Thank you.

My boyfriend is usually right.

It’s too bad because isn’t it my God-given privilege as a woman to always be right? Kidding of course. But seriously, my man has a freak-ton of insight, and he is often right. Which is why it’s time for me to come out of the closet: I want to be a writer. When he suggested it was time, I had my ammo ready: Doesn’t every third person in the world want to be a writer? Aren’t they all better than I am? Don’t they all have stacks three miles high of rejection letters? And he said, “So? You have a story to tell.” And I said…nothing because I felt lucky all over that God put a man in my life who believes in me that much.

So here’s where this is all coming from. Someone once said whatever vocation works to end the thing you hate most and bolster the thing you love most is the vocation you ought to be in. (Unfortunately, I did not take this person’s identity to heart like I did the idea itself, so let me know if you know where I got it. I suspect it’s someone ripping off Buechner’s quote.) For me, the thing I hated most when I started preparing for a career was that many kids go home every afternoon to places where they are never told how priceless, how necessary, and how on purpose they are. Alternately, the thing I loved most was, and is, magic. And language is a form of magic. How is it that I can make certain vocal noises or write certain squigglies that transfer thoughts from my head to yours? Why does that work? You can imagine, then, that getting to teach 95 people a day how to do it in another language is incredibly special to me. So, if you want to combat teenagers’ low self-esteem and you love magic more than anything else—and if you’re me—you become a French teacher. You spend your days telling teenagers how pricelessly valuable they are while you introduce them to magic. It’s perfect, and I have no plans to quit.

But seven years later, I now know a broader scope of both loneliness and magic. Sometimes kids aren’t the only ones lonely. Sometimes wives are. Sometimes husbands are. I know that loneliness. God blessed me—and I do mean blessed me—with sexual dysfunction, divorce, miscarriages, and complete brokenness before him. And then he blessed me with the grace and peace that come from allowing him to fix the whole crappy mess and make it beautiful, make me beautiful. He healed my heart completely, even from all that junk. Without having gone through the past five years, I don’t know how I would’ve ever come to understand his love, compassion, and eagerness to redeem. I don’t know how I would’ve so intimately learned his presence if I hadn’t had to hold onto him. So now what I love most in the world is Jesus and his unbelievable redemption—which is in my mind the very highest form of magic. And what I still hate most is that some people’s reality is loneliness. When I put together that love and hatred, I get…writing my story.

I tell you this to say thank you, thank you immeasurably, for the encouraging comments and emails. No words exist to express how grateful I am for your willingness to read my story and share yours. I don’t know what form my writing will take—it may be something that exists only in small circles at my own church—but it is the burning in my heart. I want everyone to know that Jesus heals, Jesus rescues, and Jesus loves. I am proof.

And I have to thank JB, without whom—literally—my blog would not exist. In a Gmail chat last May, she said, “Maybe you could write a blog about all this.” So I did because I have learned that, like my boyfriend, she is usually right.

Which brings my gratitude full circle. I anticipate many more moments of saying (slowly and with a French accent), “You are riiiiiiight,” to my man, who will in turn smile and say more nice things to me. I am just that lucky.

Slaying my dragon.

My official diagnosis was vaginismus, or severe tightening of the vagina that makes sex incredibly painful or even impossible. For me it was a chicken-and-egg question: there was no way to know whether it was already happening before my surgery or whether the surgery indirectly caused it. Dr. C believed the latter, saying the surgery likely gave me a subconscious fear of sex; my physical therapist said it was a moot point. Women with vaginismus often go years without getting treatment because so few doctors know how to remedy it. Many in the medical community feel that vaginismus is strictly emotional and write it off with a “prescription” for sex therapy. I was lucky enough to have a doctor who believed in a holistic approach: Dr. C made me an appointment with a physical therapist who works exclusively with women’s health, listed home remedies and simple exercises that are proven to help, and suggested I see a university psychologist. She encouraged me to think realistically but hopefully: “Physical therapy will take longer than a pill,” she cautioned. “But if we can retrain your muscles, we can completely eradicate the problem.”

The idea of physical therapy was odd to me. What was the therapist going to do, massage my lady parts into submission? Mini nightmares (cue Jaws theme) edged into my mind at random times of yet another medical professional getting involved with my uncooperative body. But in October 2010 I entered the physical therapist’s office half an hour before my appointment and filled out the obligatory paperwork. When Penny came out to greet me, I knew I’d made the right decision. She was a leftover hippie, sporting chunky jewelry and au naturel, brown and gray hair. Penny is originally from San Francisco but had found a home in our own Virginian hippie oasis. She took me back to her therapy room, closed the door, and said, “What am I going to help you with?” And with that, she stole my heart. She was so confident, so compassionate, and so ready to help.

