I want want my husband of 20 years. He’s tall, smart, nice, and incredibly handsome in an Ichabod Crane way, just the way I like it. In our early days we were hot and heavy, we traveled across the Puget Sound to meet and make love in different bars, slept, reached out to each other in the middle of the night and in the morning, and never got enough.
But in the end, two babies and the freight train that has gone through the transition hit. Honestly, it’s only afterwards that menopause feels like tons of twisted metal knocked me over. In reality, the metamorphosis from “40 and Still Feeling Cute” to “50 and Way Past My Prime” was slow, insidious and confusing. One Reason for the Mystery of “Am I Menopause or Not?” was an endometrial ablation I had ten years ago – a procedure that destroyed my uterine lining to avoid suffering from monthly menstrual bloodbaths. The results were amazing, but left me unsure of exactly when I was going through the big comedown.
My main clues were insomnia, which I’ve always had problems with anyway, and painful ― distressing ― sex that made my husband feel guilty and I fell into a pit of intimacy avoidance.
I wasn’t ready to accept this blow to my marriage or my identity, so I decided to ask my gynecologist for a referral to a pelvic floor physical therapist. I’m not sure where I learned about this option or what exactly such a PT can do to help, but with the reference in hand I did…nothing. Every year I would go to my OB-GYN and ask her to do the referral again. But I continued to slowly walk my way to nowhere. Meanwhile, my libido dwindled and sex hurt more than ever.
Finally, I made the appointment and was assigned a physiotherapist, Kaeli Gockel, who appeared to be in the prime of her own reproductive years but somehow possessed an old soul for middle-aged women scribbling with where we now fit into society.
One of the first things she addressed was the connection between pain and mind. She explained that once the brain senses pain in a certain part of the body, it becomes more alert to danger of the next injury. Your body can even produce nerve endings where pain occurs or where it is expected pain. In my case, my vagina must have been ejecting new pain receptors like small fireworks. This meant taking a deep breath and relearning my body that it could trust me to stop any activity that causes vaginal discomfort.
Another goal was to keep my vaginal walls supple by stretching them, which was surprisingly necessary even after the birth of two nearly 10-pound babies in the Aughts. I was told to order expensive silicone dilators in various sizes, and Kaeli taught me how to use them – insert and press in a semicircle as if going from the 3 o’clock to 9 o’clock positions. We discussed urinary incontinence and flatulence as matter-of-factly as if we were talking about traffic or how we take our coffee… or fart while sitting in traffic drinking coffee.
Early on, we brought my gynecologist back into the process of renewing my underworld. She agreed to prescribe estrogen cream, which I have to put in messy two to three times a week with the aim of moistening the tissues and making them “bounce.”
“I remember a male friend who my son’s teacher once scornfully described as ‘postmenopausal’. That, among other comments I’ve heard from excoriating mature women, made an impression.”
Unfortunately, menopause has caused me quite a bit of embarrassment. My skin has gathered in dry grooves and folds. I’m reaching for lube, but instead of being a nice enhancement, it’s a necessary tool. I remember a male friend that my son’s teacher once scornfully described as “postmenopausal.” That, among other comments I’ve heard from disapproving mature women, left an impression. For this, Kaeli recommended mindfulness-led meditations, as well as viewing artist Jamie McCartney’s “Great Wall of Vagina,” which displays his sculptures of more than 400 female genitalia. To see! Vaginal abnormalities are actually normal!
As the climax of this process, Kaeli invited my husband for an appointment. An excellent sport, he accepted the invitation. For the first time since I started seeing her, I was nervous. Do we have to do this with the lights fully on? Would he be disgusted? Would he still want to try sex with me after this? However, with Kaeli’s patient coaching, he learned how to help me with the dilators, and the session went well. My husband even seemed grateful that we included him.
After all my work, Kaeli suggested I buy myself a sex toy as a treat. I had only owned gifted sex toys, and they were based on what my then boyfriend or husband thought I would like, so I splurged on a clitoral vibrator. Let’s say it makes me forget my aging body, bright lights, or even what planet I’m on.
Nothing about this pelvic floor physical therapy was cheap or easy. And I’m still not 100% pain free when I have sex, but I feel like I’m getting there. Still, I realize how lucky I am to have the time, money, and insurance to address these issues. This shouldn’t be a privilege for a select few – everyone should have access to everything they need to create a healthy, happy sex life.
I recently found an Instagram post from Dr. Sara Reardon, a pelvic floor physical therapist, who relieves my guilt about the currency of both the health insurance deductible and the time I’ve spent rehabilitating my sex life. In the post, she responded to a doctor who noted that pelvic floor physical therapy is currently on trendy. “Pelvic floor PT is not a trend. It’s an integral part of healthcare that has been overlooked and underused for too long,” Reardon’s post says. And Kaeli, my PT, says:My dream is that one day everyone will have easy shameless access to pelvic health and sexual wellness. I truly believe that we cannot have true equality until we have equality in the orgasm and we cannot achieve that until painful intercourse is taken seriously by insurance companies.
It took me 19 years after the birth of my first child to finally see a pelvic floor physical therapist and what bumps (plus hopefully bangs and bumps) I face on the road to good postmenopausal sex, I’m, at the very least, doing my best to get everything running smoothly. to keep.
Angie McCullagh is a Seattle writer with work in The Independent, The Sun Magazine, Wired, Writer’s Digest and several other outlets. She lives with her husband, a street dog and two teenagers. Follow her on Twitter on @Angiehisattle.
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