Female Pelvic Pain.
It is well known that muscle spasms occur with musculoskeletal pain conditions, for example in lower back or neck pain. In the same way, the pelvic floor muscles can spasm and can be cause pain during intercourse, or contribute to referred pain within the perineal, vaginal and lower abdomen area.
Pelvic pain is often complex and is not something that women readily discussed, thus most women suffer in silence, with consequences for intimacy and impacts on their relationship. Pelvic pain occurs in approximately 25% of women, with well researched evidence that pelvic floor physiotherapy can reduce and improve the symptoms of pelvic pain.
How does pelvic pain occur?
Pelvic pain is often multifactorial, but the main things that can worsen or cause ongoing pelvic pain and painful intercourse includes:
-painful periods, often paired with a diagnosis of endometriosis,ovarian cysts,polycystic ovary syndrome,
-stressful period socially, at work or at home
-previous trauma to the pelvic or lower abdomen area
-previous surgery and/or injuries within the pelvic region, vaginal or abdomen area
-childbirth, including stitches, traumatic vaginal birth or episiotomy scars
-vaginal dryness from menopause or breastfeeding
-recurrent urinary tract infections and/or thrush
What are the signs and symptoms of pelvic pain or painful intercourse?
-painful penetrative intercourse
-pain or inability to use tampons
-pain in perianal or vaginal area
-spasm in pelvic floor muscles
-constipation or inability to completely empty your bowels
-ongoing bloating in abdomen
-pain within the lower abdomen, pelvic floor or vaginal area
How can we help with pelvic pain?
Most clients who have pelvic pain are often worried about exacerbation of pelvic pain with touching your abdominal area, and with the completion of an internal vaginal examination.
During your initial consultation, physiotherapist Aileen spends most of her time listening to your history and your concerns. She is very gentle and compassionate, and will only complete any further assessments (including vaginal examination) once you are happy to proceed and only if she deems it necessary to address your pelvic pain.
Physiotherapist Aileen believes in completing a thorough and comprehensive assessment, setting clear and achievable goals with you and further explains the contributing factors and causes for your pain. A treatment plan is further discussed with a self-management with pelvic pain to reduce your pain levels, improve your quality of life and to enable you to return to pain-free intercourse.
This normally involves:
– Assessing and diagnosing the type of pelvic pain that you might have, as pelvic pain is often classified into vaginismus, vulvodynia, vestibulodynia,interstitial cystitis.
– Treatment normally involves improving your pelvic floor awareness and teaching you to release and relax your pelvic floor and abdominal muscles, as it is often in a spasm and is tight.
– Prescribing you with stretches for the muscles in your abdomen and your pelvic area including your glutes, hip flexors and your core.
– Discussing relaxation strategies to help with managing your stress
We also work in a multidisciplinary team setting which might include referring you onto a gynaecologist, general practitioner, sexologist or psychologist if we both think that it would accelerate your progress.