Latest news with #pelvichealth
Irish Times
03-07-2025
- Health
- Irish Times
‘By the time we see couples, there is no hand-holding, let alone sex': how to treat female sexual pain
While sex is not a defining factor in a healthy relationship, it can be a key cornerstone for connection and intimacy. Sex is known to be linked to a number of positives, such as lower stress and blood pressure, a higher rate of happiness and a better self-image – to name but a few. But how a person responds to sex can be complex, and female sexual pain can greatly affect a couple. 'A lot of pelvic health conditions are still taboo for many and, to be fair, most people do not discuss their sexual health with others,' says Linsey Blair, a couple and individual psychotherapist and psychosexual therapist with the Evidence Based Therapy Centre (EBTC) in Galway. 'It may be more difficult to discuss if one is feeling they are not functioning 'normally'. I think things are changing, but very slowly. We need to end the stigma associated with sexual health conditions and create awareness around options available for people to get solutions. Sometimes, people just don't know the help is there.' READ MORE Female sexual pain disorders present with a variety of symptoms, including pain or discomfort with penetration or being unable to tolerate any penetration whatsoever, be that with a digit, a tampon, menstrual cup or penis. Pain is not specifically internal, but also on the vulva, the outer genitals. 'A woman who previously could have pain-free sex may start to experience pain or discomfort,' says Sylvia Farrell, a chartered physiotherapist specialising in women's and men's pelvic health. 'There are many possible reasons for this, including trauma related to childbirth if scarring is present from tearing, episiotomy or invasive medical procedures.' [ 'Many women are taught they should put up with it': What to do about painful sex Opens in new window ] Farrell notes there are also hormonal changes that can happen at different life stages for women, namely around menopause when these variations can cause structural changes or affect the vagina's lubricant, which in turn may impact how comfortable or enjoyable sex is. How couples deal with a pain disorder can impact marital sexual satisfaction. Most often this comes down to communication being the barrier, rather than the pain disorder itself. 'When a woman finds penetration sore or uncomfortable, instead of explaining this to her partner and seeking help, she may start to withdraw from sex,' explains Blair. 'This often means that all forms of touch get withdrawn in case they lead to sex. By the time we see couples, there is no hand-holding, hugging or light touch, let alone sex. This is not directly because of the female pelvic pain disorder.' When couples are affected by female sexual pain, Blair and Farrell note that the first step is to seek help in identifying the pain and managing a plan on how best to treat it, which could be seeking support from a pelvic health physio or sex therapist. Ideally, both. 'A burning, friction pain during penetration may simply be lack of lubrication or using a lubricant that is causing a reaction,' says Farrell, who treats the condition from a physical point of view. 'It could also be a sign that the couple are moving to penetration too soon. If the pain is a deep pain that occurs in certain sexual positions, again it could be penetrating too soon. If the pain is a stinging, tearing pain and the penis cannot get in, this is a vaginismus-type pain.' Equally, Blair, who would seek to treat the pain from an emotional or psychological perspective, believes that sexual pain is always trying to communicate something, and so while it is helpful to treat it physically, it is also important to explore what is happening emotionally. 'I have seen female sexual pain develop as a result of stress either in the couple's relationship or related to other external factors,' she says. 'If a couple are going too fast to penetration this might be painful for the female. After repeated sexual experiences of pain, the vagina will start to react and 'brace' itself for the pain by tightening, which unfortunately leads to more pain, and so a disorder that needs physio input might start to develop. 'I would not automatically assume that the symptomatic partner is the one with the problem and if this is fixed all will be fine. If the issue is related to stress or problems in the relationship dynamic or individual trauma then it will not be fixed by a physical treatment plan alone.' Blair also points out that, often when sexual pain occurs, rather than the couple immediately discussing it, they keep trying the same things again and again, hoping maybe next time will be better. 'This just reinforces the pain cycle,' she says. 'If there is a lot of pelvic or genital pain, I would simply engage much more with the rest of the body and play around with the parts that often get left out like the feet, ears, stomach, backs of legs that are all very sensitive to touch. 'Just moving away from the genitals will actually help the body relax and the muscles, including the pelvic floor, will start to soften. This alone isn't a cure for sexual pain, but it is a way to keep the couple connected sexually without retriggering and thereby reinforcing the pain response.' Farrell and Blair have developed a joint model of pelvic health physio and couples therapy at EBTC as a whole body and mind approach to female sexual pain disorders. 'The body and mind are constantly relating and impacting one and other,' says Blair. 