Fibroids and Feminism, and How Massage Can Help
A medical complaint that many women have that they are often unaware of is FIBROIDS. These are benign growths in, on or around the uterus that are often painless but can also create pain in other women, plus discomfort, bloating, heavy periods, pain during intercourse and a range of other negative symptoms.
They can be inside the uterus growing in the lining, so that they bulge out into the uterine cavity, which would interfere with the growth of a foetus. Then there are deeper ones that grow in the muscle beneath the lining. Still others tend to dangle down from the lining attached to a thread, so wobble around. Yet others grow on the outside of the uterus, pressing against unrelated nearby organs. They can be as small as a coffee bean or as large as a grapefruit. All women can get them, but especially black women.
Doctors say the cause is unknown. However, as a feminist, I am always rather suspicious when the medical establishment, which is overwhelmingly white, male and straight, declares that a female pain issue just happens for no reason. I am especially curious when black women seemingly suffer pain more greatly than white women. Now, there are some diseases that do indeed manifest in certain ethnic groups more than others and some of those groups are Black. However, those diseases tend to have an obvious origin, mainly relating to DNA or some other scientifically valid and understandable reason. However, for something to simply arise for no reason, only in women and especially in Black ones, and cause pain, seems highly suspect.
The female sex hormones, oestrogen and progesterone, appear to play a role in fibroid development, since the surface of fibroids contains a greater number of receptors for those hormones than the rest of the uterine lining. Further, fibroids seem to spontaneously develop.
I became curious when I compared this phenomenon to my own experience of painful things developing for no reason. Obviously, as a man, I don’t get fibroids; however, I do get canker sores in my mouth. Different to cold sores, which are a manifestation of the herpes simplex virus, a canker sore usually appears on gums, tongue or lips as a small, painful abscess, which rages for about a week before disappearing. I usually get them if I am thirsty and stressed at the same time. If I’m just thirsty, they don’t usually appear but stress and anxiety seem to bring them on.
Further, other people with stress can suffer stomach ulcers.
I began to suspect that there might be a link. I researched online and — lo and behold! — women who have suffered sex abuse or trauma or rape report greater incidence of fibroids, plus black women suffer more from abuse, trauma or rape than white women, so they get fibroids more. I read a range of different scientific studies investigating these issues.
Also, many women who are stressed tend to eat more and gain weight, with those suffering from abuse or trauma reporting greater anxiety and depression. An increase in adipose tissue promotes oestrogen production. Overweight men have also noticed that increases in adipose tissue leads to a decline in serum testosterone and a corresponding increase in oestrogen, creating female-like symptoms like “man boobs”.
Even to a non-medical person such as myself, these connections seem like they could be a reasonable explanation for the appearance of fibroids.
In massage therapy, there are further instances to observe. Women clients often hold tension in three places — just below the solar plexus, the stomach, and inside the vagina. We can massage the first two without too many ethical dilemmas. When these areas are massaged, women report that, before they can appreciate relaxation or pleasure, there is some emotional release to get through. Typically, a woman might get tearful or even moan or wail quietly. Once this emotion is released, there is a sense of cleansing, like a physical version of the “smiling through tears” feeling that feels so good to many people. After that, then relaxation can occur, which can then lead to pleasure. Unfortunately, for inside the vagina, rules of ethics prohibit the therapist from doing anything about it.
This is understandable, for issues of safety; but, in a perfect world, it is a pity since there is a lot that could be done.
The uterus, where fibroids occur, is deeper inside than the vaginal canal. The two structures are separated by the cervix, a tough, doughnut-shaped muscle that is designed to stop the penis from entering the uterus, which could be dangerous, both for the woman and to a baby if the woman is already pregnant. No therapist has fingers long enough to do anything inside the uterus but, if it were ethically acceptable, the vagina could be massaged.
It can be observed that some female clients take it upon themselves to exhibit sexual behaviour in the massage room if the therapist has created a safe space where the client can relax. Typically, this behaviour is directed towards herself rather than the therapist. For many women, the experience of being naked (but draped) in a safe space with a male therapist whose hands are touching her skin and yet nothing bad happens is a new and novel experience. I have been dismayed by the fact that a woman could have had a large number of boyfriends, one night stands or other lovers and yet I have been told that I am the first man they had met where they felt like they could choose how to express their sexuality without pressure. Although the massage room is not supposed to be the place for this, to a certain extent, I sense a tension between the ethical obligation I have and the safe space I have created. It sometimes feels that one should cancel out the other — if you need ethics, the space is not really safe; if the space is truly safe, then you don’t need ethics. However, I try to maintain both as best I can, and a big part of that is letting the client decide how far she wants to go and myself doing nothing except being present and accepting her feminine wisdom on the matter.
Typically, women will touch their breasts and/or put their hand inside their underwear to stimulate their genitalia as the massage continues normally. Although the ways women do this vary widely from woman to woman, there seems to be a trend where women who believe in themselves, have a positive outlook, are intelligent, well-educated and have dreams for their future, tend to caress their breasts with reverence, very gently, while their fingers move deeply inside their vagina. Meanwhile, women who suffer from low self-esteem, have suffered abuse, trauma and other negative experiences, have low levels of education, work dead-end jobs and are pessimistic about their future life chances tend to mash their breasts vigorously, kneading and pummelling, while down below, their fingers focus an external genitalia such as the clitoris or first inch or so of the vaginal opening. It’s as if she has to work hard to get any pleasurable sensation from her breasts, while beyond the entrance, there’s no feeling or sensation, as though everything’s dead in there.