I told my story…again…rather dispassionately by now. My optimism had waned over the years, and I was starting to believe that, as Dr. B had warned me in the counseling room, “Some women just don’t care for sex, and it’s possible you are one of them.” Penny listened patiently, nodded, and said, “I can help. We’re going to get your insurance to cover this, and we’re going to train your muscles to relax. When you relax, the pain will subside. You might have some vestibular vulvodynia, especially since you still have scar tissue, but if the muscles stay calm, you probably won’t notice it.” So once more, I crawled up into the stirrups. Penny explained every move she made, locating tense and less tense areas, making a sort of map for treatment. The next appointment, she hooked me up to a biofeedback machine that used color-coded graphs to show us exactly which muscles succumbed to spasms, when, and how intensely. Because of the information the machine provided, I began to differentiate my pelvic floor muscles, feel when they tensed, and learn how to release them. Tensing had become such a habit that I realized I was holding them tight even when it didn’t make sense—while studying, for example, or while driving.

Penny also taught me generalized relaxation techniques. As you might imagine, going through a master’s program away from my family-and-friends support system while dealing with sexual dysfunction and increasing marital difficulties was pretty stressful. As I employed Penny’s global relaxation techniques, we found I was better able to manage the tensing of my pelvic floor due to stress. Over the next few months I spent hours and hours in Penny’s therapy room, practicing deep breathing, intentional muscle relaxing, and pelvic floor strengthening exercises. For her own part, Penny used the biofeedback machine, manual manipulation—the weirdest-feeling pelvic exam you can imagine, and strain-counterstrain techniques on my lower back (which is connected to pelvic floor muscles). Strain-counterstrain was my favorite. It’s a muscle-relaxing method in which you find a tender and/or ticklish muscle—in either case, it’s tensed—and apply pressure for 60-90 seconds until the muscle melts like butter. Although I had never had back pain, I felt so good after strain-counterstrain sessions.

I saw successes every step of the way. After just a few sessions with Penny, I started noticing when the spasms happened, and I was able, gradually, to mitigate them and then stop them altogether. Next, I was able to start using tampons, which had never been possible. Then, I made it through an entire exam with Dr. C with absolutely no pain whatsoever. Finally, when Penny had to use certain instruments during manual manipulation, the spasms eventually stopped. Granted, I had to be present in the moment, focusing on my pelvic floor muscles and their movements…but for the first time, I wasn’t having any spasms at all. That was the first moment of my life that I felt true confidence in my body. Maybe—maybe—there would come a day when it didn’t feel broken. Maybe there would come a day that sex would be enjoyable. Maybe I would one day feel womanly and feminine and even…did I dare say it?…alluring. For the first time, all of this seemed possible. At this point, no sex of any kind had been a part of my life for several months, but with the possibilities there, I started feeling a sense of pride in my body and decided it was time to lose weight. And that is exactly what I did.

For more information on vaginismus, visit this incredibly helpful website.

“If you'll place your feet in the stirrups…”

There are a number of reasons I consider my time at the University of Virginia a gift, but near the top is Dr. C, even though she represents hours and hours of having my feet in the stirrups. Not only did Dr. C extensively research the symptoms I described, but she also called doctor friends and colleagues who are specialists in the field of female sexual issues. After spending hours on my case, she took time to explain to me in precise, comprehensible terms what my body might be doing and gave me a choice of treatment options without pushing me in any particular direction. Two diagnoses were possible, and we had to decide which it was before we could design a viable treatment plan.

The first possibility—the one we were both hoping it wasn’t—was vulvodynia. Vulvodynia is chronic vulvar pain, and there’s no cure. The pangs can be anywhere from dull to crippling, and they attack you as you drive, swim, run after your children, wash clothes, and everything in between. While sex of course intensifies the pain, it’s more or less always there when vulvodynia is the culprit. The “treatments” are pain management programs, not cures, and many of them are, honestly, creepy. One commonly invoked method is a topical ointment featuring capsaicin, the active component of chili peppers. Chili peppers. That’s right: we’re talking feeding puréed chili peppers to my lady parts. Quite literally spicing up my sex life. The idea behind capsaicin—which, by the way, is every bit as much of a skin irritant as you’re imagining—is that you shock the nerves. Eventually, the nerves will calm themselves when they get over the pain spike. It seemed like thinly veiled, sarcastic masochism to me. “You think you’ve got pain right now? Wait’ll you feel this, dollface.” Cue the chili peppers.

