Pelvic Pain: It's so not fair.

Today we're talking about pelvic pain. What it is, what can cause it, the different types, and things that can help.

Pelvic pain can be any sensation that is not pleasurable or neutral (like pressure or light touch), and can feel uncomfortable and includes sensations like:

  • Burning
  • Itching
  • Feeling like your bladder is full or you have to go when you don’t
  • Sharp pain
  • Sore or achy
  • Tightness/tension
  • Shooting pain
  • Numbness or tingling (not the good kind!)
  • Feeling coldness or heat without explanation
  • General discomfort

This pain may always be present or may only be present some of the time. Maybe it's only with penetration or after a workout, maybe it starts after sitting on a hard surface for a few minutes. All of this is classified as pelvic pain.

Pelvic pain sucks.

Too often is pelvic pain brushed off as just something you have to live with or "get over." Maybe you've been told it'll get "better with time" or to "have a glass of wine" to help. That's absolute bullsh*t. You deserve better.

Similar to what I've talked about in previous posts, any pelvic pain can have a variety of causes. Rarely is persistent pelvic pain caused by just one thing. Usually, it becomes persistent because there was one thing (a diagnosis, injury, event) that caused you body to change and adapt to accommodate it. At first, these adaptations made by the body are a good thing. They help you continue through life and do the things you need to do. However, over time, these adaptations - like changing the way you move, changing the way you use your muscles to support you, altering your posture, and increasing hypervigilance to protect you from things perceived by the body as "unsafe" become the very things that cause you pain.

Your body is doing it's best, it just needs some new information letting it know that it's safe.

So, a lot can cause pelvic pain. Let's first talk about some conditions, injuries, and surgeries that can cause it:

  • Pregnancy
  • Childbirth
  • Prolonged sitting
  • Autoimmune disease
  • Anxiety
  • Depression
  • Constipation/IBS
  • Over-exercising or a sport that involves a lot of high impact activity or load like crossfit, dance, gymnastics, track/cross country etc.
  • Any abdominal surgery
  • Endometriosis/Adenomyosis
  • Uterine fibroids
  • Mast cell activation syndrome
  • Ehlers Danlos/Hypermobility syndrome
  • Lichen Sclerosus
  • Vulvodynia
  • Pudendal neuralgia
  • Sciatica
  • Femoral nerve palsy
  • Pelvic congestion
  • Prostatitis in men
  • Polycystic Ovarian Syndrome
  • Hemorrhoids
  • UTI, Bacterial vaginosis, yeast infections, STI/Ds, or other infection
  • Pelvic Organ Prolapse

While some of the above cannot change, your nervous system and your muscles can and fortunately, you don't have to be stuck in this cycle of pain. There are absolutely actionable things you can do to find relief. Relief is never immediate, especially if you've been dealing with pain/discomfort for >3 months (or years!). However, you will feel better over time.

The key ways to address pelvic pain include:

  • Nervous system downregulation: meditation, breathing/relaxation exercises, restorative yoga
  • Diaphragmatic and belly breathing
  • Improving joint, muscular, fascial, and/or neural mobility through stretching, walking, and strengthening
  • Improve core strength
  • Address posture and not staying in any one posture for too long
  • Perineal massage
  • Hormone management
  • Decreasing inflammation through dietary changes
  • Have regular, daily bowel movements
  • Sleep 7-9 hours
  • Drinking more water
  • Using a lubricant for sensitive skin
  • Acupuncture
  • See a pelvic floor physical therapist

I can't know the exact source of your pain, but doing the above suggestions will definitely help.

Notice that kegels are not on this list. Often, when we google pelvic pain or vaginismus or pain with sex etc the answers on webMD and healthline are to perform kegels and see a psychologist. I'm a lover of both of these things - but they do not get to the physical source of your symptoms. Kegels will most likely make your pain worse. Finding the right psychologist will *absolutely* help your mental state and ability to cope and process thoughts, emotions, and life events. However, it doesn't reach the physical source of your experience.

If you're feeling discouraged, I'm so sorry. Pelvic pain is the worst. It can be scary, intense, and so limiting in such important and sacred functions like bowel/bladder emptying, sex, or even just sitting or standing or exercise. Know that pelvic pain is not permanent and there are ways to overcome it.

l8r b@b3s

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