Mea vulva

What is a vulva?

In English, “vulva” (Latin) is the term used to describe the outer part of the female genitalia. In Polish we say “srom”, but because women (including me) do not like this word for various reasons and are departing from it, its spelling is increasingly being polonised.

So the vulva consists of, among others, the pubic mound, two outer and two inner labia, the clitoris and the vestibule of the vagina.

How much is vulva massage different from tantric massage or even perineal massage performed before childbirth?

The massage that I perform is based on tantric and tao massage, but also on my experience as a pelvic floor muscle training instructor and doula, i.e., a companion for women in the perinatal period, during childbirth and puerperium. I adapt the massage method to the person who comes to me, depending on the problem and needs she signals.

On the other hand, what makes this massage most different from tantric or yoni mapping is the lack of exclusive G-spot orientation. The overriding goal is therefore not sexual pleasure.

But can pleasure be its purpose?

Pleasure may appear. I had clients who experienced an orgasm during the massage, or those who were close to experiencing ecstasy during the massage, but were unable or unwilling to come in front of me. Then they said that being in a state of deep relaxation after the massage, it was much easier and faster for them to have an orgasm at home.

But if a woman comes to me with a scar from an episiotomy in childbirth, then we stop there, I don’t go into her sexuality if she doesn’t want to.

What else distinguishes vulva massage?

Contrary to tantric massage, my massage is not silent. I keep in touch with the person I am massaging all the time. I must be sure that she feels comfortable, that she does not feel pain during the session, that I do not accidentally cross her boundaries. I need to know how she is doing because my touch may remind her of a difficult experience of sexual abuse, for example, and this is worth considering.

During the session, I explain step by step: “Now I will touch the muscle that surrounds the entrance to the vagina, you can feel it, and if you feel anything else, tell me immediately because it means that the muscle is tightening.” This dialogue between us is therefore closer to the dialogue we encounter every day in the office of a urogynaecological physiotherapist.

Each subsequent meeting with the same person is always preceded by a short conversation. About well-being, needs, possible fears and any discomfort you feel, especially in the pelvic area.

Does the meeting ever end with just a conversation?

The length of the conversation preceding the massage depends primarily on the person who turns to me for help. Some meetings can largely involve talking, while others are devoted exclusively to working with the body and touch. Since the meeting is long – it lasts about two and a half hours – we may sometimes limit ourselves to talking.

And what does the massage itself look like?

After the initial conversation, I invite the client to undress as much as she feels comfortable and to lie on her stomach on a typical massage table. Of course, a pregnant woman will lie on her side, not on her stomach. Most often, the client is covered with a sheet or towel for her own comfort, and I massage the entire back of her body. Then I ask her to lie down on her back so I can massage her entire front, including the face, jaws (this is very important as tight jaws usually accompany tight pelvic floor muscles), breasts and abdomen. I massage with rice oil.

If a woman is willing to have an intimate massage, I put on disposable gloves and use a special oil for massage of the perineum and a water-based lubricant. I massage the pubic mound and the outer and inner lips, asking if the woman is experiencing pain, numbness, or anything else that bothers her anywhere. If I have permission, I gently touch the clitoral area and the foreskin of the clitoris – this is usually a very erogenous zone, but can also be associated with pain and overstepping, so I do it with the consent of the woman, sometimes intuitively and sometimes according to her guidelines. Here we check together which form of touch is pleasant and relaxing, and which is irritating or painful. Thanks to this, the woman herself can recognise what she likes and what she does not.

Then I go to the area of the vaginal opening and the perineum – if the perineum was sutured, then a scar can be felt under the fingers. I massage the bulbar-spongy muscle that closes the entrance to the vagina and can be very painfully tense, making vaginal penetration intercourse difficult or impossible. Finally – if I have permission – I slide my finger deeper into the vagina, where the muscles are also tense. This way I already have access to the pelvic floor muscles and although I do not work like a urogynaecological physiotherapist, I can massage them to relax them.

When this part of the massage is over, I make sure of the woman’s well-being, check that there is no pain or tension left in her body, and that she feels good and safe emotionally.

