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PELVIC AND SEXUAL PAIN

Pelvic or sexual pain is often complex and may involve several health care professionals. It is estimated that it affects 1 in 5 women and 1 in 12 men at some time in their life – yet it’s a condition that is rarely discussed.  Specialised pelvic health physiotherapists can certainly help patients with pelvic and sexual pain.


There are many structures that can cause pain in the pelvis. Some are fairly easy to identify; others may never be completely understood. It is important to have a good medical assessment. Unfortunately, referred pain is common in the pelvis and causes much confusion. Referred pain can originate from organs, muscles, or joints. Referred pain is felt in a location other than the origin of pain.


Pelvic pain can originate from a muscle spasm, joint dysfunction, scars and adhesions, poor posture, or organ dysfunction. When a muscle is in spasm, it is contracting on its own. This decreases the oxygen to the muscle and causes pain. Muscle spasms also pull on bones and joints and can cause them to hurt. Buttock, belly, hip and pelvic floor muscles can be in spasm. Muscle spasms often feel tight and hard and may have trigger points (very sensitive areas).


Some causes that might trigger long-term pelvic or sexual pain:

-Painful periods

-Trauma to the pelvic abdominal area

-Food allergies

-Menopause

-Childbirth

-Involvement in exercise that involves lot of abdominal bracing such as dancing, running

-Recurrent UTIs/ Thrush

-Stress

-Scar adhesions


What are the signs and symptoms?

-Painful sex

-Pain with using tampons/ having internal vaginal examination

-Pain in the vaginal opening

-Painful monthly periods

-Spasm of the pelvic floor muscles

-General pain in the lower abdomen region

-Pain in tail bone

-Severe bladder pain

-Alternating diarrhoea and constipation as well as belly pain


You might have seen a specialist and have been diagnosed with Vulvodynia, Vestibulodynia, Vaginismus, Endometrosis, Painful Bladder Syndrome or Interstitial Cystitis.


Therapy may include specialised exercises targeted at relaxation, education, manual techniques to release and stretch muscles and scars, and modalities for pain relief. We will work with you and other health professionals involved to make a plan targeted to your goals.


If you would like to learn more about pelvic pain, here are some key resources:

Pelvic Pain Foundation of Australia

This free, downloadable booklet is an intro to many of the common pain symptoms: period pain, bloating, bowel troubles, painful sex, bladder troubles, fatigue, anxiety, stabbing pains, pudendal neuralgia, headaches, migraine – and importantly, Chronic (persistent) Pain. Chronic pain is when pain has been present on most days for more than 3-6 months.

Endometriosis New Zealand

On this website, you can find out more about the disease, and evidence based best practice treatment and management. You will also find information about self-management – the things you can do for yourself that guide you on nutrition, coping and general well-being.

Books

Heal Pelvic Pain: The Proven Stretching, Strengthening, and Nutrition Program for Relieving Pain, Incontinence,& I.B.S, and Other Symptoms Without Surgery

by Amy Stein


This book gets to the root of your disorder with:

A stretching, muscle-strengthening, and massage program you can do at home

  • Guidelines on foods that will ease your discomfort

  • Suggestions for stress- and pain-reducing home spa treatments

  • Exercises for building core strength and enhancing sexual pleasure

Better Sex through Mindfulness - How Women Can Cultivate Desire

By Lori A. Brotto, Phd.

Dr. Lori Brotto is a Professor in the UBC Department of Obstetrics and Gynaecology, and a Registered Psychologist. She is the Executive Director of the Women's Health Research Institute at BC Women’s Hospital. Dr. Brotto holds a Canada Research Chair in Women's Sexual Health. She is the director of the UBC Sexual Health Laboratory where research primarily focuses on advancing the science of psychological and mindfulness-based interventions for women’s sexual health. Dr. Brotto is an Associate Editor for the Archives of Sexual Behavior, has over 150 peer-reviewed publications, is passionate about knowledge translation, and as such, is frequently featured in the media on sexual health topics. Her book, Better Sex Through Mindfulness: How Women Can Cultivate Desire (Greystone Publishing) is a knowledge translation of her research over the past 15 years demonstrating the benefits of mindfulness for women’s sexual concerns and genital pain.


Permission

By Lauren White

Lauren White is a Sexologist, who have helped women feel they have little to no libido. In Permission, Lauren offers guidance and practical wisdom that will help you to explore your relationship with sex, intimacy and your personal health. It will cultivate, support and liberate your feminine reclamation so that you will never seek, or most importantly, need permission for your own sexual expression ever again.

Women's Anatomy of Arousal: Secret Maps to Buried Pleasure

by Sheri Winston CNM. RN. BSN. LMT


Sheri offers empowering entertaining erotic education for everyone. Her holistic teachings are informed by her fifteen years as a sexuality teacher, on top of decades of practice as a certified nurse-midwife, gynecology practitioner, registered nurse, childbirth educator and massage therapist.

Come as You Are: The Surprising New Science that Will Transform Your Sex Life

by Emily Nagoski Ph.D.


An essential exploration of why and how women’s sexuality works—based on research and brain science.

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