Tag Archives: Chronic Pelvic Pain Syndrome

New Film on Vaginismus Helps Raise Awareness of Pelvic Pain

Tightly Wound, a new short film about one woman’s journey with vaginismus and pelvic rehab, gives an insight into the real social struggles that can beset sufferers of pelvic pain. The 10 minute animated film was created by Shelby Hadden and Sebastian Bisbal, and it can be viewed at www.tightlywoundfilm.com.

Vaginismus is a condition in which the vaginal muscles contract involuntarily. The muscle contraction makes it impossible to insert anything into the vagina, and the condition can have a number of causes. Shelby discovered that she suffers from this condition when she first started attempting to use tampons. In the film she describes a “tearing, stabbing pain; the worst pain I’ve ever had”.

When Shelby Hadden found herself seeking treatment, she might have expected a gynecologist to be able to clear things up right away. Unfortunately there was no clear solution to her pain. She tells us in the video that a number of doctors weren’t able to identify the cause of her vaginismus. Many even prescribed unsuccessful treatments like inserting small candles during menses, or using alcohol to loosen her muscles.

Vaginismus and Pelvic Floor Dysfunction

The scientific and medical community do not have a great grasp on vaginismus and female sexual pain disorders quite yet. A 2014 literature review published in the journal Current Opinion in Psychiatry by Simonelli et al. “did not provide clear evidence in support of the superiority of any treatment” and established that there is a need for more placedo-controlled trials. “A lot of work remained to be done to understand such a complex and multifaceted disturbance as genital sexual pain, but the articles examined showed that we are slowly adding more knowledge on the etiological cause and treatment models for such conditions.”

Women who suffer from vaginismus can often feel isolated. A 2018 study by Stout, Meints, and Hirsh published in the Archives of Sexual Behavior demonstrated that “more frequent and severe pain during intercourse leads to more loneliness, which then leads to increased depressive symptoms.” The authors show that women with pain during intercourse also experience higher rates of loneliness and depressive symptoms. This study suggests that having a sense of community is an important factor in patient care.

Creating a sense of community

That’s one reason that so many pelvic rehab professionals are excited to see this new film raising awareness of the condition. Upon it’s recent publication, Tightly Wound has been getting rave reviews from patients and clinicians around social media.

A review by Talli Rosenbaum, who is an active researcher and lecturer in the field of pelvic floor dysfunction and sexual health, shares what some of her patients experience. Talli writes that “[Tightly Wound] reflects the experience of many women with vaginismus and other forms of pelvic and vaginal pain syndromes. They feel isolated and alone, they are offered treatment solutions that are painful and embarrassing, and they frequently expose themselves to distressing and painful examinations only to be told by the examining practitioner that he or she can’t find anything wrong.” Talli’s excellent review goes on to address the role of vaginal penetration in sex and sexuality, which is definitely worth a read at tallirosenbaum.com.

Vaginismus impacts millions of women around the world, and many don’t know that treatment is an option. Women’s health support groups can help patients share resources and link up with adequately trained medical professionals. Online groups like the Vaginismus Support Facebook group are a great place to start for patients seeking peer support.

Thank you to Shelby for telling her story, and for helping to raise awareness of pelvic pain conditions.

Need to find a pelvic rehab practitioner?

Our index of pelvic rehab physical therapists and other professionals will help patients get treatment for conditions like vaginismus. Visit www.pelvicrehab.com to find a pelvic rehab practitioner near you.

 

Can Pelvic Rehab Physical Therapy Help Dysmenorrhea?

dysmenorrhea, menstrual crampsDysmenorrhea is the condition of having pain with menstruation, and it affects more than 50% of women. Painful menstrual cramps can last 1-2 days with menses every month, and some women may not experience menstrual pain later in life. Dysmenorrhea can be either primary or secondary, depending on the likely cause and symptoms of the condition. Either form of dysmenorrhea can be treated, though treatments will vary depending on the root cause of the problem

Primary Dysmenorrhea

Primary dysmenorrhea is usually caused by chemicals called prostaglandins which come from the lining of the uterus, and are most prevalent on the first day of menstruation. As menstruation continues, prostaglandin levels decrease, and the pain that they cause begins to decrease.

