In early 2023, I communicated with Brittany Browning about the book she was writing (!) about why vaginismus is so poorly understood. What a topic! I was thrilled to participate and figured I’d share my answers to her questions below.

Brittany: Would you mind sharing more about your personal journey with vaginismus? Specifically, how long it took you to arrive at a diagnosis and any roadblocks you experienced along the way. 

Missi: My vaginismus is situational. I remember first encountering pain with sex the first time I had it, and every time after that. I just assumed everyone was lying about sex and pretending it felt good. Plus, gynecological appointments were always painful. I would also periodically have pain with tampon insertion; to this day,  even if I don’t feel pain, I’m highly aware of the tampon/string. I’m not sure when exactly I started to realize that other people didn’t necessarily experience these things. Even once I did, it took me a long time to do anything about it. Fear, insecurity, and lack of knowledge prevented me from ever saying anything to anyone. It wasn’t until my early 30s that I mentioned this to my gynecologist. Luckily, she quickly referred me to my first pelvic floor PT.

I recognize not every person is this lucky when it comes to their healthcare providers. My roadblocks were all internal. For me, it’s also important to share that I didn’t seek help for my vaginismus until getting sober from alcohol. I’m not sure I would have said anything had I not gotten sober; I used it as a numbing agent for over a decade. When I hear stories of people being told by doctors to “have a glass of wine and relax,” I cringe and have a moment of gratitude that no one ever said that to me. 

B: I know we talked about there not being substantial research on what causes vaginismus, but do you have any ideas about what caused yours? 

M: I have theories on a number of contributing factors that range from physical to emotional.

Physically, I was a dancer growing up, and I had what people commonly refer to as a “sway back” — think butt sticking out back, ribs poking out forward. “Tuck your tailbone” was a correction I often received, and rather than addressing it by correctly engaging my core, I squeezed the bottom of my glues together. This developed a pretty strong movement/holding pattern over years of practice that I still have trouble not resorting to when I move my body. This puts pressure on my lower back, and makes the way my core and pelvic floor muscles function wonky. I’m essentially using my pelvic floor and glutes to do the work that other core muscles should be doing. On a potentially related note, I clench the same muscles when I’m stressed. 

I think the emotional factors are likely stronger in my vaginismus, especially because it’s situational, but I don’t think the physical should be totally overlooked since I did develop such strong habits/patterns over the course of a decade. I think this also potentially explains why I made progress in PT but also quickly plateaued.

Emotionally, I had some adverse experiences as a child that I’m still untangling. I stopped growing around age 10 and underwent a series of intimate medical appointments and tests. For years, it felt like all doctors did or cared about was checking my body to see if I showed any sign of puberty — breast growth or pubic hair. I remember repeatedly being asked about my eating habits because they thought I had an eating disorder (I didn’t). I had to get x-rays to measure my bone age (3-4 years behind my chronological age). I had an ultrasound to make sure my reproductive organs were functioning; everyone else in the waiting room that day was pregnant and staring at me with my dad (I was twelve or thirteen but probably looked nine or ten).  I was tested for growth hormone deficiency. At one point I was put on progesterone to see if it would kick start puberty; I got my period for a few months while on it, but it didn’t stick once I stopped the hormone.* 

This was around the same time that an ER episode about a little girl who turned out to be a hermaphrodite aired; if I remember correctly, her name was Barbara/Barbie, and the line at the end was “I guess Barbie is actually a Ken.” This possibility terrified me. I can laugh about it now, but the fear felt very real at the time. (Sidenote, Jeanette McCurdy mentioned this episode in her memoir because she auditioned for the role and I was so glad to learn another human in history was impacted by this episode in some way, even if for completely different reasons.) 

Eventually, I just started growing again. They never figured out why I stopped or started. It was all pointless.

I recognize that nothing intentionally harmful was ever done to me, but the experience made a lasting impact. For a long time I was very neurotic about my body, but in a completely different way than the cultural narrative. I didn’t want to be small and skinny. I wanted boobs and hips. I didn’t want to have to shop in the children’s section. I was so jealous when a friend would get her period. By the time my peers were getting nervous and fearful about their first gynecological exams, I was incredibly apathetic to the experience. No one knew about my appointments, so I joked to myself internally that I was already pretty used to undressing and spreading my legs for  dudes in a white coats**.  I was  really closed off to parts of my body. Like one of those censorship black bars on TV/images was placed across my pelvis. It isn’t that I had never experienced any kind of pleasure there, but I was completely unaware of the tension I held.

When I acknowledge everything I went through as a kid, the fact that I have painful gynecological exams and sex really isn’t a mystery.  Not that I know anyone who enjoys a speculum (but maybe they’re out there!).

When I started working on overcoming vaginismus, I started with the physical. But that only took me so far. I quickly made progress but also quickly plateaued. I realized I needed to move into therapy to address my childhood experience. I’m still working through all the impacts that had on me, but the more I work through that, the easier it is for me to relax my entire body, pelvic floor included.

B: Who (if anyone) do you talk about vaginismus with in real life? Has keeping it a secret in any capacity been part of your journey? 

