What is female sexual dysfunction?
Its time we pay attention to what is important
The first time I remember being explicitly aware of the divide between men and women as far as medical treatment goes was at the age of 12. I was sitting with my parents in the office of our family doctor after being recently diagnosed with obsessive-compulsive disorder, my parents asked what treatments were available. The doctor chuckled and said, “I wouldn’t really worry about it. Girls are just more dramatic.”
Cut to me in my early 30s, months after the birth of our daughter, and I had 20 dedicated tabs open at any given moment trying to find absolutely any explanation as to why sex had become difficult. Specifically, I was searching for why I was suddenly plagued with unyielding tightness and pain.
While my doctor at the time assured me I was merely a stressed out new mom and needed to relax, my vagina and I begged to differ. Where my doctor disappointed, but didn’t exactly shock me, my trusted Internet had little else to offer. There was post after post from trusted medical sites that boiled down to, “Okay, but have you tried a glass of wine and a hot bath?” and private online mothering groups that assured me my struggles were basically my nethers punishing me for having a C-section. None of it acknowledged what I was going through, nor did it make me feel particularly chill.
The term “female sexual dysfunction” was only first used as medical vernacular in 1998, many years after the pursuit of a cure for male sexual dysfunction was well under way. 1998 was the golden year of MSD; Viagra was about to burst onto the scene. And now that MSD was real enough to warrant a groundbreaking treatment, doctors reluctantly allowed FSD to be a thing.
As long as the possibility of FSD has been around, folks have been hell-bent on proving it isn’t real. Arguments against FSD are generally presented under the guise of protecting women from “disease mongering.” Researcher Leonore Tiefer referred to the naming of FSD as “a textbook case of disease mongering by the pharmaceutical industry and by other agents of medicalization.” While MSD is treated as a real, and solvable, medical issue, arguments against FSD suggest women are trying to steal men’s erectile thunder.
For example, when I Google “debate over the existence of female sexual dysfunction” I am treated to pages of articles and studies and op-ed pieces insisting any woman who thinks she has FSD is being had, and at the bottom of the page, Google suggests “female hysteria treatment” as the closest related search. Despite the widely accepted statistic that the majority of women will experience painful sex during their lifetimes, an article on Health.com that never fails to spike my blood pressure wonders, “Is it really dysfunction if it’s happening to almost half of all women? Or is it normal?”
Just because something is common doesn’t make it “normal.”
After the birth of our second child, my vagina went on an unrelenting lockdown again. Where sex had been difficult before, it was impossible at this point. No amount of deep breathing or glasses of wine or hot baths could undo whatever had gone wrong. It now stemmed beyond actual intercourse. I couldn’t use tampons or have my yearly gynecological exam. Basically, nothing was getting in there, and I was overwhelmed by fear, frustration, and if I’m being completely honest, internalized guilt and shame that my body had stopped doing what it was supposed to be doing. Why couldn’t I be cured by the glass of wine that the Internet and several doctors assured me was all I needed?
WHY COULDN’T I BE CURED BY THE GLASS OF WINE THAT THE INTERNET AND SEVERAL DOCTORS ASSURED ME WAS ALL I NEEDED?
At a desperate trip to my OB/GYN for answers, he dropped the diagnosis of vaginismus. I left that appointment with a referral to a vagina physical therapist, a referral to a regular therapist, and a prescription for Xanax lost amidst a bunch of brightly colored brochures. Wait, this was a thing? With a treatment protocol? Even with a diagnosis in hand, I still was coming up empty whenever I turned to the Internet for guidance and information.
His treatment plan was so sensible, I was actually furious that no one had brought this stuff up sooner. While there wasn’t a magical pill, I wasn’t on my own. Secondary vaginismus has a host of causes, from trauma to stress to physical changes such as, ya know, birthing a giant 10-pound baby. He was kind and specific as we discussed how female arousal does indeed work way differently than male arousal. Not worse, not even necessarily more complicated, just apples and oranges.
I was given a stack of at-home physical therapy techniques to try, and a list of what can only be described as medicinal sex toys to use in that venture. If that didn’t get me where I needed to be, off to therapy I would go to see if I could spank my inner moppet and deal with any psychological issues that might be complicating things.
From there, if I was in need, there was a light dose of Xanax to help relax my body when sex was attempted, and if I needed to tag in extra help, the vagina therapists at the hospital were standing by to treat the condition. And it’s exactly what it sounds like. If you pulled a hamstring or tore your rotator cuff, you’d use a physical therapist to get your muscles back into fighting shape.
