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"I can barely sit down without hurting. Have sex? Forget about it!"

December 19, 2016 | Mary South, MD, MHA


Most of us are busy and subjected to many demands. The daily grind can be overwhelming. Taking care of kids, dealing with overbearing bosses, meeting deadlines, paying bills, and keeping up with a million little tasks are just a few of the stress-inducing things we deal with every day. Some of us face even greater stressors, such as illness, financial instability, or even abuse by a spouse or partner.

Our bodies all respond differently to stress. Some of us get sick more easily. Some of us get heartburn. I carry tension in my shoulders. Sometimes, I notice at the end of a long day that my shoulders are approaching the level of my ears because I am tensing up my muscles so much. For many women I see in my practice, tension is held in the pelvic floor muscles. It might sound crazy, but women respond to different types of stress by subconsciously contracting their pelvic floor muscles to the point that the muscles are essentially in spasm. Furthermore, inactivity or diminished physical activity can cause weakness in the pelvic floor muscles that can also lead to pelvic floor muscle spasms. Click here to learn more about pelvic floor muscles.

What happens when the pelvic floor muscles are in spasm?
They hurt! Just like any other muscles cramp, when pelvic floor muscles go into spasm from stress, trauma, or just from being weak, the blood flow to the muscles cuts off and causes pain. Women with a pelvic floor muscle spasm report one or more of the following symptoms:

• Pain with sitting for prolonged periods
• Need to sit on one butt cheek or the other (can’t sit squarely on bottom)
• Urinary hesitancy (can’t always get the stream started)
• Pelvic or vaginal pressure
• Feeling like “something is falling out”
• Inability to have sex without pain
• When having sex, partner feels like he is “hitting something” and penetration is not possible

What can be done?
It’s important to see your health care provider to confirm the diagnosis of pelvic floor muscle spasm. He or she may recommend the following treatment options:

• Self-digital massage: pull down on the muscles with your thumb to stretch them
• Soak in a hot bath or sit on a heating pad
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Intravaginal valium suppositories
Pelvic floor physical therapy with pelvic floor exercises and relaxation techniques
• Vaginal dilators
• Pelvic floor muscles trigger point injections

Just so you know, pelvic floor muscle spasm is just one way to describe this cause of pelvic pain. It is also known as vaginismus, levator ani syndrome, or pelvic floor myalgia.

Seek help today and, remember, you are not alone. Many other women are suffering from the same symptoms as you and there are many different treatment options!

Find more articles on Pelvic Pain