'When a tear after birth occurs, the body's response to pain causes the mind to begin fearing penetration or physical touch and the minds solution is to get the body out of danger by withdrawing from touch. The anxiety caused by the mind then feeds back into the body and strengthens the pain response because anxiety in the body causes more muscle tension.' [ 'Sex is difficult and sometimes impossible for me' Opens in new window ] Blair also suggests that if there is a history of sexual trauma, then the mind will associate sex with negative and frightening emotions. As with traumatic birth experiences, this fear around sex will then get into the body and cause a bodily response of tightening that can then lead to pain and reinforce the idea of sex being dangerous. 'These are psychological issues that have led to a somatic response,' says Blair. 'There is no issue that is just somatic and when we work with sexual pain it is obviously not just psychological.' Farrell and Blair have identified that the dual approach of sessions with a sex therapist and a pelvic health physio, who continually liaise and adjust treatment plans in accordance with new information, makes for a very effective form of treatment. Additionally, the sex therapist can help the couple create more intimacy in their relationship. Overall, the intervention is a holistic approach to somatic-led pain.
News.com.au
25-06-2025
- Health
- News.com.au
‘Unsafe': Doctor warns against common shower act
It will probably come as no surprise to you that people pee in the shower. In fact, statistics show that 61 per cent of people engage in this multi-tasking habit. But while emptying your bladder when nature calls may seem harmless, it turns out that urinating while standing up can cause long-term harm, especially for women. Dr Zac, a prominent Australian GP, has warned that this shower act is particularly concerning if it becomes routine. UTI risks from urinating in the shower Firstly, it's a common misconception that urine is sterile, because even healthy people have bacteria in their urine, says Dr Zac. Therefore, when you urinate in the shower, you may be spreading bacteria over your skin, feet, and other areas (particularly if there's a cut or broken skin barrier), which could increase your risk of reinfection or spreading urinary tract bacteria. This risk is higher if you are already dealing with a UTI, as that urine contains more bacteria. It's also more concerning for women, who are four times more likely to develop a UTI than men. Urinating position linked to pelvic health issues While hygiene and infection risks are important, there's an additional aspect – how your urination position affects your pelvic health. For women, standing to urinate, such as in the shower, can interfere with complete bladder emptying. 'The female body is designed to urinate in a seated or squatting position — this allows the pelvic floor muscles to fully relax and the bladder to empty effectively,' explains Dr Zac. 'When standing upright in the shower, those muscles may stay partially engaged, meaning the bladder may not fully empty.' Over time, this incomplete emptying can strain the bladder and potentially cause issues like residual urine, bacterial growth, or urgency problems. The brain-bladder reflex If you find yourself needing to urinate whenever you hear running water, it might be because you've conditioned your brain-bladder reflex through habitual shower urination. 'You can condition the bladder to feel urgency when it's not actually full — leading to an overactive bladder or urge incontinence over time,' he adds. This phenomenon is well documented in bladder retraining studies and in research involving patients with functional urinary disorders. A 2022 study used Pavlovian theory (from Pavlov's famous dog experiments) to explain how repeated exposure to cues like being in a shower can increase urinary urgency, even if the bladder isn't full. What are the signs that something might be wrong? While it may seem convenient, urinating in the shower could be causing more damage than you realise. So, how can you tell if your bathroom routines are affecting your bladder or urinary health? 'One of the first and most obvious signs of a urinary tract infection is a stinging or burning sensation when urinating,' says Dr Zac. 'It's caused by inflammation and irritation of the urethral lining due to bacterial overgrowth. If you feel this, especially after changing your toilet habits, it's a warning sign.' Going to the toilet more often than usual is another clear indication that something isn't right. 'If you feel like you can't hold it, this could mean your bladder is irritated, inflamed, or conditioned into urgency,' he explains. 'This might be due to overtraining the bladder reflex, or it could signal the start of a UTI. Either way, it's worth consulting your GP or pelvic health physiotherapist.' Leaking urine, especially during exercise, laughter, or sneezing, is known as 'stress incontinence', and is another sign of weakened pelvic floor muscles — possibly from habitual urination while standing. Signs of infection or inflammation in your bladder or kidneys may also be another indicator, and include pelvic discomfort or lower back pain, particularly if a UTI has spread. If these symptoms are accompanied by fever, nausea, or vomiting, it could be a kidney infection, which needs urgent antibiotics. 'Cloudy, bloody, or foul-smelling urine are more classic infection signs. Blood in the urine should always be taken seriously and checked by a doctor — even if it appears just once,' warns Dr Zac. So while the occasional shower wee is likely safe for most, making it a daily habit, especially for women, is probably not the best idea.
