Reena’s throat was dry. At the back of her mind, there was a cloud of fear threatening to render her immobile. There was a lump forming in her throat; a feeling of dread slowly begin to rise from her gut. A physical examination was the last thing she would have liked, but unfortunately for her, it was something she just could not avoid, if she wanted to set things right in her life.
Dr. Samatha sensed the overpowering emotions that Reena was experiencing, just by looking at her face. She knew she needed some time to be ready, which is why some time is what she gave her. When Dr. Samatha felt it was time to get started, she approached her and requested Reena to allow her to examine her vagina. “I’m going to begin with a visual examination, Reena, please don’t be worried. I am not going to hurt you, ok,” Dr. Samatha said. After much hesitation, Reena finally mustered the courage to let Dr. Samatha do her work.
Once that was done, Dr. Samatha knew she had a challenge on her plate. However, having examined several patients harboring the same fear, Dr. Samatha had a clear plan of action inside her hear, which she knew she would execute not just with clinical precision, but keeping Reena’s comfort at the paramount. “Now,” she said, “I will proceed towards the physical examination, ok. I know this sounds incredibly scary and almost impossible to go through, but you have to invest all your trust in me. Ok, are you ready,” Dr. Samatha asked.
Reena’s face met her with a blank look. Yet, Dr. Samatha knew that she needed to be quick, so that it would be over even before Reena could think too much about it. Even as Dr. Samatha tried to get through with it, Reena’s fear got the best of her and the first attempt was not successful. Here again, is where the compassion of a doctor is very important. While many doctors would have been irritated at this point, yet, Dr. Samatha knew that it was only comfort and compassion that would help both of them succeed.
“It’s ok, Reena. I know it will be a bit uncomfortable and scary, yet, this is the only way in which we will know what to next, right. It’s best to get it over with than just prolong something that has to happen, no?” Going slow, Dr. Samatha had told Reena that she’d stop the moment Reena felt it was too much for her. What eventually happened was the fact that Dr. Samatha was successful in examining Reena and the ordeal was over.
Once the examination was done, Dr. Samatha was able to rule out other possibilities and could safely conclude that Reena, in fact, did present with a classic case of vaginismus. As she broke the news to Reena, she said that it was nothing to be worried about as there were proven ways to treat this very successfully. “Once you are through with all the steps I lay out for you, you’ll be one of the happiest and relieved patients that I have,” she said, showing Reena a ray of hope that she had looked forward to.
While Reena was expecting a battery of tests awaiting her along with a list of medicines to be consumed, what Dr. Samatha told her left her absolutely surprised. For women who have vaginismus, medicines cannot be a form of treatment. Considering the fact that vaginismus finds its origin mostly in the mind than in the vagina, strong willpower is what the doctor would recommend. This, of course, is not the only solution. There is a tool that Reena would need to sort this out - a vaginal dilator.
This is exactly what Reena asked Dr. Samatha. “Vaginismus is the result of your vaginal muscles tightening because of fear/discomfort that the thought of inserting something in your vagina triggers. Dilators are tools that help you make your vaginal muscles more elastic, while making you comfortable with the act of insertion,” Dr. Samatha said. “Now, obviously, you would want to know how to use them, where to buy them from and all of that, right? Well, that’s what I am here for. You can find vaginal dilators online easily. They come in different sizes - sometimes in 5, sometimes in 8, with the first size being the smallest, gradually proceeding to the biggest size, which is the last,” Dr. Samatha explained.
Reena was processing all the information, but even before she could ask, Dr. Samatha knew exactly what was on her mind. “You’d obviously try with the smallest size first, progressing towards the biggest size. Go slowly, inserting the first size for as deep as possible and once you are comfortable, hold it in for some time. Do this for a few days till you do not feel any resistance from your vaginal muscles, before moving on to the next size. Continue the process until you are comfortable with the biggest size,” Dr. Samatha added.
Beginning to understand the procedure, Reena had one doubt. “But doctor, what if I get stuck on the first size itself? What if I am not even successful in inserting the smallest size?” Dr. Samatha eased her worries in an instant. “That’s where you can come back to me. In fact, I’d suggest you start the process here itself. Once your dilators are here, come back and let’s have a five-week session, wherein I’ll help you with the insertions. Once you are comfortable, you can try it on your own. Whatsay,” Dr. Samatha asked.
Dr. Samatha’s plan for Reema was to combine the powers of cognitive-behavioral therapy along with the usage of dilators to arrive at a satisfactory outcome.
That seemed like a plan. With Dr. Samatha’s reassurance, Reena knew she could get this fixed. She walked back home with a strong determination replacing all the fears that she had.
Did Reena try out the dilators? Did it work out for her? In the next blog, we’ll not just answer these questions, but will also explain why a condition like this should not be buried deep in your hearts, but should be discussed with a gynecologist.
