The Importance of Seeing a Pelvic Floor Therapist After a Sexually Transmitted Disease

Sexually transmitted diseases (STDs) are a significant public health concern in the United States, affecting millions of individuals each year.  According to data from the Centers for Disease Control and Prevention (CDC), STDs are among the most commonly reported infectious diseases in the United States. Each year, millions of new cases of STDs are diagnosed, highlighting the widespread nature of these infections. There are several types of STDs, each with its own prevalence rates. Some of the most common STDs in the United States include chlamydia, gonorrhea, syphilis, herpes simplex virus (HSV), human papillomavirus (HPV), and human immunodeficiency virus (HIV).

Chlamydia is one of the most frequently reported STDs in the U.S. It is caused by the bacterium Chlamydia trachomatis and can affect both men and women. The CDC estimates that over 1.8 million cases of chlamydia were reported in 2020 alone. Gonorrhea is another common bacterial STD that can affect various parts of the body, including the genitals, rectum, and throat. In recent years, gonorrhea rates have been rising, with over 600,000 cases reported in 2020. This widespread incidence of STDs has significant implications on public health.

Dealing with a sexually transmitted disease (STD) can be a challenging and often emotionally draining experience. Beyond the medical treatment, many individuals may not realize the potential long-term impact an STD can have on their pelvic health. In this blog post, we’ll delve into why it’s crucial to consider seeing a pelvic floor therapist after experiencing an STD.

Understanding Pelvic Floor Health:

Before we discuss the connection between STDs and pelvic floor therapy, it’s essential to understand the role of the pelvic floor. The pelvic floor refers to a group of muscles, ligaments, and connective tissues that support pelvic organs such as the bladder, uterus, and rectum. These muscles play a vital role in various bodily functions, including bladder and bowel control, sexual function, and overall pelvic stability.

Impact of STDs on Pelvic Health:

Sexually transmitted diseases (STDs) can have a significant impact on the pelvic floor, leading to various pelvic floor dysfunctions and complications. Here’s an expanded look at how STDs can affect the pelvic floor:

  1. Pelvic Inflammatory Disease (PID): STDs such as chlamydia and gonorrhea can cause pelvic inflammatory disease (PID). When left untreated PID is characterized by inflammation of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. The inflammation can spread to surrounding tissues, including the pelvic floor muscles, leading to pelvic pain, discomfort, and potential scarring.
  2. Chronic Pelvic Pain: STDs, particularly those causing PID or genital ulcers (e.g., herpes simplex virus), can contribute to chronic pelvic pain. Inflammation, scarring, and nerve sensitization in the pelvic region can result in persistent pain that affects daily activities and quality of life.
  3. Pelvic Floor Muscle Tension: STDs can lead to pelvic floor muscle tension and spasms. Conditions like genital herpes, which cause pain and discomfort in the genital area, can result in involuntary muscle contractions as the body’s response to pain. Over time, this muscle tension can contribute to pelvic floor dysfunction, including pelvic floor hypertonicity (increased muscle tone).
  4. Urinary and Bowel Dysfunction: Some STDs can affect bladder and bowel function, leading to urinary and bowel dysfunction. For example, an STD may result in urinary urgency, frequency, incontinence, or difficulty emptying the bladder. Similarly, it can lead to bowel issues such as constipation, fecal incontinence, or difficulty with bowel movements.
  5. Sexual Dysfunction: STDs and their associated symptoms, such as pain during intercourse (dyspareunia), genital discomfort, or changes in sexual function, can contribute to sexual dysfunction. Pelvic floor muscle tension, scarring, and psychological factors related to STD diagnosis and treatment can impact sexual desire, arousal, and satisfaction.
  6. Pelvic Organ Prolapse: In severe cases, chronic inflammation, scarring, and weakening of pelvic floor support structures due to untreated STDs can contribute to pelvic organ prolapse. This condition occurs when pelvic organs, such as the uterus, bladder, or rectum, descend or protrude into the vaginal canal due to inadequate support from the pelvic floor muscles and connective tissues.
  7. Emotional and Psychological Impact: Dealing with an STD can be emotionally distressing, leading to anxiety, depression, and stress. These psychological factors can contribute to pelvic floor dysfunction by influencing muscle tone, exacerbating pain perception, and affecting overall pelvic health.

Why See a Pelvic Floor Therapist?