Yahoo
12-06-2025
- Health
- Yahoo
The Rise of Virtual Physical Therapy for Pelvic Health Wellness
SAN DIEGO, June 12, 2025 /PRNewswire/ -- The complex web that makes up the pelvic floor is central to daily human function. It also can be central to chronic pelvic pain, incontinence, and sexual function issues—for both women and men. Once shrouded in silence because of embarrassment and overlooked as a part of normal pregnancy or aging, pelvic health awareness has become a trending topic. More and more, people are beginning to understand that by alleviating pelvic symptoms and improving pelvic-floor muscle function, they can boost their self-confidence and quality of life. This rising awareness is empowering individuals to seek care, ask questions, and demand solutions that address not just the symptoms but the root causes of their pelvic health dysfunction and resultant quality of life disruption. Fortunately, health plans and employer groups have taken notice of this emerging demand. "Any physical therapist who has studied the anatomy of the human pelvis could tell you the interconnectedness of the bones, muscles, connective tissues, and organs is nothing short of fascinating," says American Specialty Health (ASH) Senior Vice President of Rehabilitation Services and Digital Self Care Solutions Jaynie Bjornaraa PhD, MPH, PT. Physical therapy, with its evidence-based approach and clinical techniques, has become an indispensable tool in the treatment of pelvic health issues. Specialized pelvic floor treatment focuses on assessing and rehabilitating the muscles, ligaments, and connective tissue in the pelvic region and beyond. This rehabilitation with individualized patient education can provide relief to patients struggling with a wide array of conditions. But there can be barriers to care, says Dr. Bjornaraa. Physical therapy coverage for some of these conditions may be limited; and access to physical therapists who specialize in providing pelvic health specific rehabilitative care can be a challenge, especially in rural and more remote areas. Thankfully, says Dr. Bjornaraa, the rise of virtual physical therapy is reshaping the landscape of pelvic health treatment, bringing accessibility and convenience to an even broader audience. "Through innovative telehealth platforms, like my company's ASHCare™ program, patients can connect with specialists from the comfort of home," said Dr. Bjornaraa. "It also can remove such barriers as geographic limitations, transportation challenges, or the stigma often associated with seeking help for pelvic health issues." Virtual physical therapy leverages technology to offer personalized care, allowing therapists to guide patients through exercises, provide education, and monitor progress in real time. This approach also helps balance access to treatment, ensuring that individuals in rural or underserved areas can receive expert advice without the need for extensive travel. Further, virtual sessions empower patients to integrate therapy seamlessly into their daily routines, according to Dr. Bjornaraa, making it easier to adhere to treatment plans and achieve lasting results. By combining convenience with professional oversight, virtual physical therapy is proving transformative for those tackling pelvic health challenges. Whether addressing postpartum recovery, incontinence, chronic pain, or other pelvic health issues, this model of therapy ensures that no one must suffer in silence or postpone care due to logistical hurdles. About American Specialty Health American Specialty Health Incorporated (ASH) is one of the nation's premier independent and privately owned specialty health organizations offering technology-enabled services for benefits management and administrative services for health plans, and partners with employers, associations, and others. ASH currently covers 62+ million eligible members nationwide. With offices in California and Indiana, ASH has more than 1,700 employees. For more information about ASH, visit follow us on LinkedIn and Facebook; or call 800-848-3555. Media Contacts:Jack ChirrickAmerican Specialty Health Inc.(619) 557-2361jackc@ View original content to download multimedia: SOURCE American Specialty Health Incorporated
Health Line
10-06-2025
- Health
- Health Line
Can You Use Pelvic Floor Therapy for Endometriosis?
