• Dr. Lauren Peterson, PT, DPT

Physical therapy for pelvic pain

The most vivid memory from the Pre-Cana class I took with my husband was the teaching that in a Catholic marriage it is imperative to be open to life and to be committed to raising your children in the Church. Having and raising children is a joy and pleasure which most Catholic couples look forward to and see as the next natural step in life, if the sacrament of marriage is where we have been called. Not to mention that the holy scriptures tell us that man and woman are to be one - that our union in marriage is consummated through intercourse, and part of the love from God is shown in the birth of a child.

When sex with your spouse isn’t straightforward

But what if you can't consummate your marriage? What if intercourse is not the pleasure that society describes, but instead a barrier to your marriage and children? What if intercourse is so painful that your partner feels coercive or abusive when trying to initiate sexual relations or you start to feel yourself tense up at the mere thought of attempting intimacy again? It can make you feel less than, it can put a strain on your marriage, it can be a barrier to having children, it can make you feel incomplete as a woman and a married Catholic, but it shouldn’t.

If intercourse is not pleasurable for you, if intercourse is painful for you, you are not alone.

Pelvic pain disorders

Millions of women suffer from a variety of pelvic pain disorders. They are characterized by intermittent or constant pain anywhere in your groin (including your low abdomen). If your pain is so severe that it is preventing you from engaging in sex with your husband, that is certainly going to have an impact on your ability to be a mother.

Pelvic pain manifests in a variety of ways. Two of the most common pelvic pain conditions are known as vaginismus and dyspareunia. Vaginismus is an involuntary tightening of pelvic muscles. Whereas, dyspareunia means very specifically painful intercourse. But maybe you experience a constant, raw feeling of pain, a condition known as vulvodynia. Or maybe you feel pain only when your genitals are touched, a condition known as vestibulodynia. Or maybe your pain started with the insertion of a tampon.

No matter how your pain started or when it occurs, if pain is preventing you from participating fully in your marriage, if it is preventing you from engaging in sexual intercourse, your pain is a problem and one that you shouldn’t feel embarrassed about. And you shouldn’t feel like you have to deal with it silently or alone.

Don’t suffer in silence

Pelvic pain may be something you have suffered from for a long time. Or it may be relatively new for you, which can make it that much more frustrating to your partner and put an even bigger strain on your relationship. Oftentimes women have suffered in silence, not knowing that treatment options exist, or who even to talk to. It is all too common that I hear that a woman reached out to her Ob/Gyn, only to have her concerns dismissed. Or being told to “relax”, “take a bubble bath” or “drink a glass of wine”.

I want you to know that treatment options do exist, that you are normal, and that you are perfectly created in the image of God. That you were created in the image of God, just as were Adam and Eve, means that you are made of muscle and bone and connective tissue. Being human means that you can suffer bodily and emotional wounds, which can present themselves in a variety of ways.

What do you do in pelvic floor physical therapy for pelvic pain?

If you have never heard of pelvic floor physical therapy before, you can be forgiven. While the field itself is well studied, and has strong evidence-based practice, most women and even many Ob/Gyns are unfamiliar with what a pelvic floor physical therapist does or how they can help. Remember that your body is made up of muscle, bone, and connective tissue. So just like your leg or your arm, your pelvic floor can be injured, unhealthy or weak. It is the foundation of your core, made up primarily of your hip bones, sacrum and pelvic floor muscles. As the foundation of your core, pelvic floor muscles are responsible for, or take part in, some really important functions of daily life including holding in your organs, coordinating your breathing, standing, sitting, walking and, most importantly, urogenital functioning (that is sex, urination and defecation).

While each of us is made in the image of God, each of us is unique. When it comes to pelvic pain, we are unique in our anatomy, and unique in when and how our pain occurs. That means that a cookie-cutter approach to pelvic pain might help you improve, but to get the best outcome you need to see a pelvic floor physical therapist who can develop your personal plan of care. When it comes to the women I help with their pelvic pain, there are six treatment elements I used in varied combinations to help my patients get the most from treatment.