Dr Ruth Missed the Mark

I have mixed feelings about this advice column from Dr Ruth that I spotted on Twitter.

I was super bummed to read the first half of the first sentence, a response to the question

What are the roots of sexual pain? Also, what would you say is the best way to overcome it? 

Dr Ruth writes,

In the vast majority of cases, it is psychological...

Really? How does she know that? Judging by my stack of books on pelvic pain, that seems like outdated information, although I don't have hard data to back up my assertion. 

What I like about the article is that she asserts no woman should have pain during sexual intercourse. True.

The rest of the response disappoints. The only disorder she mentions is vaginismus, which she says is psychological. She doesn't give a single physiological reason for sexual pain, of which there are many: pudendal nerve pain, endometriosis, painful bladder syndrome, vulvodynia, clitorodynia, pelvic floor dysfunction...and those are just the ones I picked up from scanning the cover of one book sitting here on my desk.

Dr Ruth also neglected to mention how under-informed the majority of gynecologists are about these very real disorders, making it seem as though a single office visit would quickly answer that question.  

...the first thing a woman who is experiencing pain during intercourse should do is see a gynecologist. If her gynecologist gives the all-clear, then that alone will be a great help in overcoming any psychological factors.

If only it were so simple. In reality women experiencing painful sex often have to go to multiple doctors to get a diagnosis. Dr Ruth does not mention the emotional damage they suffer because doctors (and authority figures like Dr Ruth) have not provided them with adequate information.

I also doubt her assertion that getting the all-clear from a gynecologist would be a great help in overcoming psychological factors; if the root of your sexual pain is psychological, I would imagine that it would require a great amount of work to overcome that issue. 

Overall, I was sorely disappointed by this column, especially coming from such a famous figure as Dr Ruth. Here is my response to the question at hand:

Dear Reader,

I am sorry to hear that you have been having pain with intercourse. Please know you are not alone; many women suffer this at some point during their lives. There are a wide variety of physiological reasons for pelvic pain. The problem may stem from your dermatological, muscular, orthopedic, psychological, central or peripheral nervous systems, or it may be a combination of the above.

I recommend that you educate yourself first, by reading "Healing Painful Sex" by Deborah Coady MD and Nancy Fish MSW, MPH. Then start seeing gynecologists; you will probably have to see more than one to get an accurate diagnosis, because unfortunately most gynecologists do not receive adequate training in pelvic pain disorders. Be persistent. Remember that no woman should hurt during sex.

Good luck on your journey!

#imEnough

On Saturday at the BlogHer conference (again, I know) I saw the new band The Mrs introduce their first single, "Enough." The song brought tears to my eyes and I was not the only one. Here's the song, and the inspiration behind it. And if you are as pumped as I am about this development on the pop scene, here's where you can buy swag.

If you are anything like me, your pelvic pain has done a number on your self-esteem. Think of this single as good medicine. Yes, you may have pain, but you are not broken - you are enough, just the way you are.

Can't wait for The Mrs to come out with a full length album and go on tour. I'll be in the front row, screaming like a teenager!

Why is this post about a blogging conference?

It is 6:45 on a Sunday morning and I have sat down to tell you about my amazing experience at BlogHer 2014. What does this have to do with pelvic pain? Everything.

Over the past three days my cause - our cause - has been so beautifully embraced by the BlogHer community. When I said that I was starting a blog about pelvic pain, women opened up and shared their stories, gave me resources and recommendations, even offered to mentor me! Every break-out I went to I made sure to ask a question, introducing it by letting people know about the blog. They laughed at the tagline...and then came up to me after to give me their cards.

I am telling you all of this to let you know that you are not alone. Women everywhere have experiences with pelvic pain - uterine pain, vulvar pain, vaginal pain, bladder and bowel pain (and I'm sure there's more that I missed) - and they are hungry for a voice, for recognition, for gynecologists and urologists and gastroentereologists who are respectful and knowledgeable.

Not a single woman who shared her story of pelvic pain with me said that she got good care, that the problem was solved easily, quickly, and respectfully. Even though there was so much diversity in what type of pelvic pain they experienced, there was a sad unity in that their doctors weren't equipped to provide them with adequate care, never mind excellent care.

Attending BlogHer 2014 fired me up even more to start a Pelvic Revolution. We need attention, awareness, funding, research, and improved training so that doctors can be sensitive to their patients' experience.

So I encourage you to SPEAK UP. If you are too shy to do so in real life, then start poking around online. Share your experiences here in the comments, or start your own blog.

Alone we suffer, together we heal!

Here's me outside the San Jose Convention Center, holding up my conference badge. Note the pelvic pain friendly cotton leggings and dress ;) Click on the photo to go to BlogHer.com and learn more about this great community of women bloggers.