Vulvodynia Symptoms Prior to Painful Intercourse

The beginning of my experiences with provoked vulvodynia is blurry.

My medical history is long, complicated, intertwined, and emotional. It takes me to a place of incredible vulnerability due to childhood trauma and violation that I experienced. As a result, I have gaps in my memory… some spanning years of my childhood. I’ve been able to recover some memories through trauma therapy, but I still have large chunks of my childhood and early teenage years missing from my memory vault.

What I’m trying to say is that it is difficult to pinpoint the first time that I felt any vulvovaginal discomfort or pain.

The first noticeable, traumatically painful vulvovaginal experience that I couldn’t lock away and forget was on my honeymoon… though my brain worked hard to block that from my memory. In fact, my brain worked really hard during the first few years of my marriage to dissociate from the experiences and memories of painful intercourse — but I couldn’t forget for long because… newlyweds. And so, because my brain’s go-to coping mechanism of forgetting wasn’t possible, I was forced to actively live with the fact that intercourse was painful and the trauma that took over my life.

My (ex)husband and I were both raised in very conservative, religious homes and were both virgins prior to getting married. Neither of us was prepared for the pain that intercourse would cause me… neither of us was prepared for the trauma it would weave into every fiber of our marriage.

But that’s a blog post for another day. Today I want to focus on pre-marriage symptoms. Hindsight is 20/20, which allows me to reflect on the experiences that could have tipped me off to something being not quite right. I want to mention them, in case they resonate with someone else.

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Vulvodynia Pain While Riding a Bike

I hated riding bikes. I’m not sure when that hatred started, but it was fairly young… definitely at or before preteen status.

It surprised me how other people enjoyed riding bikes. I regularly thought to myself… Isn’t it uncomfortable for everyone? Did they just get used to it? Was I weak somehow because I couldn’t just get used to the pain?

To me, riding a bike feels like I weigh 5 times more than I do… and all that pressure is centralized in my vulva and vagina. The seat feels like it is stabbing into me… stabbing through me. My feet carry none of the weight. Shifting more towards my rear relieves none of the pressure in my vulva. Even using a wider bike seat never did much.

Cycling class was torture. Believe me, I tried once in 2013 and I vowed NEVER. AGAIN.

Recumbent bikes, however, are a different story and I could generally tolerate them even before becoming pain-free… and I have cycled upright a few times since becoming pain-free but I still don’t really enjoy it.

Every few years growing up, I would think that somehow I had outgrown my distaste for bikes… but 30 seconds on one always reminded me. I even had a bike in college and never… not once… used it. Instead, I gave the bike to my roommate and opted for the 20-minute walk to and from campus.

In 2016, I had a general physical therapist (who was pretending to be a pelvic floor physical therapist… yeah, more on that another time) ask me to do an exercise on an upright bike. Even after I explained the pain it would cause me, she insisted that I just try. So I did.

30 seconds was all it took before I started sobbing. I was trying to be tough and work through the pain, but I think I lasted on the bike for a whopping minute before her conscience caught up with her and she told me I could stop.

I was in pain for hours afterward.

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Period Management (aka Sandpaper & Glass)

Oh, tampons… the bane of my teenage existence.

A necessary evil… but not anymore! I just had a hysterectomy and will never have a period again. I guess that’s one perk of having your uterus fall out of your body. Thanks, prolapse! Anyways, I digress…

Honestly, for years, I just assumed that tampons were painful for everyone and I suffered through the pain alone. It never really occurred to me to bring it up with friends or family. Menstrual cycles had enough of a taboo already and I didn’t want to call more attention to… periods.

Sometimes inserting and taking out tampons was no big deal, but other times it was awful. The silver lining was that the pain was pretty short-lived. I usually didn’t suffer for hours afterward (like I did with bikes or like I later experienced after intercourse).

As a teenager, my family bought tampons with a cardboard applicator, you know, the kind with the dry cotton sticking out of the top? The very first time I used said tampon, I didn’t know that I was supposed to remove the cardboard and I left it inserted. A few hours later, I was in the locker room at my Junior High changing for tennis practice when I casually called from the stall how I might need to miss practice because wearing a tampon hurt. My friend explained it wasn’t supposed to hurt and walked me through the steps-of-inserting-a-tampon until I realized my mistake.

