Gynaecologist – my second visit

My visit to the vagina doctor

vagina monologue

I am 27 years old. I am a sexually active adult. I am a medical doctor. And I have a problem with my vagina.
Any one of the above points should be enough for me to have the contact details of a trusted gynaecologist on speed dial.
I should have been going for (at the very least) annual gynaecology check-ups from the beginning of time (medically speaking, from the first year I became sexually active). I have not.

To date, I have seen the vagina doctor exactly twice, both this year. The first time was an informal consultation with a senior colleague, for contraceptive matters. The second – a consult with a private gynaecologist about pain…vaginal pain…vaginal pain during sex.

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Searching for a doctor

As one does when looking for a medical practitioner, I went online, searched for gynaecologists near me, read the recommendations and made an appointment. My requirements were simple: female gynaecologist within reasonable distance.

Female doctor?

(Wanting a female gynaecologist for me was not some feminist ideology, as people would expect. It was prompted by a fear instilled in me in medical school, during my gynaecology rotation. One specialist gynaecologist, a man, was performing vaginal examinations on the patients in the ward. He had what I would [ignorantly] assess as abnormally wide fingers for a gynaecologist. And, instead of being gentler with his examination for fear of causing harm to his patients, he would shove his large monstrosity of a hand into the woman’s sensitive parts.

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And when the woman [inevitably] screeches from pain and involuntarily contracts her inner thigh muscles to alleviate the pain, he would scold her, slap her thigh into submission and carry on violently assessing. The scene scarred me for life. I concluded that male gynaecologists lacked the compassion and sensitivity required to treat a woman’s most private space, and vowed to only ever consult female gynaecologists.

The gross generalization on my part has since lifted, because I have come across gentler, kinder, more compassionate male gynaecologists at work. However, in seeking one for myself, I could not help but be terrified at the thought [unlikely though it may be] of experiencing that same treatment. So, I opted for a female doctor.)

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The consult

I found a lady doctor, reasonably nearby, and went to see her. She was a cute, tiny, elderly white woman with a chatty spirit and beautiful history-taking skill (the doctor in me admired and took mental notes).

After a candid conversation about her home country (England), the book she’s thinking of writing (in which she swore on her mother I’d be featured), the irregularity of my menstrual periods and the future of medical specialties, she asked why I came to see her.

I have vaginismus

Sex is painful, I told her. It is debilitating and excruciating, I added. I think I have vaginismus.
Interesting, she responded. Is this with your current partner or?
No ma’am, I exclaimed. It has been this way since my first sexual experience years ago. It has been painful from the onset. And I just broke up with my boyfriend.

She prodded further. She asked about STIs and yeast infections, contraception and condom use, lifetime number of sexual partners and their race(s), and love for and emotional attachment to them at the time.

Secondary trauma

I underwent a transvaginal ultrasound. (This is where the doctor places a camera probe the size of a penis into the vagina to see how the insides look. It can show if someone has fibroids, polyps, tumours and the like. It can show if there’s a guest growing in the womb. And it can assess if the cervix of the womb is inflamed, by eliciting pain on touching.) Naturally, with my vaginismus, the process was uncomfortable. It was, after all, similar to a penis insertion or a pap smear (also an uncomfortable experience for me).

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Vaginismus is in the mind, not the body

Fortunately, there was nothing to find on the scan. My vagina and uterus were anatomically perfect, she reported. I should have been relieved. There was nothing physically wrong with me. But I was not relieved. Because what that meant was, my very physical, very debilitating and excruciating problem, did not have an easily recognizable cause. It must be psychological, I thought.

Her diagnosis

This beautiful, tiny elderly doctor with a talkative spirit and conservative mindset cleaned the ultrasound probe, paused for a minute, gave me a sly look, and gave me an exclusionary diagnosis.
“I think it’s a good thing you broke up with the boy. Your vagina was refusing his entry because he’s not the one. When you finally find the one, sex won’t be painful. And maybe he was just big. Think about it.”

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I chuckled at the statement, though I should have been indignant. Her final assessment of my years of sexual discomfort (with different people at different times in my life) was reduced to the size of my boyfriend’s penis.

I left the office, with the reassurance that my vagina and uterus were anatomical perfection but, with an unsolved pain issue. And this cute, conservative, elderly doctor suggested it could be solved by procuring a gentleman with less girth.
That isn’t exactly how vaginismus works but, per doctor’s orders, no more big mack trucks for me.