Since massage is not only focused on our sexuality, who can or should benefit from it?

I massage all women, regardless of their age, health condition and experience. I also massage women in a healthy, i.e., physiological pregnancy, although here, of course, the massage is different because I have to take care not to harm and not to cause a contraction, but from some point of pregnancy we can focus on learning to massage the perineum before childbirth. In principle, there are no contraindications to such a massage, even menstruation.

Do women come to you with an already diagnosed problem or do people looking for an answer to the question: “what’s wrong with me” predominate?

Some women come with a very clearly defined problem. For example, they say that they have painful intercourse in a very specific position, and they want to know how to change that. These people are very aware of their bodies and want to work together on this pain. But there are also some that say: “I don’t know anything about my femininity, I don’t know what I like, I can’t even touch myself ‘down there’.” These women most often feel that they have no relationship with their pelvis and intimate areas, they have often never experienced a single orgasm in their lives, they do not know what their vulva looks like, they would like to learn a touch that is good or even pleasant for them.

There are also those whose problems are primarily of a medical nature: they have painful periods, were born with MRKH syndrome (congenital lack or underdevelopment of the uterus and vagina), and suffer from vaginismus.

There is also a group of women who are happy with their bodies, they are fine, but are looking for a way to relax, like to be massaged, and no one has ever considered these parts of the body during a session.

The most numerous group of my clients, however, are people who are trying to deal with trauma after experiencing violence and sexual abuse, women who have experienced dramatic births, obstetric violence, who have not come to terms with what their vulva looks like after giving birth. And these traumas are very much concentrated in the form of tensions in the body and “cut off” women from their pelvis and sexuality.

Is working with such people the most difficult?

It is certainly rather more long-lasting and should be comprehensive. First of all, it is worthwhile for people who have experienced sexual violence to undergo classic psychotherapy. During or after therapy, these people often feel that they still need to work with the body. Most often they say that they feel that the body is still “holding” the trauma and they miss the moment when the body completes the healing process. And it can come, among others, thanks to the massage.

But it’s not only the experience of a trauma that has tensed up the body that requires patient work. Also, some medical dysfunctions such as vaginismus. I remember a client with whom I worked for many months, because when she came to me for the first time, we could only insert a fingertip into her vagina, her muscles were so tight. After a few months, we were able to insert the entire finger. That is a great success! Of course, in the case of vaginismus, massage alone is not enough, in parallel, such a patient should also see a urogynaecological physiotherapist, it is also often worth considering classic psychotherapy or consultation with a sexologist.

Anyway, if the source of the problem are medical dysfunctions, the therapy should be carried out in at least two ways. The massage itself would be insufficient, we will not be able to deal with painful menstruation in this way if its cause lies in untreated endometriosis. Just as back massage won’t help if the pain is caused by renal colic.

Do you also see women during or after menopause?

So far, I have not massaged a woman in her sixties, 50+ is the upper age limit. But one of my clients told her grandmother about the massage and she, after listening to a detailed account, asked her granddaughter to arrange a session. She has not appeared in my office yet, but I hope that older women will also come.

What can such a massage bring them?

First of all, it can be an interesting experience developing their sexuality. I imagine that for a woman brought up in completely different times and with a different approach to the body, it can be an enriching experience. We should also remember that women who gave birth during communist times have the right to have a real trauma after this event – we call these times “concrete obstetrics” for a reason – so it can also be an element of regaining this experience for them.

On the other hand – since I am also a pelvic floor muscle training instructor, I am the right person to talk to when a woman is struggling with urinary incontinence, which can happen to a perimenopausal person and should not be a taboo subject, but a common area to talk about how to change your habits and how to help yourself, because perhaps no surgery will be needed.

And yet on the other hand – during the menopause, the amount of oestrogen secreted in the body decreases, which negatively affects the vaginal mucosa, which becomes thinner, drier and more prone to abrasions and micro-injuries, making intercourse painful. Regular (auto)massage will have a positive effect on the tissue, which will be better supplied with blood, nourished and moisturised. Therefore, it can be said that such massage in the case of a woman in perimenopausal age will be a prophylaxis of painful intercourse. Advantages only!

