Sex & Pelvic Health
Great news! I have just received my women’s health coaching certificate to add to my somatic sex-coaching certificate.
Being a health coach, of course, does not mean I would ever try to treat you the way a nurse practitioner or doctor would treat you, but it does mean that if you come to me for help transforming your life or your pleasure, if there’s a medical problem at play, I’m much likelier to know where to send you for medical care right away. Even better (as you’d probably figure out which doctor to see on your own eventually), I can also help you with the body-mind piece, which can get to the problems upstream of the symptoms. So many of our physical ailments are inexorably linked to our stressed out nervous systems. You know this. I know this. Your doctor knows this. Everybody knows it! Unfortunately, that knowledge tends to land as another thing to worry and beat yourself up about,
“I know I just need to stress less!” Is a common client refrain. If only it were that easy! I’m grateful to Dagmar Kahn, my health teacher, for giving actual strategies for soothing the nervous system that are way, way more effective than just blaming yourself for your stress.
Today, it’s going to be story-time about my vagina, so if that’s TMI to you, I bid you farewell till next time.
I am a girl with a long, itchy history of vulva and vagina problems. Every single one of these problems negatively impacted my ability to experience pleasure, both sexual and general.
The problems manifested like yeast infections. Itching, swelling, massive inflammation. The itching was so bad — SO BAD!!! — that I worried I was going to have to quit my job so I could just scratch my crotch perpetually forever. And it was cyclic. It was worst leading up to my period. So every month, I’d have to go to the GYN and get a sample taken and they’d look at it under the microscope and tell me they didn’t see any yeast. And then they’d send it off for culture, and a few days later, they’d say, “well there was some candida in the culture.” And then they’d put me on monistat or fluconozole (the oral anti-fungal that works great but is really tough on your organs). And then it would start all over again.
Some days, I’d come home and take off my pants and have my husband just look, because it felt so, so wrong. I can’t really see my own vulva in the absence of a spotlight, binoculars, and mirror all arranged just-so, so I’d outsource this. My vulva was so, so swollen. Bright red. White sheen over everything. And it felt FRAGILE, like I would tear at any moment.
I was a mess. Month after month, I’d be peacing out of work and going to the GYN at rush hour for another swab, another “nothing!” another “actually, a little candida” and another round of meds. Day after day I’d be itching like the dickens and feel like if I sat down wrong, my vagina would split in half. Obviously, I was not having sex. I was also not having FUN! I was miserable. I was doing ALL THE THINGS. I changed my detergent and did extra rinses. I stopped wearing underwear altogether, and only wore big, airy skirts or hammer pants (vaginas love to breathe). I grew my pubic hair out to full length (full bush = full filtration and protection from the rest of the world — and it does help). I tried dietary stuff, too, elimination diet and everything. No dice. I kept asking my doctors and nurses, “could it be the IUD?”
Every single one of them gave a resounding, “NO! Impossible.”
The GYN nurse I love gave me the name of a vulva specialist with a wait list several months long. (Think BOTH gynecologist AND dermatologist in one brilliant woman). In the meantime, I called up a bunch of dermatologists who don’t look at vaginas until I found one who would.
“Hmmmm.” She said. “Has anyone mentioned lichen sclerosis to you?” She gave me the number of the same specialist I was already waiting on appointment for.
Lichen sclerosis is a terrible auto-immune disease where your immune system attacks the genitals. After reading a few articles about it, I dubbed it “zombie vagina” because of the way the scar tissue can build up and parts of your labia can actually fall off if it goes untreated for long enough. It is not a fun diagnosis. The treatment is steroidal, but it’s tricky, because a lot of steroids are not appropriate for use on the delicate tissues of the vulva, and you have to balance the skin-thinning side effects against the harm of the inflammation itself. I am also, paradoxically, allergic to some topical steroids.
When I finally saw the specialist, she was gentle and listened carefully. She had to take a biopsy of the scarring, and I had a PTSD flashback, but the nurse held my hand and let me cry and the doctor was so understanding.
Fortunately, I did not have vulva cancer, which was a concern. I ended up going on an absolute blitz of fluconozole (diflucan) and weaning off steroids. My flare ups decreased.
But every now and then, around my period, it’d come back again. Not as bad as before, but that same old white sheen over red swelling and just feeling wrong.
“Take out the IUD.” I told my nurse. “I know you said it can’t be that, but I’ve tried everything else.”
“I’d do the same thing if I were in your shoes.” She said, and yanked it out.
The flare ups reduced even more. I didn’t get the sheen anymore. I didn’t get the mad itching. Sometimes, before my period, I’d still feel ever-so-slightly off.
The final piece was quitting my job. I quit my beautiful but stressful job. I went to online school to be a sex coach. I started living at a pace of life that my nervous system could keep up with.
I have never had a yeast infection or any symptoms of lichen sclerosis again. Not even once.
Every piece was important.
It was important to get acute medical help when I was in an acute crisis. That vulva specialist saved me from the worst impacts of lichen sclerosis.
It was important to follow my intuition that the IUD was not working in my body anymore. Just because it worked at first does not mean I have to trust that it works forever. Removing that in the face of every member of my team’s “no” took a lot of self-trust and worthiness — and I was right. It absolutely was a piece of the puzzle.
It was important to overhaul my life to reduce my stress so that my body could finally, FINALLY calm down.
People on the internet often talk about it as a disease that doesn’t have a cure. If I were to blaze into the reddit page on LS and say I cured my own case, ultimately, with stress reduction, I’d get eviscerated. And, it’s true: I don’t know how I’ll be in 20 years. But I do know that I feel thoroughly healthy now. My vagina is pink and supple and happy and stretchy and I never itch or feel like I’m going to tear. Mine is a healthy, flourishing vagina.
Obviously my medical team also helped me come back from where I was in crisis. I don’t mean to sell them short. But the thing that got me to full, robust, pink, happy health was that last piece: overhauling my life. I believe that I had ignored my body’s objections to stress so hard and so long that my poor vagina had to come to me kicking and screaming and absolutely debilitating me to get me to slow down and listen.
So now I check in with my vulva every day. Can I feel her? Does she have anything to say to me?
It’s funny, growing up I always heard that letting your genitals guide your life was a very terrible thing — think of men behaving badly: “He was letting his penis make his decisions.” I think the problem isn’t that he let his penis make decisions, I think it’s that he let his penis override his heart. Well, I was letting my head override my voice and my heart and my gut and my womb and ESPECIALLY my poor vagina.
If you’re suffering in your body right now, I encourage you to get really quiet and put your hand gently over the uncomfortable places and ask each one in turn, “Honey, what do you need?” Then just listen. Start to track it. How often are you over-riding your body’s deepest knowing? How much are you depriving yourself in the name of efficiency, independence, or moral fortitude?
You don’t need a coach to empower your own vagina. But if you ever want a coach to help you where physical discomfort has come and crashed your personal life, hit that free consult button at the top and tell me all about it. I’m here.