Another treatment possibility is a vestibulectomy. I will explain as gently as possible. A vestibulectom-ist (that is not a real word) excises the really egregiously painful tissue in the vaginal vestibule, scooping out all the skin and tissue with the overactive nerves. To re-cover the excised area, a vaginal extension is performed, pulling vaginal skin forward over the area and securing it. Crossing your legs yet, women? The short version is that the surgery pulls out painful skin and covers it back up by using your lady parts like a rubber band sewn in place. The problem with this treatment—I say that as though there’s only one—is the formidably low success rate. As in, 50-60% according to most doctors. I’m sorry, but if you’re going to stretch my lady business, I’m going to need a higher chance of success than eh, maybe.

Other less invasive options are practiced. Dr. C offered me tricyclic antidepressants, for example. They are meant to affect the mental patterns of pain your brain creates. Despite how desperately I wanted to be cured, the idea of using antidepressants to alter receptors in my brain just so I could enjoy getting frisky seemed like regret waiting to happen. I did use Lidocaine, a topical numbing agent, for a while. But you might imagine the (viable) complaints my husband had about numbing ointment. Plus, it worked about as well as I imagine the chili peppers would. So Dr. C and I decided to rule out vulvodynia and assume my pain was vaginismus instead.

Unlike vulvodynia, vaginismus is not chronic. It is vaginal pain triggered by certain activities or movements. Also unlike vulvodynia, the pain is muscular rather than nervous. While vaginismus is certainly the root of much dysfunction and emotional and physical pain, the splendidly good news is that muscles can be trained in a way that nerves cannot. So if vaginismus is the problem, it is possible to be completely cured by working on the muscles. (I will talk more about vaginismus in the future.)

I am happy to report that my problem was in fact vaginismus, correctly diagnosed for the first time by Dr. C in October of 2010. We were finally, after two and a half years, on the right track. As I left her office, I could feel it—hope.

My ovaries were killing me. Literally.

Just two weeks after the evening I discussed in my last post, we moved out of state for me to go to school. Part of my scholarship was 100% coverage for any services provided by the health clinic, so within a month of our arrival, I made an appointment with the university gynecologist. I wanted answers and figured that starting all over with a new doctor might occasion them.

Words cannot express how grateful I am for the incredible health insurance the university provided me and the amazing doctors who helped me. Dr. A was my first doctor at the university, and he listened patiently to my story. He promised me we’d find an answer. When I’d finished giving him all the pertinent details, he began asking me some questions—how much energy did I have, what were my eating habits, what was my typical menstruation cycle. Answer by answer, we elucidated the constellation of symptoms and their probable cause: polycystic ovarian syndrome (PCOS). It explained so many of my body’s abnormalities. In order to verify the diagnosis, we checked my thyroid, blood sugar, and hormone levels. Just as Dr. A suspected, the culprit was PCOS. He referred me to Dr. C, a specialist at the university in female reproductive disorders.

Dr. C gave me tons of information on PCOS. She explained that the catalyst for my sugar cravings and low energy level was insulin resistance, which often accompanies PCOS. Additionally, my hormones were imbalanced, causing irregular periods and other embarrassing problems. Gone untreated, Dr. C told me that PCOS would likely lead to diabetes and perhaps eventual death from it. Despite the enormity of my frustration with my body and the severity of the issue, I still struggled with the decision to start Metformin. For one, a family member of mine had experienced serious problems as a result of taking it. But also, I didn’t like the thought of being on a medication for the rest of my life, especially at the age of 24. After a few weeks of serious thought and prayer, I filled the prescription.

The first six weeks I was on the drug weren’t my favorite days. Metformin causes nausea, painful cramps, and trapped gas, to name a few. I started on the lowest dosage possible and still felt awful. Every time I had to increase the dosage, the symptoms redoubled. But after I’d paid my dues—about ten weeks in—I started seeing a genuine difference in the way I felt. I dropped 10 pounds almost instantly and found it much easier to lose weight even after that, having regulated my insulin imbalance. I had more energy. My menstruation cycle regulated. I felt better than ever, truly. I felt well, healthy. It seemed, honestly, like everything had improved. Except my sex life.

