Tag: dyspareunia

  • “Can I examine you?” #Periodically 18

    “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?giphy (4)

    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?

    periodically3

  • Persistence – #Periodically 17

    Persistence – #Periodically 17

    Long time no #Periodically, but don’t fear I’m back with another exciting instalment of “WTF is happening in Hilary’s pelvis” – I’m sure you were all anxiously waiting.

    So we left off with the discovery of two cysts, one functional (good), one hemorrhagic (bad) on my right ovary. The protocol is to wait six weeks to see if they go or grow. I also had a blood test taken the day after the first internal ultrasound and was informed there was something in those blood results that I needed to see a doctor about, but typically (#ToryBritain) the first available appointment was six weeks away. Conveniently though, it was scheduled for the day after the follow up ultrasound.

    I had a couple of really rough weeks in the middle of the wait for “answers”. I was both stressing about what was wrong with my blood (who tests for PCOS and Ovarian Cancer, says something’s wrong but doesn’t tell you what?!), dealing with a sudden and random horrible outbreak of acne and a flare-up of top-notch pain. I was pretty miserable company for a fortnight (sorry friends and family – thank you for not disowning me).

    Let’s throw it back to November 2016 for a second, where the first blood results I had to search for a problem revealed nothing. I did have slightly higher levels of androgens (male hormones) than normal, but nothing that warranted suspicion of PCOS (Polycystic Ovarian Syndrome). So when they found the cysts and something in my blood this November, I couldn’t help but wonder if I had just noticed symptoms of PCOS really early, and the androgens were now at a higher level and had been picked up in my blood. So what does any sane person do in this situation? I GOOGLED. I’m actually glad I did as I quickly learnt the surprising fact that despite the name, polycystic ovaries does not involve many cysts. It involves much smaller bubbles of fluid that grown on the ovaries in abundance. I don’t have that, so I relaxed. But my hairy disposition and sudden acne break out didn’t help calm my PCOS suspicions.

    Now because life is cruel, the six weeks came around and I was due on my period the exact same day as the internal ultrasound. While offering some potential technical problems, it also meant I was super on edge as I tried to suppress my PMS in the hope of postponing my period (this actually worked remarkably well but it also postponed and intensified my PMS, would not recommend). The internal ultrasound goes smoothly albeit painfully, and the sonographer immediately says “oooooh no,” as she sees that the hemorrhagic cyst is still there. “That should have gone,” she said. Problem is, it didn’t grow either, which, she explained, means it’s unlikely I will be referred for any kind of treatment. So I have a “persistent hemorrhagic cyst”.

    The next day I show up bright, early and menstruating for my blood test results. Happily, it was nothing too serious, just that my iron levels are a tiny bit low, which is consistent with having too heavy periods. Unfortunately, I hadn’t seen this doctor before, and having to explain all my symptoms all over again mid the hormonal meltdown I was having, resulted in some really attractive sobbing as I explained the last few years of pills, pain and frustration. This sobbing only worsened when she informed me that contrary to what I’d been told, Dr C never actually got around to referring me to a gynae in Essex. I explained to her that a big part of my frustration is that in 2015 I ran a marathon, in 2016 I ran a marathon but in 2017 I need a lie down after a dog walk. Not being able to have sex isn’t great either obviously, but exercise is a really great way of feeling like you have some control over your body, it’s difficult losing that control.

    However, the sobbing seems to have worked as Dr E has referred me to a local hospital, which should be quicker, and like the God she clearly is, she gave me something. I remain a little perplexed that no one has ever even offered me the medication she prescribed before, as its literal purpose is lightening menstrual flow and potentially easing period pain. It’s non-hormonal and I take it only when I’m on – pixie dust, clearly (Mefenamic Acid IRL). I can’t say I’ve noticed a huge difference thus far, but my period pain has been a little more manageable. I can’t take ibuprofen with it, which makes me nervous that if it doesn’t work then my main source of pain relief is out the window, but we’ll give it a good ol’ college try.

    FullSizeRender
    The latest venture.

    There are lots of frustrating things about this situation, but the two I’ve learnt this week are that the combined pill might stop the cysts from growing in the first place but that no doctor wants to put me on it because of DVT and breast cancer risk factors. The other is that both the sonographer and Dr E’s response to my pain outside of my period has been to say, “yes, sometimes cysts can be painful”. Trying to communicate to them that whatever is causing my pain, cyst or otherwise, is really painful often is proving difficult.

    So with a bit of persistence, like the pesky cyst, I’ve managed to get something to help with period pain, iron tablets that should help with sleepiness, and hopefully a decent and quick referral. It’s not exactly good news, but it’s something.

    Confused? Start the saga from the beginning here. 

