On my first day of pelvic floor physical therapy, I filled out a questionnaire that asked if I had experienced any sexual trauma or assault—as so many of those questionnaires do. For nearly 17 years, I’ve just avoided the question, or denied the honest answer. But on that day, before I embarked on a type of therapy that already had me a little anxious, something made me check “yes.” Of course, I prayed I wouldn’t have to go into detail about it, that it wasn’t something my therapist and I would actually discuss. After all, I was being seen for UI due to multiple prolapses, not because I was a sexual assault survivor!
But I am a sexual assault survivor. And the night that I was raped has been the catalyst for all of the physical issues I’ve experienced pretty much since I was 19. The vagina is a muscle that remembers, and when it experiences trauma—unless it’s dealt with in a healthy, productive manner—the vagina will not forget. So while I was busy trying to forget what happened to me, my body was holding it all inside.
Here’s what my vagina remembers: In 2001, I was sexually assaulted by an acquaintance on my college campus. It was ugly and brutal, and because I was scared to death of the potential fallout (no prolapse pun intended, I swear) of that night, I didn’t deal with it properly. I did not seek medical assistance, go to the police, or do any of the things we’re taught to do when a trauma of that nature occurs.
Instead, I ran. I transferred to a school close to home, where I figured my assaulter would not be able to hurt me again. I hid what happened from my family, I told very few friends, and I never told my doctors. Telling people would mean reliving it, and reliving it was not high on my list of things to do. I never imagined that the pain and trauma he had inflicted could continue to hurt me, even outside of physical proximity to him.
This vaginal memory led to vaginismus, a painful disorder where the vagina adversely reacts to sex and sexual stimuli. For years, I did not know that it isn’t normal to feel pain and dryness in anticipation of sex. I wasn’t aware that my body wasn’t supposed to tighten up right before sex and feel pain and pressure for hours or days after. I thought wanting to avoid sex at all costs as often as possible was normal, and since I had no control over my physical and mental reactions to it, I assumed this was just the way it was supposed to be. I also didn’t know that my severe uterine prolapse and two types of UI might not be the result of four pregnancies in five years, as I had suspected. I didn’t know that this was all happening as a direct response to trauma.
As the weeks went by, and my pelvic floor physical therapist and I talked more about my body, the pieces of the puzzle started to come together. Pelvic floor dysfunction, including prolapse, is noted in many women who have survived sexual abuse and trauma, and I’m a prime example. As more conversations took place surrounding this, I was able to see how hiding from the rape and trying to forget it has ultimately done more harm than good.
So where can I go from here? It’s a process, but I’m learning. The first step was for me to confront what happened head-on, which led to a conversation with my parents 17 years after it should have occurred. This was not the healing experience I needed it to be, but I am moving onward. Next, I am seeking counseling for the first time in my life and taking an antidepressant, which also happens to help withchronic pain and the daily effects of UI. I’m on the right track and feel good about where things are headed for the first time in a long time.
In terms of UI, I’m also working with my physical therapist on training my vagina to trust again. Its trust issues have built themselves up over the years into a tight ball of little angry fists saying, “You, sir, shall not pass.” To make sex less painful, I’m taking matters literally into my own hands with the help of vaginal dilators, devices of increasing size that are inserted into the vagina to help the muscles learn to relax. When used properly and consistently—and in conjunction with therapy and counseling—they can help treat vaginismus as well as other vaginal dysfunctions. They help increase muscle control, which in turn helps manage UI.
Right now, I’m on the second-to-smallest dilator and working my way up. It’s going to be a process to get where I need to be, but I’m learning that anything worth doing is worth doing the hard way. After all, reflecting on and processing my UI’s true causes has been painful, but through it, I’ve learned I’m really strong. And, it turns out, my pelvic floor is too.
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