How many of us have been told that, when it comes to sexual or genital pain?
It hurts to to put in a tampon...It’s all in your head.
It hurts to have sex...It’s all in your head.
It hurts to have a pelvic exam...It’s all in your head.
It hurts more than normal when I cramp during my period...It’s all in your head.
I have been diagnosed with vestibulodynia (formerly vulvar vestibulitis), vulvodynia, vaginismus, endometriosis, ovarian adhesions, pelvic floor dysfunction, and a scarred perineum from an incorrect repair of an episiotomy. I had a gynecologist tell me that the pain (from the scarred post-episiotomy perineum) was all in my head and I should just drink a glass of wine and relax. I got a second opinion, and had to have a reconstructive surgery.
But...It’s all in my head.
Let me let you in on a secret...it is in your head. But so is pain from a broken arm, open heart surgery, or a hangnail. All pain is technically "in our head." Nerves detect potential damage or danger, alert the brain, which then creates the pain sensation. Pain is our bodies way of protecting us - it warns us to stop the damage-causing action, or to get help. So, yes, it’s all in your head. But that doesn’t mean it isn’t very real.
And you are not alone. There are more cases of vulvodynia than there are of breast cancer - and we see pink ribbons everywhere. 1 in 7 men and 1 in 3 women experience unwanted pain during vaginal intercourse. When you go to the gynecologist, do they ask you about sexual health beyond birth control? Do they ask you about pain? Do they ask you about pleasure? Are the labia, the clitoris, the vaginal vestibule looked at, or do they simply stick in a speculum to peek at the cervix? A 2012 survey of United States gynecologists showed that only 40% asked patients about sexual problems and less than 14% asked about sexual satisfaction and pleasure with sexual activity.
You deserve care that takes you seriously, that recognizes what pain is and its purpose, and that doesn’t settle for just masking pain. When we ignore pain, try to push through it, or numb it through alcohol, desensitizing gels, or other means, we do our bodies a disservice. We negate the very real warning signs our brain is sending, and we stop trusting ourselves.
Your pain is real. Your pain is your body doing its job. It’s time we start trusting our bodies, and partnering with medical professionals who do the same.