  • Gynaecological Whiplash #Periodically 15

    Gynaecological Whiplash #Periodically 15

    I feel like I should start this blog with a “Previously on #Periodically…” but it might just be easier to read Periodically 10, 11 and 12 if you’re new. If you (understandably) can’t be bothered, here’s the gist: in August I had laparoscopic surgery to look for endometriosis, they found nothing but a regular (functional/ovulation) cyst on my right ovary and said there was “no gynaecological cause of pain”. While my belly button took some recovery meanders, I readied myself for my first doctors appointment since moving back to Essex and to look beyond gynaecology (towards bowels and bladder) to find a cause for my pelvic pain. Since then I’ve processed the news and the language issues I was worrying about in Articulating Pain – saying “dementors” instead of pelvic pain has stuck pretty firmly in my vocabulary.

    I must confess, trying to find the words to articulate how confused I am at the moment is proving difficult. Every time I process one fact, something contradicts it and I’m in a new hole of confusion and disillusion. So bear with me. 

    October started with September’s late period and a whole load of nauseating, black-out pain. And it really surprised me. I was surprised because by linguistically and medically disassociating my pain from my menstrual cycle, I think I thought the gynaecological symptoms would disassociate themselves too. Foolish, of course, but that period was a bit of a wake up call.

    Before my first GP appointment I had my symptom spiel ready, I’d checked that my discharge letter from Swansea had transferred and I was ready to start the process once again. Dr C, my new GP, listened to my symptoms, felt my abdomen, read the “no gynaecological cause of pain” letter, then turned to me and said “I am not convinced”. Excuse me? “I am not convinced that it is not gynaecological. You don’t experience painful periods or painful sex unless there is a gynaecological problem”. He ordered an ultrasound and some blood tests and said he would refer me to a gynaecologist.

    I was pissed off. I’d been jokingly forecasting that the doctor was going to refer me to a gyane in this appointment for weeks but I had been joking. I was mad, and my general attitude was “it has taken me 12 months to get to where I am now (which is nowhere) and now we’re going to start all over again from the same place”. Basically, I sulked for a fortnight. Until…

    This week, I headed to the ultrasound with my mum, confused as to why they hadn’t told me to drink a litre of water like last time. The reason I didn’t need any water was because it happened to be an internal ultrasound. Now they had my attention – I’d be moaning for months that it seemed strange to me that I’d never had one of these. While Dr T, who carried out the ultrasound, and the chaperone described the device as a “wet tampon”, I would describe it as a very solid USB dildo that’s plugged into a computer being watched by two doctors and your mum. To my surprise, it hurt almost as much as sex and has left me in the same horrible post-sex pain, but perhaps we now know why.

    I can’t believe I’m writing this. I have a cyst! Two actually, on my right ovary. Yep, what the fuck? Sorry I can’t be more eloquent about this but I am so beyond confused and conflicted at this point that the words in sentence putting is falling out of nick. (What?) One is a small 2cm functional cyst – potentially an ovulation cyst but where I was in my cycle would suggest otherwise. The other cyst however is over 4cm and looks like an hemorrhagic cyst, meaning it has been bled into, which is, get this, potentially an endometrioma or endometrioid cyst. Hmm, those words sound familiar, don’t they?

    Once I had my nickers back on my mum and I expressed our shock upon this discovery to Dr T, explaining the fruitless laparoscopy results just two months earlier. Dr T said: “what and the laparoscopy didn’t find any endometriosis? That’s funny because all your symptoms point towards that”. We all laughed and I went home with the promise that we’ll check to see if the cyst is still there and whether it has grown in six weeks.

    I say laugh but I mean a sort of hysterical confusion and shock induced gurgle. Now, to answer some question my friends have hit me with since the Great Cyst Discovery of October ’17:

    What does this mean? I don’t know.
    Why didn’t they find it in the surgery? I don’t know. It’s possible that it wasn’t there, or that cysts have come and gone and during the lap things just happened to be clear.
    Is this PCOS? I don’t know.
    Is this endometriosis? I don’t know.
    Will they take it out? I don’t know – seems unlikely given my favourite sentence “sometimes you just have to live with it” was uttered during this appointment.
    If they do, would you want to go through surgery (belly button nightmares) all over again? I don’t know.
    Did they actually do anything in the laparoscopy or did they just cut you open, have a cup of tea and then stitch you up (badly)? Maybe. No. A lot of my frustration earlier this week was directed at the surgeons in Swansea, but I know that’s unfair. They knew what they were doing, things must’ve been clear in August. Or maybe the functional cyst they saw was not as functional as they thought.

    I don’t know whether to be mad, happy or upset – I am just very confused. I guess I can say “ovulation pain” rather than “dementors with knives” again now? Plus there’s the fact the whiplash might continue if in six weeks the cyst has disappeared without a trace. I almost begin to get that fuzzy “I’m not imagining it all!” feeling, before I begin to wonder if I imagined the whole surgery in the first place.

    So things are once again painfully up in the air, but for now I am just grateful that despite my obvious doubt, Dr C listened to his gut.

    A bit lost? Don’t blame you. Find the rest of the #Periodically blogs here. Or if it’s a little too TMI for you, I blog about books too here and, finally, last week’s blog can be found here.

    wth