Pelvic Pain and Sexual Health- When to Seek Help

Any amount of pelvic pain or discomfort with intimacy is not something that you should live with. Meaning you should get help so that you can have the best pelvic health. Pain is a signal from the body and a message telling us that there is something wrong. The next step is listening to what our body is telling us and then acting upon it to get help.

Pelvic pain can be known as the silent sufferer as no one knows that you are walking around in pain. You are not wearing a brace, using crutches or a walker- no one can see that you are in pain from a quick glance. There are too many people walking around just dealing with pelvic pain not knowing that they can get real support and help. Now to say that pelvic floor physical therapy is not commonly discussed or known about is an understatement. When I went to physical therapy school, which was a three-year program, we had one day where they discussed pelvic health (in its entirety). Only one day where they explained some different pelvic floor issues that people could be suffering from and the basics of how we could help these patients. Most of that day was spent on urinary incontinence as it is one of the most common pelvic symptoms we see in PT and we barely touched the topic of pelvic pain.

It wasn’t until I was practicing as a physical therapist that I was truly introduced to the world of pelvic health and everything that encompasses. Pelvic health covers so many different things in the world of physical therapy, such as pelvic pain, pain with intimacy, pelvic organ prolapse, urinary incontinence, fecal incontinence, GI dysfunctions, constipation, diastasis rectus (separation of the abdominals), and so much more. So, if physical therapist don’t get the proper education about pelvic health and this is an area where we can make a huge impact on relieving peoples pelvic pain and discomfort with intimacy…how can we expect that patients know that they can get help?!

When you are suffering with pelvic pain, the first step is acknowledging that you’re having pain or dysfunction in your pelvic floor. The next step is realizing that you are ready to do something about it and make a change. Then a lot of people go to their doctor, their GYN, or midwives to discuss the issue and ideally you are guided to get help from a pelvic floor physical therapist. There are so many ways that we can help make a difference in this issue and we want to take a team approach of involving the necessary healthcare providers to get you the help that you deserve.

The pelvic floor is a group of muscles that connect to the bottom of our pelvis and help to support our bladder to function, our bowels health, sexual health, they help to stabilize the lumbar spine, and they help with lymphatic drainage. It is a group of small muscles that all work together to perform these important functions that most of us don’t think twice about until there’s a problem like pelvic pain. The pelvic floor muscles should be able to contract when they need to and relax when they need to. This is something that we can have conscious control over. First off you must know where these muscles are and how to use them. A pelvic floor physical therapist can help you connect with this part of your body so that you understand what’s going on. Just like any other muscle in the body we need a balance of length and strength so that the muscles operate correctly. If we get too much tension in a muscle that can lead us down a pain path. If we get too much length or flexibility in a muscle that can lead us down another path of instability. Neither is something that you want to deal with and finding that optimal balance is essential.

Often, when you have pelvic pain, part of the issue is that your pelvic floor muscles have tightened and then are having a difficult time relaxing the muscles. This is not always the case, but most of the time we find underlying tension in the pelvic floor muscles that contributes to your pelvic pain. Understanding how to relax these muscles is part of the process and techniques that pelvic floor PT’s will help guide you through so that you can feel the difference of when your muscles are tight versus when they are relaxed.

The other big factor that we see more often than not as pelvic floor PT’s is the link of stress in our life to tension in the pelvic floor. Most of us know that when we’re stressed, tense, anxious, have a lot on our mind or a lot on our plate, that our muscles tighten up. Most people know and feel that they hold their tension in their neck and shoulders when they are stressed. This can be a factor in neck pain, poor posture at the computer and more.

The other place that people commonly hold stress and tension, but they don’t even realize it is the pelvic floor. There has been extensive research and studies showing the connection of muscle activation in the pelvic floor when we are stressed, tense, afraid, anxious, and really any heightened emotion the pelvic floor turns ON. Now this is our body’s ability to protect and hold everything in. The pelvic floor muscles engage telling our bladder and our bowels that nothing needs to happen at that point in time (hold everything in). We go into protection mode which is okay and sometimes needed. But the downside comes in when those muscles stay tight all the time contributing to pelvic pain because we don’t even realize they’re tight in the first place.

So, the first thing is being able to connect with your pelvic floor and identify what your muscles are doing. The next step is checking in with your muscles throughout the day because all day long we are thrown different levels of stressors in our life. The stressor does not have to be major. It could be that you are pressed for a deadline at work, or someone cuts you off while you’re driving and almost causes an accident or you’re running late to pick up your kids from school. Any of those stressors cause our muscles to contract and so we need to check in with our muscles throughout the day to see what they’re doing. Then the next step is having the ability to let our muscles go or relax or lengthen.

When we work with patients as a pelvic floor PT, we look at short term success versus long term gains. This is the biggest impact that we can see in our patients lives meaning people have made the connection of what’s going on with their pelvic floor muscles throughout their day. Throughout their life, they then have the conscious ability to connect with their pelvic floor and to actively reduce that tension. This will provide you the long-term changes that most people are seeking in their life.

Now there are a lot of other factors that come into play and there’s lots of things that a skilled pelvic floor physical therapist can teach you to help lengthen the tissues as well as teaching you optimal breathing patterns and stretching. Then when your body is ready, it’s essential that strengthening is part of your program for healing. We need to make sure that pressure is taken off the pelvic floor muscles and you have strength surrounding that pelvis. Having a dedicated hip and abdominal strengthening program is essential for full recovery.

The biggest impact that we see as a pelvic floor physical therapist with patients that have pelvic pain is the effect that it has on their relationship. Intimacy is typically a part of many people’s relationships and a way that people connect. When this is taken away because of pelvic pain, there’s a very big impact on the relationship, on the ability to connect and on the mental health aspect as this challenge carries a heavy burden.

If you walk away from this with anything, it would be that you can get help for your pelvic pain or discomfort with intimacy and that it’s not your fault. There are so many factors that can cause or contribute to pelvic pain and there are a lot of factors that are out of our control. There are things that happen to us in life such as surgery, having children, trauma, injuries, underlying medical conditions or disease processes that can cause or contribute to pelvic pain that are out of our control.

In my world as a pelvic floor physical therapist, there is no amount of pelvic pain that you should have to deal with. You can get help and there are so many providers out there that want to help you make a positive impact in your pelvic health.

If you are ready to make a change and get help, then I recommend you seek out a pelvic floor physical therapist. They will be able to guide you on the right steps for you to take, further explain the problem and completely understand the amount of healing that can happen for you. I’ve seen it time and time again, and it ceases to amaze me the change that people can make in their life and then in turn in their relationship with their partners. It’s a wonderful gift and it’s a partnership or a team when you find a good fit as a pelvic floor physical therapist because we are here to help guide you and support you on your path. We want to empower you and educate you, so that you can heal. At Breakaway Physical Therapy, we believe so much in our patients finding the right fit on their path to healing that we offer free consultations. You can have a chance to sit with a pelvic health specialist and ask all your questions and make sure there were the right people to help you on your road to recovery.

My only question is…what are you waiting for? Are you ready to change your life because we are here to help!