Is shame the dominant feeling in your office?

The women who come to me are aware of what massage they have come for. They know that we will work all over the body, from the top of the head to the intimate areas, if they want to. But it’s important for them to remember that they can always say: “I’m ready to undress, but not yet ready to be massaged there.” The masseur – in this case me – must respect such a declaration and it is also an element of joint work, it is the woman who sets the limits in which I move. From the first meeting, I emphasise that we do not work under duress, that you can come several times and slowly open up. There are women who will undress after a few meetings and allow themselves to be touched after a few more meetings. This process must not be rushed.

It should also be remembered that our needs change, for example depending on the time of the cycle, mood and body sensitivity to touch. Therefore, even if the last time a regular client wanted a vulva massage, this time I will ask her for permission again because today she has the right not to feel like being touched.

We talk a lot about embarrassment in my office, which is why, as I mentioned before, I do not work in silence. I also talk to my client to touch this shame and disarm it.

But shame is not only the fear of undressing, we are also ashamed to articulate our needs and verbalise our objection.

It is very important for me to support women in regaining their own body, in learning to signal needs and to set limits. Vulva massage can help women learn to articulate both their desires and discomfort, and above all, the ability to say the word “no”.

As a sex educator, I have recently had the pleasure of conducting workshops for women as part of the “Power and Sexual Violence” project. We talked a lot about their feeling that the body below the waist was not theirs since they had been forcibly coerced into some sexual activity. Next year, the coordinators of this project want to compete for a subsidy, thanks to which the vulva massage would be financed for all participating women, because thanks to it they have a chance to regain this forcefully taken, intimate, delicate area of the body.

Not only people who experienced violence have the impression that the body is not entirely theirs.

I have such a reflection that our intimate areas are constantly touched for a specific purpose – be it at the doctor’s, during childbirth, or to bring us to orgasm. This area is almost never touched like that. Why do we stroke each other tenderly all over our body and our vagina or vulva are never touched in this way? Or we put a lotion or oil on the whole body, but avoid the intimate area? We look at ourselves in the mirror, sometimes even with a magnifying glass, but we hardly ever look at the vulva. After all, it is the same part of the body as any other. The vulva also deserves attention, care and tender, non-erotic touch.

A vulva massage has, among other things, to convince women that there are no worse or better places in our bodies.

Can we do this massage alone at home afterwards?

I would encourage this very much. I do not like the paternalistic approach “I am a healer, only I will take this pain off you” because it is still a narrative for me emphasising that someone will do something with our body without our conscious participation, carry out the whole process next to us. I want to entrust my agency to the person who comes to me, so I am happy when my clients say: “Thank you. I don’t need the massage anymore!” because that means they’ve taken matters into their own hands.

Therefore, during the sessions, I tell them exactly what I am doing. Sometimes I also use a mirror, so the client can watch me work with my fingers so that she can then recreate the same movements at home. I also often recommend self-massage and self-love sessions (optionally in front of a mirror) at home.

Is there a chance to popularise this method? If the masseur refers their clients to a doctor, why can’t doctors support the treatment not only with physiotherapy, but also with massage?

There are more and more doctors who are noticing other methods. They may not send you for a massage yet, but sometimes they refer you to urologynaecological physiotherapists, so I’m hopeful. Although there are still gynaecologists who, when asked about the benefits of perineal massage before delivery, can answer: “It’s a waste of money, they will cut you in the delivery room and that’s it.”

More and more doctors understand it because more and more people say that the body becomes tense in response to difficult experiences, and if we do not relax it consciously, pain-inducing, chronic tensions in a given area will arise. But what is worse – a tense muscle is less supplied with blood, so it is not nourished and, as a result, insensitive to touch, but more susceptible to injuries (e.g., during childbirth). It’s our physiology, there’s no magic to it.

 

Kamila Raczyńska-Chomyn, doula, sex educator

Author: Magdalena Keler

Illustration: Marta Frej

The text was published in „Wysokie Obcasy” a magazine of „Gazeta Wyborcza” on 17 July 2021