Oddly, the one thing I’d gone in for answers about went unaided. It wasn’t Dr. A’s fault or Dr. C’s fault. It was simply that hormones and insulin and cysts were apparently not causing my dysfunction. When I mentioned this to Dr. C, she said, “It’s so odd…Normally, women with PCOS have a higher sex drive and lower occurrence of dysfunction, due to elevated testosterone levels. We’ll figure it out, Amie. I promise.”

She meant it.

If you want more information on PCOS, this is a good place to start. You’ll find a list of symptoms, treatments, FAQ, and other good stuff there.

And then there's this moment…

As time went on, sex became somewhat easier: the shock of the pain ebbed because I knew what I was in for each time. But I wasn’t satisfied with that—I had more in mind for my sexuality—so I began reading voraciously. I read The Gift of Sex by Clifford and Joyce Penner, a book Dr. B called “a good starting place.” And it certainly would’ve been, had I been normal. I read Sheet Music by Kevin Leman, a recommendation from a friend that turned out to be really interesting, if not especially helpful in my then-current state. I read Cosmo articles. I read excerpts of The Celebration of Sex by Douglas Rosenau. I read The Act of Marriage by Tim and Beverly LaHaye (skip it). I read excerpts of Intended for Pleasure by Ed Wheat. I read articles from several websites. I even read a book about kissing. The problem with all that material was that nowhere did it describe anyone like me. Advice for avoiding awkward wedding nights, rekindling the passion for older couples, adjusting to babies in the house, and breaking sexual inhibitions abounded…but there was nothing for me. When I used indices to reread portions that supposedly addressed lack of sex drive and/or painful sex, the most I found was “Try some relaxation techniques,” or “See a doctor.” Once more I felt alone in my struggle and frustrated that I couldn’t seem to help myself. These books were designed for people whose biggest problem was ignorance or a stressful schedule. Mine was all-out dysfunction.

I seemed to be hitting the same wall with Dr. B by that point. I’d tried all the sexy music, sensual massage, and non-intercourse intimacy I could handle. I’d lit candles, I’d watched romantic movies, I’d read and written some erotica. And don’t get me wrong: Dr. B’s influence was absolutely crucial in my battle for healthy sexuality, and with his help I made some very important strides. But my sometimes-impatient self was irked when the speed of my progress cooled. Even though there were occasional days and nights on which I truly wanted to have sex, it still wasn’t “making love.” It was fulfilling an uncomfortable, frustrating duty. I was nearing the end of my rapidly fraying rope, and unfortunately, that is where the story pauses for the next year and a half of my marriage. Sex was possible but excruciating, and my enthusiasm for satisfying sex was evaporating by the minute. I threw up my hands in frustration with God for not erasing the problem.

The night I ran completely out of patience, two years into marriage, is still as vivid a memory as the chili I ate tonight. My husband and I had another couple over for dinner, and after dessert we decided to play a game (as often happens if you are my dinner guest—fair warning). Although we knew we were at a disadvantage—they’d weathered several more years of marriage than we had—we were up for the challenge of the Newlywed Game. One question the two husbands were asked was, “When was your hottest night of lovemaking in the past year?” They both recorded answers with seemingly little difficulty. However, when my husband revealed his response, his friend said, “For us, pretty much every time is awesome. You must not have had a lot of sex if you can remember a specific night.” Usually I have a great poker face, but that night I sat there stunned, staring at my husband’s friend, with whom it didn’t seem to register that he’d said something deeply insulting. All the feelings of being exposed, of fighting an embarrassing battle of inadequacy, washed over me. Burning, crimson shame appeared on my face. Everybody knows, the sickening voice in my head whispered. Everybody knows.

For me, the problem with all this sexual strife is that it’s the one thing we’re supposed to figure out entirely on our own. All any person or book ever said was, “It hurts in the beginning,” and “Figuring it all out with your partner is so much fun!” Well…what about those of us for whom it was still painful after two years? What about those of us who couldn’t figure anything out, even with a manual like Sheet Music, because it was impossible to make even the “easy” stuff work? Who are we supposed to turn to? Try to talk about sex in your Bible study, and you’ll likely make the room fidget and drop eye contact faster than you can say “scented massage oil” unless you have an unusually open group. I found that very few people, even my closest friends, were able to give me real, honest information, their words being veiled by a sense of propriety. (Not that there’s anything wrong with propriety; it’s just frustrating to hear about it over and over when you truly need answers.)

After my husband’s friend made his comment, it was literally weeks before I was able to face my bedroom frustration again. Everything had simply begun to feel insurmountable.