Many people with endometriosis have symptoms like pelvic pain, painful penetration, and bowel or bladder discomfort. In some cases, pelvic floor therapy can improve these symptoms. Pelvic floor therapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. It can help relieve symptoms associated with endometriosis. While some exercises can be done at home, it's recommended to consult a trained pelvic floor specialist — typically, a physiotherapist specializing in pelvic health. How does pelvic floor therapy work? Pelvic floor therapy involves a combination of techniques aimed at improving the function of the pelvic floor muscles. It's not just a matter of doing Kegel exercises. These may include: Manual therapy: Hands-on techniques (e.g., massage) to release muscle tension and improve tissue mobility. Stretching and strengthening exercises: Targeted movements to enhance muscle flexibility and strength. Education: Guidance on posture, breathing, and daily habits that may impact pelvic floor health. Depending on your individual needs, your physiotherapist may use: Biofeedback: Sensors provide real-time feedback on muscle activity, which can help you learn to control these muscles more effectively. Transcutaneous electrical nerve stimulation (TENS): This involves sending small electrical currents to certain body parts. Your physiotherapist will likely also suggest pelvic floor exercises for you to do at home. These interventions aim to address muscle imbalances and reduce pain associated with endometriosis. What are the potential benefits? Research indicates that pelvic floor therapy can offer several benefits for people with endometriosis. These benefits include: Pain reduction: A study found that 63% of people with endometriosis experienced an improvement in pain after six sessions of pelvic floor therapy. Improved sexual function: By addressing muscle tension and discomfort, therapy can alleviate pain during penetration. Enhanced bowel and bladder control: Strengthening pelvic muscles can help manage symptoms like constipation or urinary urgency. A study looked at the effects of physical therapy in teenagers and young adults with endometriosis and chronic pelvic pain. It found that a course of pelvic physiotherapy significantly improved their daily functioning. What are the potential side effects or risks? Pelvic floor therapy is generally considered safe. However, potential considerations include: Initial discomfort: Some people may experience temporary soreness after sessions. Emotional response: Addressing pelvic health can sometimes evoke emotional reactions, especially if past trauma is involved. Cost and accessibility: Not all insurance plans cover pelvic floor therapy, and finding a specialized therapist may be challenging in some areas. It's essential to discuss any concerns with a healthcare professional before starting therapy. Who is pelvic floor therapy for, and how can you get started? Pelvic floor therapy may be beneficial for people with endometriosis who experience: Chronic pelvic pain Painful penetration Bowel or bladder dysfunction Muscle tightness or spasms in the pelvic region To get started, find a qualified therapist. Look for physiotherapists with experience in treating endometriosis-related pelvic floor issues. Some pelvic floor physiotherapists require a referral from another healthcare professional. Consider asking your usual GP or gynecologist, if you have one, for a referral. The first session usually consists of an initial assessment. The doctor will ask about your symptoms and medical history and evaluate your condition. From there, the doctor can develop a personalized treatment plan.