So, that. Except with vaginas.
This all came to a very unfortunate head when the stress and guilt and frustration built up on a PTA-mom play date. Driving back from whatever the newest Twilight movie in theaters was, I sort of half-screamed at this car full of women I’d just met, “DID YOU GUYS KNOW THERE ARE PHYSICAL THERAPISTS FOR VAGINAS?”
DRIVING BACK FROM WHATEVER THE NEWEST TWILIGHT MOVIE IN THEATERS WAS, I SORT OF HALF-SCREAMED AT THIS CAR FULL OF WOMEN I’D JUST MET, “DID YOU GUYS KNOW THERE ARE PHYSICAL THERAPISTS FOR VAGINAS?”
Imagine my surprise when yeah, four of them totally knew there were vagina therapists because they had either been to see them, had dealt with vaginismus or a similar disorder in the past, or had known someone who had.
While I suppose I should have been delighted to find other people dealing with fritzing junk, what I did instead was continue screaming. “OKAY BUT WHY IS NO ONE TALKING ABOUT THIS!?”
When I asked my doctor why this wasn’t common knowledge, his frustration was immediate and palpable. He explained that even in the medical profession, any sort of female sexual disorders were wildly under-discussed, perpetually misunderstood, and generally chalked up to women being uptight and “needing to relax.” I got the distinct impression that he was even referring to other members of his own practice.
He suggested that this is one more—huge—way our system is based upon a male model of health, and women’s issues are relegated to the side. A trend that exists in our current paradigm everywhere from how we deal with heart disease to any complaint of physical pain. And we know how our current administration and GOP would like to view pregnancy as a pre-existing condition. Hell, the way things are headed, I’m waiting for being in possession of a vagina to be considered a preexisting condition.
In general, we’re more willing to acknowledge male sexual health, while speaking about women’s bodies remains taboo. We regularly see ads for erectile dysfunction medication during prime time television, or “male enhancement” vitamin supplements available at your local health store. But outside of birth control (which everyone is happy to sell even though few insurances are willing to properly cover it), there’s barely a peep about vaginismus or vulvodynia or vaginitis or anything related to sexual dysfunction or sexual pleasure for anyone sans penis.
My now years-long quest for information and support led me to even sit down and write a novel. About vaginas.
There is still little consensus about female sexual dysfunction. There are those who think no such thing exists. There are others that think physical disorders such as vaginismus are real, but for the most part could be solved with a glass of wine and a husband doing the dishes to take some pressure off a wife. (Eyeroll.)
Some argue that women are merely trying to steal the Viagra spotlight of menfolk with their real struggles. Some believe this is all a play by Big Pharma to try and trick women into thinking their vaginas aren’t working so they can get pumped full of Vagagra. (Patent-pending.)
I’ve even seen folks say trying to push the medical community to focus on female sexual dysfunctions in the same way we look at male dysfunctions (i.e. in the form of a pill or scientific fix) is antifeminist, and not cognizant enough of our differences, and should therefore be stopped. Head scratching yet?
While I don’t have any official answers to shut down all those voices, I can say that after years of dealing with my own bits on parade, and many a fruitless Google search, and one or two outraged rants geared at pig-headed doctors, there are a few things I know for certain.
Treatment, does in fact, exist. For me, it took about a year of at-home therapy and work with a therapist on finding ways to let the little things go, and forgive my body for well, being human. And now, while this is something that’s just a part of my life, I’ve managed to find a way to not let my rebelling vagina call all the shots
If your sex life isn’t going the way you wish it would, you are 100 percent allowed to talk to a doctor about that. One who will listen to you and not dismiss things as “normal” because that word is subjective and ridiculous in most connotations.
If you are feeling pain during sex, I don’t care how many women can say, “Pssh, I went through that!” It doesn’t make it your fate forever and always, amen. Sure, a glass of wine might actually be a thing that helps you out. But it may also require more than that, and you deserve medical professionals and resources that will treat your vagina as importantly as any penis that should wander their way.
But more than anything, you are entitled to never, ever be told that a physical concern isn’t worth considering with care and empathy.
Because while hot baths are super, and I highly recommend them should they be your jam, I can safely say that after 36 years on this planet, they are not a conclusive treatment for OCD, vaginismus, arthritis, autoimmune diseases, migraines, or hypoglycemia. (All conditions I have been told to let Calgon take away.)
For my next trick, I would like to see detailed studies on how many men get the “hot bath” prescription for whatever ails them.
From: ELLE USA