Besides Instagram? 😉 

The first person I told was my gynecologist, and then of course my first PT. But that was it for years. I was single when I started PT, so I didn’t have to have the sex conversation until 2-3 years afterward. I spoke to a former boyfriend and he handled it really well. I’ve told a handful of friends but not too many people in my personal circles know about it.

Beyond that, I started and deleted like, 3 different blogs between 2018-2020. But things stuck a little more when I started @yogaforvaginismus.  My account for personal musings, @thevaginismusmonologues, started in the fall of 2022 (I've since paused this account to focus on one thing at a time).  I’d been thinking about this for years and finally decided to just do it. I have no way to describe my reasoning other than feeling called to do it. In fact, I could tell you a million reasons why I should not have started these projects. But here we are. 

Keeping it a secret before @thevaginismusmonologues definitely had an impact in that it hindered my healing progress. It’s been cathartic to have community. That is something I learned while getting sober. I think one of the reasons I haven’t really tackled my vaginismus like I did sobriety was because I haven’t done the best job of creating that foundation.

When it came to building community, I reached out to the Vaginismus Network in 2020 or 2021 and got connected with someone in my area. The Vaginismus Network is UK-based but they were actually able to pair me with someone in North Carolina, which was amazing! She and I hang out every few months. Our conversations were originally vaginismus-centric but have expanded beyond that. Last fall I signed up for support group calls with Hope & Her. Overlapping that, I worked with Lindsay Dorka of Anchor Pelvic Health. Lindsay is an occupational therapist who dealt with chronic pain and realized her treatment needed to go beyond the body. It’s been so freeing to be able to have conversations with different women about this. It helps me understand my own vaginismus so much more, in addition to the benefits of feeling seen and understood.

B: Has your sobriety journey been impacted by your vaginismus treatment, or vice versa? I’m curious about this because I was told by a medical doctor at 19 years old to “loosen up with a glass of wine” and I’ve learned that this is a very common piece of advice. I wasn’t even old enough to buy or drink alcohol yet! You mentioning your sobriety journey had me thinking about that problematic statement in a completely different way. 

For those of us who have struggled with addiction, how awful to be relying on something that is causing so much damage in one’s life, and potentially trying to rid oneself of that substance, only to be told we must hold on to it in order to establish or grow a deeper connection with someone we love? It can do a lot of harm. Especially when desiring connection is generally already a contributing factor to substance use.

For those not concerned about their alcohol consumption, or who never drank to begin with, it’s still incredibly harmful. It invalidates the pain and personal experience being had by the patient, and frankly, it’s terrible medical advice. Alcohol has been shown to not only hold no health benefits; it’s far more damaging to personal and public health than most substances the scientific/medical/legal communities have determined to be harmful. If alcohol wasn’t so culturally acceptable/promoted, it would be no different than telling someone to smoke a cigarette before sex. And no present-day doctor would do that in their right mind. To flippantly imply that it is the magical elixir that is going to solve a person’s pelvic or relationship problems is irresponsible. 

B: What sort of financial impact (if any) has your treatment had? (Out-of-pocket medical expenses, prescriptions, dilator sets, therapy, pelvic floor PT, etc.) 

M: Oh gosh…I think it would be safe to say I have spent a minimum of $10,000 on resources and treatments in the last 4 years. I think that estimate is conservative. It might actually be closer to $15-20K. Luckily, some of my PT and therapy could be covered by insurance or an HSA, but definitely not all of it. 

Here are all the things I can think of that I have paid for:

• Pelvic floor physical therapy: $80/session. 
• Therapy: $125-175/session
• Various online programs, support groups, and coaching: $5,000
• Dilator set and wand: $150
• Books: $200 if not more
• Massages (psoas and glutes): $200/massage

B: What advice would you give to someone newly experiencing symptoms of vaginismus? 

M: I am training myself to no longer view my vaginismus as an enemy, but as my very best friend. She is amazing and she truly only has my best interests in mind. For better or for worse, my vagina apparently a barometer for my stress level, and that is kind of amazing when I really think about it.

Well-intentioned medical providers and physical therapists will likely suggest physical treatments to physical symptoms, and those can be helpful, but they only took me so far. In my experience, I didn’t see results until I started addressing trauma and building confidence in myself. That often requires maintenance. When I don’t do that, my symptoms come back. If I can’t relax, there is no point attempting to dilate. It’s not happening. Your vaginismus might be your body sending you a signal that something is not okay. It could be reacting to a past trauma that needs healing. It could be reacting to what it perceives to be a present day threat. Everything might be okay. But maybe something isn’t. It’s your job to figure that out and nurture that wound.

Lastly, community is key. Maybe the number one thing. There are other people who will see you, understand you, relate to you, and help you. Being seen and understood is SO important. Healing happens in community. Find it.

*One thing I am grateful for from this experience was the high level of predictability of my first period. Not many people will ever receive such a beautiful gift. When, years later, I finally actually got my period, I was both elated and prepared for action.

**If you are wondering if this impacted my sex life, the answer is yes.

Brittany created the blog Hard Things on Substack to connect with others who have vaginismus  as well as medical professionals who treat it. You can follow Brittany on all the socials:

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