Yahoo
11-05-2025
- Health
- Yahoo
My bowel had to be removed after years of constipation
A woman whose bowel had to be removed due to chronic and severe constipation says we should all be more open to talking about basic bodily functions. Kathryn Nicklas, 26, was told for several years that her constipation was caused by irritable bowel syndrome (IBS) and she was repeatedly prescribed laxatives. She said embarrassment about her symptoms as a teenager meant she had struggled to advocate for her condition to be taken seriously. Prof Julie Cornish, a leading pelvic health doctor, said many patients required surgery for pelvic health problems but that simpler solutions were possible when symptoms were spotted sooner. 'I wouldn't poo if my husband was at home' Women 'scared to laugh or sneeze' due to incontinence Ms Nicklas, who works in north Wales, said before her surgery she was "taking laxatives like they were smarties" but "still struggling to go to the toilet". "I was forever living in floaty dresses because of the bloating and even bought maternity jeans just to be comfortable," she said. "If I was able to go [for a poo] it would only be as a result of irrigation or an enema. I'd come home from work and spend an hour on the toilet – I had no life, because I was always uncomfortable." She added: "On one occasion I didn't go to the toilet for four weeks and was admitted to hospital. "They said I was so full of poo, everything had just stopped working." Despite various tests and changes to her diet, no cause was ever found, but years of constipation had a long lasting impact on Ms Nicklas' pelvic organs – causing pain, vaginal bleeding and bloating. Ms Nicklas' large bowel was removed in 2022. As an adult, Ms Nicklas said she advocated for her symptoms to be taken seriously, but as a teenager she said embarrassment about bodily functions had made that more difficult. "Looking back now, why is that such an embarrassing thing? "Why is going to the toilet so embarrassing when it's just a normal function that everybody does? "Would my constipation have been better if I hadn't have refused to go to the toilet unless I was at home and my brothers weren't around and no one could hear me? Because that's not healthy decision making," she added. "As a result of the constipation and so many years of it my body's been affected. "Your pelvic floor gets absolutely destroyed by the fact that you're constantly trying to go but you can't go." Prof Cornish, a colorectal surgeon, said pelvic health issues affected both men and women. "It is a public health issue that actually we need to be giving information to people at an earlier stage – and it's not just women and girls, it's also boys and men because pelvic health issues affect everybody in different ways," she said. "We're not just talking about gynaecological bits, we're talking about the bladder and bowel which can be impacted and that does have a bearing on things like pelvic organ prolapse. "So if you are chronically constipated for many years you are far more likely to develop problems with a prolapse." The need for better understanding is part of the reason why Prof Cornish set up the Everywoman health festival in Cardiff, which is now in its third year. A thousand tickets will be given free to teenagers this year, with educational sessions planned on menstrual health, pelvic health and knowing basic body parts. Shakira Hassan, a specialist women's health physiotherapist, treats a wide range of conditions including pelvic pain, bladder, bowel and prolapse issues, where pelvic organs have lowered out of place. "If you were to examine most women over 40, 50% of those women will actually have a pelvic organ prolapse, so it's about being able to educate and empower those women to be able to still lead a really normal and well life," she said. Ms Hassan said stigma was a huge factor, which could be worse in some cultures. "We know that potentially one in three women will experience some urinary incontinence and potentially one in four women will experience some level of faecal incontinence throughout their life. That's huge numbers – it's really common." "Education is key," said Prof Cornish. "And the difficulty is that whilst there are some people who have that understanding or are able to access that education, you're essentially disenfranchising a large proportion of the population who may not be able to access it, and they may end up being the patients that I see more of. "You see the inequalities that are out there. "But all of this leads to a massive delay in treatment and usually an increase in the severity of symptoms and treatments needed. "We all have a responsibility for our own health and that is going to be key – it's not just about off-loading it to the NHS, so I think the more we teach our children, that's going to empower them to take responsibility going forward." The Welsh government said: "Health and wellbeing is a mandatory part of the curriculum for Wales and helps learners to understand different factors that affect their physical health. "Our guidance expects children to learn about a range of health conditions that can affect them." 'I want my womb removed but doctors say I'm too young' Cut wait times for extra cash, FM warns health bosses 'I discovered my fat build-up condition after a Love Islander had it'
