Any hope for provoked pain? Pelvic pain/vulvodynia

NicoleB34

NicoleB34

Well known member
Hello all I haven’t posted for a while because mind-body techniques have made me about 70% better, and I’ve been out living and enjoying my life and doing all the things the doctors told me not to do! This includes riding my bike multiple times a week despite having pudendal neuralgia.
My unprovoked pain, you know, just the pain of existing, is much better but I still struggle badly with provoked pain.
I have had vulvodynia for many years and as many as you know, this can cause a serious quality of life, mental health, and major stress on your personal relationships. I’m in my late 30s and I feel like I will never know what it’s like to have a normal romantic life (and now and then, I get jealous and sad of those who do.)
I’m pretty good at the whole mind-body thing, so why is this the last thing that I can’t get under control? The nerves are so sensitive and it’s like pressing a wound. Has anyone ever reversed this? I have heard that removing the anxiety and fear around sex can help a lot, but that doesn’t seem to be working for me. I try to approach it with positivity only to be let down.
 
The symptoms you describe are classic "triggered" pain, or as you wrote "provoked". It is no different from any other conditioned to response to innocuous stimuli: positions, movements, activities, weather, temperature, foods, smells, computer screens, places, time of day. Sexual intercourse is the same thing...innocuous. There would be no one alive on the planet if it was a dangerous activity. I think if you look deeper at the emotional connection to the trigger, it's fraught with symbolic meaning and a threat of a different sort. The threat of being alone, not in a relationship that you desire...sort of a social death. This is how your brain interprets it. Love and connection is a need and the reason we are here, at the end of the day. You stated you are in your late 30's so there are thoughts that come along with that, that need to be addressed. What are the actual emotions that these triggered symptoms (pain) is trying to "protect" you from, and what message are they telling you?? This is the emotional work that can't be skipped over. In addition to that, you will need to neutralize the trigger through graded exposure and other strategies. This can take on many forms and you will have to explore. You can start by visualizing the activity, paired with thoughts of ease and joy and love. See if you can imagine, without getting triggered. Then go from there. There is also the issue around intimacy. What does that mean to you? What fears might you have around that topic? Sex is just one outward sign of intimacy but it's superficial and mechanical, if the emotions aren't there. There are so many layers to this topic! Is it really about sex or something deeper? Fear of rejection or abandonment when vulnerable? Fear of getting hurt? Fears around body image? Fears around "performance"? Fears or inner conflict about having children? It seems like this topic would be rich with possibilities. Really give it some thought.

I also suggest some kind of therapy or coaching to get you over this last hurdle. It is a high stakes thing for you and your brain is using it like crazy to keep you in the TMS strategy. TMS hides behind these kinds of things really really well!!
 
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It's basically a muscle spasm or cramp of that area. I got the same thing when I had my first pelvic exam (and I'm not in any relationships) and found out I got an unrelated yeast infection. My obgyn recommended de sensitizing that area with some insertable plastic tubes.

That spot is supposed to be sensitive but the spasm is more like a leg cramp. You wouldn't keep worrying about when you would get your next leg cramp. If you breathe slowly the spasm will go away faster. Don't worry about it or it will spasm tighter etc. It's no different than the pain of constipation etc. Graded exposure to physical triggers could help.
 
Yes, you can overcome it. This is what I have been struggling with for two years (provoked vestibulodynia and vulvodynia). I had done all the mind body work, I had healed almost all over my other ailments (IBS, migraines, back pain) but this was really difficult for me to shake. No amount of TMS work was reducing the sensitivity of the area because my my brain and neural pathways had simply become completely solidified to always expect pain in my vulva (especially during sex and urination). I finally went to my Gyne and requested a numbing cream, and I used it everyday for two weeks to interrupt the pain signals - so I would put it on three times a day, and made sure I really numbed it prior to having sex (the last thing I was REALLY scared of), with the full KNOWING that I had TMS, not a structural issue, just that my brain was stuck ON to fear and be hypersensitive to the area, and I needed to find a way to relieve that which no amount of therapy was going to solve because I KNEW fully that it was TMS induced.

That was two months ago. I used to not even be able to wipe after peeing because my vulvar pain was so bad and sex was absolutely out of the question. Now I wearing tight jeans and thongs, sitting lots, and back to having sex NO ISSUE - BUT I did need a physical aide and to not torture myself anymore to get me over that last hurdle of fear and anxiety so I could SHOW my brain that there could be a no-pain state in that area, an idea that had become so foreign after years of suffering.

Alan Gordon's "Tell Me About Your Pain" podcast and pain reprocessing techniques, watching some of Dr. Schubiner's neuro circruit videos on Youtube, and Nicole Sach's pelvic pain podcasts helped me, massively.

https://podcasts.apple.com/us/podcast/episode-16-pelvic-pain-recovery-bladder-urgency-hannah/id1439580309?i=1000524187371 (‎The Cure for Chronic Pain with Nicole Sachs, LCSW: Episode 16 - Pelvic Pain Recovery and Bladder Urgency with Hannah Matluck on Apple Podcasts)

Good luck!
 
hi all, thanks for your replies. Mine is more nerve than muscle, especially really close to the surface, and I too use lidocaine before activities because it's torture otherwise.
Yes, i do have some hangups about sex and femininity and getting older, etc., but i also have what's called "primary" vulvodynia. I have had abnormal sensitivity in that area as long as i can remember, before i had any fears and stresses around relationships. Looking back though, when i was a child, i was very much a tomboy and had a lot of discomfort about being a girl. I was absolutely mortified at the thought of puberty and periods. My mom tried to be helpful, but i felt like she made it awkward. When i did go thru puberty, again, i was mortified and kept it all to myself. I just wanted to be the boyish kid i always was! this is not to suggest i had gender identity issues though, because as i got into my teens, i started to embrace my femininity as far as my outward appearance (I like hair, makeup, dresses, etc.) but in some ways i try to "look" the part because deep down i still have a sort of harshness and masculinity to my personality. Guys i've dated have noticed this, like i cant act feminine or sexy because i'm too much of a jokester. Maybe i have issues with that, i dont know. Also, i will have random times where the pain is nearly gone for no reason (though, as women, we can agree hormone cycles can play a role in sensitivity and pain). So because of that, i know it's not a damage thing, but it's incredibly stubborn and even though my mind wants to have a healthy sexual life, my body doesnt let me most of the time. Then there's the fact that i'm probably 10ish years from menopause where even healthy women start experiencing pain, hence my worry that i've lost out on the better years of my life in that regard.
 
NicoleB34 said:
Hello all I haven’t posted for a while because mind-body techniques have made me about 70% better, and I’ve been out living and enjoying my life and doing all the things the doctors told me not to do! This includes riding my bike multiple times a week despite having pudendal neuralgia.
My unprovoked pain, you know, just the pain of existing, is much better but I still struggle badly with provoked pain.
I have had vulvodynia for many years and as many as you know, this can cause a serious quality of life, mental health, and major stress on your personal relationships. I’m in my late 30s and I feel like I will never know what it’s like to have a normal romantic life (and now and then, I get jealous and sad of those who do.)
I’m pretty good at the whole mind-body thing, so why is this the last thing that I can’t get under control? The nerves are so sensitive and it’s like pressing a wound. Has anyone ever reversed this? I have heard that removing the anxiety and fear around sex can help a lot, but that doesn’t seem to be working for me. I try to approach it with positivity only to be let down.
Click to expand...
I have recovered from pelvic pain. I am happy to give you some tips if you need.
Laura
 
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