It Is In Your Pelvis, Not In Your Head

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You Can Take Control

Women often believe there is nothing they can do about their issues “down there,” such as pain with sex, severe menstrual cramping and difficulty controlling urinary or bowel function. In fact, these symptoms are often caused by a dysfunction of the pelvic floor muscles and can be rehabilitated with pelvic floor therapy.

What Is the Pelvic Floor?

The pelvic floor muscles are part of a biomechanical network of bone, nerves, tendons, ligaments and other connective tissues that reside at the base of the abdomen, in the female  private parts, or “the down low.” The intimate and intricate structures of the pelvic floor provide the mechanism for important pelvic functions like sitting, using the toilet, giving birth and having sex.

The pelvic floor provides support for the internal organs of the urinary,

reproductive and gastrointestinal systems. It also provides stability for

the spine. As a result, when the pelvic floor muscles are off balance, the pelvis and spine are destabilized. This creates symptoms like sciatica, tailbone pain, prolapse and more. Pelvic floor dysfunction can also cause embarrassing and painful issues for women.

Pain With Sex

One in five adult women currently experience pain with sex and three out of four women will experience pain with sex at some point in their life. Seeking care for sex can feel shameful or even taboo for some women. However, treating a pelvic dysfunction is a valid and appropriate solution to resuming a healthy and rewarding sex life. Gynecologists and urogynecologists both recognize pelvic floor therapy as a proven and effective treatment option for pain with sex.

Severe Menstrual Cramping

Nearly 85% of women report menstrual cramping. When cramps become severe, they can interfere with work, school and other daily responsibilities. One in four women report absenteeism due to menstrual cramping. Menstrual cramping is essentially caused by muscular overactivity of the uterine wall, which can aggravate hypertonic pelvic floor muscles and cause muscle spasms. Women will often experience the symptoms of menstrual cramps during sex, exercise or after eating certain foods, even when they are not menstruating.

Leaky Bladder and Bowels

Currently, one in five women wear diapers and the adult diaper industry is on pace to outgrow the baby diaper industry. Stereotypically we think of bowel and bladder dysfunctions as an age issue, but 65% of female athletes experience accidental bladder leakage as do 30% of postpartum women. It is also estimated that 15% of women experience accidental bowel leakage or smearing.

A popular misconception is that bowel and bladder dysfunctions can be cured with “Kegel” exercises. Exercising an injured muscle can make issues worse so when bowel or bladder issues are caused by an injured or overstimulated pelvic floor muscle, the Kegel exercises can cause further injury and worsen the symptoms. Functional bowel and bladder coordination require intricate neuromuscular sequencing. There are many tiny muscles that make up the pelvic floor. When these are too tight, too weak, imbalanced, or do not work in correct sequence with reflexive activity, women will experience bowel and bladder dysfunctions including leakage, overactive bladder, irritable bowel symptoms, and constipation. Therapy provides women with the neuromuscular reeducation to coordinate the pelvic floor muscles to stay dry and stay clean.

The social and relational consequences of pelvic floor dysfunction can be devastating. It’s important for women to take control of their pelvic health as soon as symptoms arise. A “little” leaking or a “little” pain is a big deal because these issues only get worse and can have lifetime consequences. If you believe you are experiencing a pelvic floor dysfunction, decide to take control. There is no shame in treating a painful and life-limiting condition.

A pelvic floor therapy evaluation can identify the specific pelvic structure causing pain, which is often a muscle or old scar tissue from a c-section or other surgery. Women are often surprised and relieved that their pain can be reduced and manually treated on their first visit.

Talk to your health provider about trying pelvic floor therapy.

Tara Galles MS, OTR is a pelvic floor therapist and owner of You’re In CONTROL! You can read more about her clinic at

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