Secondary Dysmenorrhea

Secondary dysmenorrhea is usually caused by a disorder in the reproductive system. Common associated disorders include; endometriosis, where uterine tissue forms outside the uterus; adenomyosis, where uterine tissue grows within the muscle walls; or fibroids, which are non-cancerous tumor-like growths that form in or around the uterus. Secondary dysmenorrhea may not occur until later in a woman’s life, and the pain tends to increase over time.

Pelvic Floor Rehab can Help Reduce Menstrual Pain

Dr. Holly Tanner, PT, DPT, MA, OCS, WCS, PRPC, LMP, BCB-PMD, CCI, writing in The Pelvic Rehab Report, assures us that there is hope for women suffering from dysmenorrhea.

A recent literature review asked if physiotherapy can help with symptoms of primary dysmenorrhea. Of the articles reviewed, 186 were chosen, and included a range of articles from descriptive, experimental studies to prospective, randomized controlled studies. A variety of interventions and approaches were included in the review, such as [transcutaneous electrical nerve stimulation], abdominal massage, acupuncture, cryotherapy and thermotherapy, connective tissue, Pilates, and belly dance. All of the approaches demonstrated some therapeutic benefit, either in response to the immediate application of the intervention, or up to a few months after the intervention was applied or instructed.

Find a Pelvic Rehab Practitioner

A pelvic rehab physical therapist will be able to diagnose dysmenorrhea via a pelvic exam or ultrasound, and can prescribe the best treatment options on a patient-by-patient basis. These specialists can help reduce or cure dysmenorrhea without the use of invasive surgeries, and they can also evaluate for any other disorders which may be complicating a patient’s condition.

Dysmenorrhea is painful and common, and most importantly it can be treated. Visit the pelvicrehab.com practitioner directory to find a pelvic rehab physical therapist who can help treat painful menstrual cramping.

Common Female Pelvic Floor Disorders

There are many conditions that can afflict the pelvis, pelvic floor muscles, and pelvic girdle. The following pelvic floor disorders affect hundreds of millions of women globally. As awareness of pelvic floor dysfunction continues to increase, the ability to find a pelvic rehab therapist becomes more important. This list is not comprehensive, and trained pelvic floor rehab therapists will be able to diagnose and treat conditions not listed here.

Diastasis Recti Abdominis

Female Pelvic Floor AnatomyOften colloquially called “mummy tummy”, “baby belly”, etc, diastasis recti abdominis occurs when the abdominal muscles are separated vertically, along what’s called the linea albia. Clinically you would be diagnosed with diastasis recti if you have more than 2cm of separation while doing a hook lying curl exercise.

Typically diastasis recti abdominis is the result of a growing fetus putting pressure on the abdominal muscles and causing them to separate. Of course, there are other ways that this type of pressure can happen, so we shouldn’t only associate the condition with pregnancy. While the majority of sufferers are postpartum women, DRA can also occur in men. It’s related to aging, weight fluctuations, weight lifting, or other circumstances that result in high pressure within the abdominal wall.

The condition is treatable, and women who experience diastasis recti abdominis can get pelvic rehab by finding a trained pelvic rehab practitioner.

For more, see our post “What’s the Deal with Mommy Tummy?” on The Pelvic Rehab Blog.

Vulvodynia

Vulvodynia is chronic pain in the vulva with an unknown cause. Vulvodynia can be localized to specific locations in the vulva, or it can be generalized pain that impacts the whole vulva and is more constant. Pain in the vulva can be caused by touch (prolonged sitting, tightly-fitted pants, touch, medical exams, etc.), or the pain can occur chronically without a direct stimulus.
The National Vulvodynia Association is an excellent resource for women suffering from this condition, and you can find treatment for vulvodynia on our practitioner directory on www.pelvicrehab.com.

Dyspareunia

Dyspareunia is the experience of pain while engaging in vaginal intercourse, and it occurs in at least 8% of American women by age 40. Some potential causes of vulvar pain can be infectious, inflammatory, neoplastic, neurologic, trauma, iatrogenic, or hormonal deficiencies. Vaginal pain during intercourse can be frequently misdiagnosed, making it important for women who suspect they may have dyspareunia to find a pelvic rehab practitioner who is trained to recognize the condition. More information is available in our post “Why is it hard to get treatment for painful sex?” on The Pelvic Rehab Blog.