That can’t possibly be true. We know as scientific fact that the anus has nerve endings but the rectum doesn’t, while the vagina is innervated all the way up to the cervix. That’s why going to the toilet doesn’t usually hurt but giving birth does. So when a woman says, “I can’t feel anything up there” in her vagina, it suggests that there is some disconnect between her brain and those nerves, rather than some blanket unscientific assertion that there are zero nerves, like in the rectum.
Further, this brain-genital connection can be re-established. In the bedroom, dirty talk can help her to focus on what’s going on and raise her mental awareness, while stroking of vestibular bulbs and outer labia will engorge them with blood and render the nerves dramatically more sensitive. Women can then tolerate better the deeper insertion of fingers. Stimulation of the G area behind the pubic bone or the anterior fornix (A-spot) close to the cervix causes pain when she is unaroused but after genital engorgement and arousal has already occurred, these spots can be pleasurable. Not before, however, any unresolved emotional tension being held there has been released. Typically, the soft wail and tearful release seen with the stomach and solar plexus will also happen there and a large number of women store an enormous amount of emotional stress in their vaginal walls and, when pressed WITHOUT arousal, this registers as pain. WITH arousal, she can tap the emotion in a safe environment, express and release it, then move on and up into the spiral of orgasmic pleasure.
As a massage therapist and a feminist, I posit that fibroids are just a deeper, uterine manifestation of that trauma-related pain in the vaginal walls. We already know that sexual trauma, such as rape, is done without consent and thus without arousal, causing pain, both physical and emotional. It doesn’t seem too far a stretch to consider that if digital stimulation is done WITH consent and WITH arousal, not just the emotional pain but also the physical pain would be relieved.
Black women are at a higher risk of rape than white women, younger women more than older women. Trauma creates hormonal changes. The typical female bodily response is to increase oestrogen to put on weight, so the woman can “survive” the trauma. Oh, look, it just so happens that the women with the most and worst fibroids are black or young or fat or rape survivors — fancy that!
So much for an “unknown cause”. All cynicism aside, though, what can we do to help these women? Massage cannot reach the uterus, plus ethics forbids us from perhaps easing the pain in areas close by that might take the edge off her pain. What gives?
We could perhaps empower her to do it herself. Encourage her to take exploratory steps at home with her own fingers to see if she can relieve trauma stored in the G area. A dildo could reach the A-spot. Recommending that she “own” her sexuality more and enjoy herself might be good. Orgasmic contractions move the uterus, so they might help The flood of hormones released by orgasm are all excellent at neutralizing the negative effects of increased oestrogen, and cortisol from stress, anxiety or depression.
I have another suggestion, however. There is a bodywork modality that is NOT massage but might be good for her case. It’s called THE ROSEN METHOD.
This modality, developed by Marion Rosen, PT, posits that there is a link between muscles and emotions. Typically, the musculature hardens and is held tensed in response to holding onto unpleasant or frightening emotions that we are scared to face directly. A prolonged tensing results in chronic pain. The Rosen Method involves gentle, light body movements — there is no deep tissue work. Areas of the musculature are treated like this until awareness of the emotional content arises in the client. He/She can then make a decision to continue holding it or release it by expressing the emotion. There is no pressure to do so from the therapist. The environment is safe. Clients who choose to release will experience a lightness and cleansing, similar to that I described before. The emotional discomfort of expressing is very brief, perhaps seconds or just a minute or so but the resulting relief is deep, profound and long-lasting. There is a focus on the diaphragm as a means of diagnosis. Depth of breathing and how much the diaphragm moves indicates to the therapist where muscle tension lies, since the diaphragm is connected to a wide range of abdominal musculature (like near the solar plexus and stomach — aha!) which, if tensed, pull the diaphragm out of its natural alignment. Further, near the diaphragm are many important vital organs that secrete hormones which can either aid or inhibit stress and anxiety and in turn, are also themselves affected by stress hormones activated elsewhere. The Rosen Method needs a specialist practitioner, so you will need to refer your client.
I believe that massage therapists can better serve their female clientele who suffer from fibroids by raising their own and clients’ feminist awareness of female trauma from sex abuse, harassment and rape and how these negative experiences create somatic pain that can lead to the development of fibroids. These can then be eased and reduced in size by manual palpation of the solar plexus and stomach and by encouraging the client to own her sexuality more by experimenting in the comfort of her own home with digital exploration of the vagina and her orgasmic pleasure, while the Rosen Method can ensure a more systemic relief of traumatic emotional memories and referred pain on a body-wide scale that can go a long way to relieving her and offering her a new life free from pain and shame.
Women need our tender, loving care, and it is my hope that your dedication to providing this as described will deepen your ability to transform your clients and give them renewed hope for the future.