At some point, tampons became regularly painful (even when I used them correctly and didn’t leave 3 inches of cardboard stuck up my vagina). I know cheap, cardboard tampons aren’t the most comfortable things on the planet for anyone, but in my case, the hard cardboard poked like glass if I misjudged my insertion angle and the exposed cotton dragged across my vaginal wall like sandpaper (hence, the previous name of my blog Sandpaper and Glass).

But the most painful tampon experience for me was removing a dry tampon (if you know, you know). I’ve spoken to other womxn who hate this sensation… but with vulvodynia, it wasn’t just uncomfortable. It literally felt like the skin inside my vagina was being ripped out. I am not exaggerating.

You might be asking yourself– why didn’t you just use pads, Grace? Great question. I used pads or wadded-up toilet paper during my lighter flow, but on heavy days my period would not work well with just pads. I wish it did… it would have saved me from a lot of very painful experiences.

Over the years I developed a pattern for how to deal with my period without triggering vulvodynia pain. On lighter days, I would use pads or toilet paper (as I mentioned before). Then, on day two or three I would switch to the heavy-flow routine. I used regular sized tampons with the smooth, plastic applicator (splurging on Tampax Pearl was a non-negotiable in my budget). With a super heavy flow, it often meant that I was switching out tampons frequently for a day or two… but that inconvenience was better than having to deal with the pain of larger tampons. In 2016, I discovered period underwear and menstrual cups. Cups were not really on my radar because I didn’t want to go through an awkward and painful learning stage where I had to figure out insertion and removal of anything else in my vagina. It was painful enough already, thank you very much. However… THINX PERIOD UNDERWEAR (not an affiliate link) changed my life and they were a staple for managing my cycle since the glorious day I wore my first pair.

I should work for period underwear companies, I recommend them so much.

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What the Hell is a Pre-Marital Exam? And Why Does it Hurt So Much?

The only other painful vaginal experience I can think of prior to marriage was using a dilator.

“But Grace,” you say, “didn’t you tell us that you were raised in an incredibly conservative home? Why was a perfectionistically obedient Mormon girl using a dilator?“

Damn, you are full of insightful questions today.

In the religious community that I was raised in (but no longer consider myself a part of), we were expected to get married quite young. I got married at 20 and I definitely felt like I was nearing old maid status, even then. That, coupled with a very conservative stance on sex education and sexual purity, meant that many of the devout members of my church had no preparation for their wedding night.

And so, for better or for worse, the religious University I attended (BYU) held pre-marital classes at the medical center (separated for men and women where participants attended with the approval of their local religious leader, of course). The female pre-martial class included a pre-marital exam, as well.

On one hand, I am grateful that there was some kind of sex education class for under-educated young adults. Hopefully, it helped a lot of people have a better start to their marriage by kicking off the conversation about sexual health, birth control, etc.

On the other hand, I am fully pissed off at the patriarchal overreach of it all. Let me tell you my experience and you can decide if you want to be pissed off with me, mmmmkay?

About a month before my wedding, I attended the female pre-marital class. I had no knowledge of what this class entailed, all I knew was that my university offered it, that my religious leader recommended it, and that my friends who had been married had attended it.

The first part was lecture-style. I was in a room with about two dozen (yes, you read that right) other girls aged 18-23 who attended the same university and were preparing to get married within the next month or two. They held these pre-marital classes twice per month and I’m sure each session had 1-3 dozen attendees. That’s a lot of marriages.

We all sat through a PowerPoint presentation by a female nurse about birth control options, STI symptoms, and family planning. I remember this portion of the pre-marital class being informative and helpful.

After this presentation, we moved on to our individual meetings with a gynecologist. Most of the appointment was fairly typical for meeting a gynecologist for the first time (I have since learned). I was able to choose my preferred birth control method (the pill at the time), received a prescription, chatted with my doctor about my timeline for wanting to get pregnant… and then I was given a set of dilators.

Now, due to my gaps in memory, it is quite possible that I had a pap smear and experienced pain which is why I was given dilators. That seems reasonable enough… right?

However, I have read from other women who had these same BYU pre-martial exams who were also given dilators without a pap smear and without experiencing pain… so I think they skipped the pap smear and just gave dilators to all the women. Which is weird… right?

In fact, I have a faint memory that I was not given a pap smear because I was told that I wouldn’t really need one until one-year after getting married. Which… isn’t true… right?

Anyways, I was given a set of six dilators made from clear plastic. They looked like test tubes with a lip/edge on the bottom (I tried to find a picture online, but I couldn’t… the closest picture I found is of these lab-grade test tubes). They were about 6 inches long and varied in width. The smallest dilator was about half an inch in diameter at the base and the largest dilator was about 1.5 inches in diameter at the base.