Urinary Dysfunction

Female urinary incontinence (the unintentional loss of urine) is very common, and it is often associated with weak pelvic floor muscles. Stress Urinary Incontinence is leakage resulting from any physical activity. Oftentimes women experience leakage when coughing, sneezing, laughing, or participating in more rigorous physical activity like exercising.

Endometriosis

Endometriosis occurs when tissue that should line the inside of the uterus forms on the ovaries, fallopian tubes, and other areas outside of the uterus. Endometriosis can lead to inflammation, scar tissue and adhesion formation and myofascial dysfunction throughout the abdominal and pelvic regions, and it can cause infertility in some cases. It affects up to 15% of women of reproductive age, and the severity of symptoms can vary greatly. Because endometriosis can be difficult to diagnose, it is important to find a pelvic health practitioner who is trained to treat pelvic rehab conditions.

Dysmennorhea

Dysmennorhea is the condition of experiencing pain with menstruation, and it afflicts as much as 50% of reproductive age women. Primary dysmenorrhea is related to menstruation, and often begins within a short period of time once menses occurs, whereas secondary dysmenorrhea is often related to a condition within the reproductive tract such as endometriosis or fibroids. There is strong evidence that pain with menstruation can be diminished with pelvic rehabilitation, making it all the more important that patients are able to find a pelvic rehab clinician near them.

Prostatitis or Pelvic Pain?

What is Prostatitis?

Prostatitis, the condition of having an inflamed prostate gland, is one of the most common diagnoses that men get when they suffer pelvic pain. According to the Prostatitis Foundation, “estimates on the number of males in the United States who will experience prostatitis during their lifetimes range up to 50 percent. Many urologic disease experts feel that from 5 to 10 percent of males will be experiencing prostatitis at a particular time, making it one of the most common urologic diseases in the U.S.”

Troublingly, this is often an inaccurate diagnosis.

Prostatitis is over-diagnosed

Prostate and Surrounding OrgansOne big problem is that different conditions can express themselves in similar ways. Prostatitis can cause sexual dysfunction, difficult and painful urination, pain in the perineum, testicles, bladder, and penis. These symptoms may also be caused by a number of other conditions as well. Chronic Pelvic Pain Syndrome can be caused by muscle spasms. Bladder malfunction can be caused by interstitial cystitis. Erectile dysfunction may be related to hormone or testosterone imbalances.

Yet some clinicians seem to be diagnosing prostatitis when the practitioner just doesn’t have a better answer. When there are many potential causes for pain, making the correct diagnosis becomes more difficult. As you might imagine, this can have some pretty nasty consequences. A hasty diagnosis can lead to treatments for a condition that the patient isn’t suffering from. It may not be surprising that those treatments can have negative side-effects that could have been avoided.

Since this condition can be caused by bacterial infections, antibiotics are one of the primary treatment options. One common family of antibiotics, fluoroquinolone, can have serious side effects. An FDA safety review has shown that fluoroquinolones are associated with disabling and potentially permanent serious side effects that can occur together.

According to the FDA safety announcement, “patients should contact your health care professional immediately if you experience any serious side effects while taking your fluoroquinolone medicine. Some signs and symptoms of serious side effects include tendon, joint and muscle pain, a “pins and needles” tingling or pricking sensation, confusion, and hallucinations. Patients should talk with your health care professional if you have any questions or concerns.” In other words, you only want to take these if you know they will help your pelvic pain.

So, what should you do?

If you have symptoms similar to those mentioned above, there is help and you should consult a medical professional right away. If your practitioner suggests that you may have prostatitis, double-check that the clinician has tested a sample of your urine and prostate fluid. It may also be helpful to have your level of prostate specific antigens (PSA) checked, as both prostatitis and prostate cancer can increase PSA levels.

If you are experiencing pelvic pain, you may want to go straight to the experts. Trained and certified pelvic rehabilitation practitioners may be better equipped to recognize the source of pelvic pain than a general practitioner. To find help near you, check our directory at www.pelvicrehab.com.


Sources and further reading:
https://www.prostatitis.org/
https://www.pcf.org/c/prostatitis-misdiagnosed-and-misunderstood/
https://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm503021.htm