic examinations in the past, but I am not exactly comforted by this diagnosis as my dyspareunia is described as deep dyspareunia, meaning the pain I experience is more internal than my vagina, it is “deep”. To me it feels a bit like a chicken or the egg situation. Did I always have vaginismus, or did I get vaginismus because my vagina is like “wow don’t go in there, it’s a mess”. My instinct is the latter, but I guess we’ll find out in therapy! My gynae’s referred solutions have to be arranged by my GP and so it’s probably going to take a while, but this feels like progress, albeit it disheartening, worrying and a little sad.

The other result of the gynae appointment was that I now have, as predicted, a pill prescription. I expressed all my concerns, and other doctors’ concerns regarding DVT and breast cancer, but the gynae was confident that going on the pill will not only help with my symptoms, but that it has the potential to cure them. We also had a discussion about what pill I am *happy* to go on. It could of course be that if I come off the pill in two years everything will come back, and it could also being that going on the pill will do sod all to help me, but at this point it’s worth a shot. I won’t be starting the pill for a few weeks, so I’ll write a blog soon about my thoughts and feelings about going back on – as you can imagine, there are a lot.

Sorry this was a long one, but me and my depressed vagina needed some processing time before writing this. There’ll be more, but in the mean time I’m going to go and learn a little more about vaginismus, how I feel about going back on the pill and maybe I’ll even re-read Naomi Wolf’s chapter about the Vagina-Brain connection – I feel like I’m going to need it more than ever.

How are we feeling about the new #Periodically picture? Yay, nay?