Female pelvic pain and sexual dysfunction

 

It is well recognised that muscle spasm occurs in other pain conditions such as neck and shoulder pain. These muscles are easily seen and examined.

The pelvic floor muscles are like any other muscle in the body and can spasm and cause significant pain with activities such as sex.

As this is something that is often not readily discussed, women often suffer in silence for years with significant consequences for both social interaction and intimacy.

It is estimated that 15% of American Women and 25% of New Zealand Women suffer from pelvic pain. This would makes it more common than asthma (10%) and back pain (14%) in Australia (Australian Bureau of Statistics Data).

Why does this occurring?

Pelvic pain and sexual pain can have simple causes such as vaginal tissue dryness from breastfeeding or menopause.

Often however, pelvic/sexual pain has complex causative mechanisms that involve not only muscles and pelvic structures but sometimes also the peripheral nervous system and central nervous system (nerves and brain).

Often, there has been a painful event (endometriosis, heavy periods) or a stressful event (new job, exams) which can lead to muscle spasm in the abdomen or pelvis - which is part the body’s natural protective response. Sometimes the body’s protective mechanism becomes too ‘switched on’ and unfortunately ongoing tightness in muscles can lead to pain.

Some things that might precipitate ongoing pelvic pain or sexual pain include:

  • Painful periods

  • Trauma to the pelvic area

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

  • Menopause

  • Childbirth

  • Recurrent UTIs/ Thrush

  • Psychological factors such as stress

What are the signs and symptoms?

  • Painful sex

  • Pain with using tampons/ having internal vaginal examination

  • Painful periods

  • Twitching/ spasm in pelvic floor muscles

  • General pain in lower abdomen region

  • Pain in tail bone

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

What can be done to help me?

A comprehensive assessment of the pain history, patterns and onset will be performed to help guide treatment.

Often treatment will involve retraining of the pelvic floor muscles - which is usually targeted at relaxation.

Many patients with pelvic or vaginal pain are anxious about internal examinations so this assessment will only be performed if and when it is necessary and you feel willing and able to undergo this examination.

Release of any tight bands of muscle in the pelvic floor that might be referring pain to other areas might be performed with manual techniques and perhaps by teaching you to use pelvic wands or pelvic dilators.

We can also teach you relaxation strategies to help manage stress (which leads to muscle tension) and give you stretches for the pelvic floor and surrounding muscles.

We will work with you and your specialist to make a plan targeted to your goals.