I have reflected a lot on this experience to hone in on the messaging I received as to why I needed the dilators. I want to convey this accurately – was I given the dilators to promote my comfort for my wedding night or to satisfy my future husband’s expectations?

And… to be honest… I think it was the latter. I don’t remember the pre-marital class or exam being focused on my pleasure, my health, or my comfort. Which isn’t surprising, but it’s still disappointing.

Then, it was made exceptionally clear to me that the dilators were not to be used for personal pleasure. Their purpose was to stretch out my vagina in order to prepare for successful intercourse on my wedding night. I’m sure my gynecologist didn’t phrase it in that way, but that was the intended goal, without a doubt.

I walked home with info pamphlets, birth control, a sample packet of lubrication, and dilators in a plastic bag mortified at the idea that someone would know what I was carrying.

My walk of shame… “good-girl syndrome” style.

I used the set of dilators a few times over the next month, and to be honest, it wasn’t a terrible experience. It wasn’t pleasurable… even if you took away the overt shame regarding self-pleasure, I was still inserting a clear test tube sans arousal. I wasn’t using the dilators for pleasure, I was using them to prepare. It was a very clinical experience.

The first few dilators in the set felt like tampon insertion, and I don’t remember any pain. As I increased in size, though, I distinctly remember discomfort and pain. I didn’t know then that there are multiple causes of vulvovaginal pain. The class didn’t cover that. Unfortunately, I had already heard the common tropes that “sex is painful the first few times” and “it’s not comfortable, but you get used to it” from TV, married friends, as a fly on the wall at bridal showers, and during the pre-marital class. So I just assumed that my pain was normal.

I remember working through that pain hoping and praying that I would be able to ‘stretch out’ enough for my wedding night. And, if my memory is accurate, I remember using the 1.5″ dilator without pain twice in the day or two before our wedding.

I thought I was ready.

My vulvodynia had other plans.

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—–> Let’s circle back to my issues with the pre-martial exam before closing out this post.

As I said before, the pre-martial presentation regarding birth control options, STIs, and family planning was pretty helpful. And, at the time, I didn’t really recognize anything about the experience that made me feel anything other than embarrassment at the idea of using dilators. However, looking back on the experience I’ve been able to identify and voice why the pre-martial exam ticks me off.

First, no part of the presentation or consultation was devoted to female pleasure. In fact, when given the dilators I was actively warned not to seek out pleasurable experiences with the set of hard plastic test tubes. This warning was really heavy-handed because even though I was technically consulting a doctor… he was using religious expectations to shame me into sexual purity.

Second, the class reinforced messages that my body was not my own. What this really comes down to is the fact that women are actively taught that their reproductive system is not for them. The class made it clear that my body needed to be ready for my husband… for my wedding. That my body needed to be ready for my future children. But I don’t ever remember being told that what I was learning was for me. I was even given a medical tool to physically prepare my body for my husband’s pleasure (and baby making), but my fiancé was given no information about how to prepare himself physically or mentally for my pleasure. The only reason my (ex)husband and I knew about the clitoris and female pleasure at all is because we were given a book to read by his progressive church leader outside of the university’s pre-marital class. Thanks, Bishop H.

• To highlight this point, I want to share an experience I read from someone who also had a pre-marital exam at BYU: “[They] put me on birth control with a start date calculated specifically so that I wouldn’t be on my period on my honeymoon. (They joked ‘so your husband won’t be grossed out.’ While I appreciate the birth control, I wish they’d centered it on MY needs—preventing children—instead of my husband’s. It also reinforced the idea that periods = yucky and shameful.)”

Third, we were not taught about foreplay at all. I am very adamant now that foreplay is sex because of my experiences with vulvodynia and de-centering society’s heteronormative “gold standard” of penetration… but I think a pre-martial class should have covered more than this goes there sex education.

Fourth, I was married in 2012, but if I had attended this class ten years earlier, birth control would not have been part of the curriculum because birth control was actively discouraged in my religion of origin until around 2003.

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This post was originally published in my previous blog, Sandpaper & Glass on 11/20/2017. I migrated my previous blog content to this new site in 2023. A lot has changed from when I originally wrote this blog post to now. Edits have been made to reflect some of those changes while maintaining the integrity of the post. For full transparency, you can read the original post here.

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Hindsight is 20/20: What symptoms of your vulvovaginal pain did you experience growing up? I’d love it if you could share them in the comments.