  • Comprehensive Assessment: A pelvic floor therapist can conduct a thorough assessment to evaluate pelvic floor muscle tone, strength, and coordination. This assessment may include internal exams (with consent) to assess the internal pelvic muscles directly.
  • Tailored Treatment Plans: Based on the assessment findings, the therapist can develop a personalized treatment plan to address specific pelvic floor issues. This plan may include exercises to strengthen weak muscles, relaxation techniques for tense muscles, and strategies to improve pelvic floor coordination.
  • Addressing Pain and Discomfort: Many individuals with STDs experience pelvic pain, discomfort during intercourse, or urinary/bowel issues. A pelvic floor therapist can provide techniques such as manual therapy, biofeedback, and therapeutic exercises to alleviate these symptoms.
  • Sexual Health Support: Pelvic floor therapists are trained to address sexual health concerns. They can help individuals regain confidence and improve sexual function post-STD by addressing physical and emotional factors affecting intimacy.
  • Preventing Long-Term Complications: Early intervention through pelvic floor therapy can help prevent long-term complications such as chronic pelvic pain, pelvic organ prolapse, and urinary incontinence that may result from untreated pelvic floor dysfunction.

In conclusion, seeing a pelvic floor therapist after experiencing an STD is crucial for comprehensive pelvic health management. These specialized therapists can provide tailored assessments, treatments, and support to address pelvic floor dysfunction resulting from STDs. By prioritizing pelvic floor health, individuals can improve their quality of life and prevent potential long-term complications. If you’ve had an STD or are experiencing pelvic health issues, don’t hesitate to consult with a qualified pelvic floor therapist for personalized care and support.

The Link Between Constipation and Pelvic Pain: Understanding the Connection

Pelvic pain is a complex and often debilitating condition that can have a significant impact on a person’s quality of life. While there are numerous factors that can contribute to pelvic pain, one often overlooked aspect is the relationship between constipation and pelvic discomfort. In this blog post, we’ll delve into the intricate connection between these two issues and explore how addressing constipation can help manage pelvic pain.

Understanding Constipation:

Constipation is a common gastrointestinal problem characterized by infrequent bowel movements, difficulty passing stools, and a feeling of incomplete evacuation. It can result from various factors, including inadequate fiber intake, dehydration, lack of physical activity, certain medications, and underlying health conditions such as irritable bowel syndrome (IBS) or pelvic floor dysfunction.

The Impact of Constipation on Pelvic Pain:

The pelvic region houses several vital organs, including the intestines, bladder, uterus (in females), and prostate (in males). When constipation occurs, the buildup of stool in the intestines can exert pressure on surrounding structures, leading to pelvic discomfort or pain. This pressure can also affect the pelvic floor muscles, causing them to become tense or dysfunctional over time.

Furthermore, chronic constipation is also linked to certain conditions like pelvic congestion syndrome (PCS) or endometriosis, which are known to cause pelvic pain. In PCS, pelvic veins become enlarged and engorged, resulting in aching or heaviness in the pelvis, worsened by prolonged sitting or standing. Endometriosis involves the growth of uterine-like tissue outside the uterus, leading to pelvic pain, especially during menstruation.

The Vicious Cycle:

The relationship between constipation and pelvic pain often creates a vicious cycle. Pelvic pain can make it uncomfortable to move or exercise, contributing to a sedentary lifestyle that further exacerbates constipation. On the other hand, chronic constipation can cause increased abdominal pressure, leading to pelvic floor dysfunction and heightened pain perception.

Addressing Constipation to Alleviate Pelvic Pain:

Managing constipation is a crucial step in relieving pelvic pain and improving overall well-being. Pelvic Floor therapy can help break this cycle.

Pelvic floor therapy is a specialized form of physical or occupational therapy aimed at addressing issues related to the pelvic floor muscles, which play a crucial role in bowel and bladder function, as well as providing support to pelvic organs. This therapy is highly beneficial for individuals experiencing constipation and pelvic pain as it targets the underlying muscular and functional aspects contributing to these conditions. Let’s delve deeper into how pelvic floor therapy works and its specific benefits for managing constipation and pelvic pain.

  • Muscle Assessment and Rehabilitation:
    • Pelvic floor therapists start by conducting a thorough assessment to evaluate the strength, tone, flexibility, and coordination of the pelvic floor muscles. This assessment helps identify any muscle imbalances, weakness, or tension that may be contributing to constipation or pelvic pain.
    • Based on the assessment findings, a personalized treatment plan is developed, incorporating various techniques to rehabilitate and optimize pelvic floor muscle function.
  • Pelvic Floor Exercises:
    • Pelvic floor therapy involves teaching specific exercises to strengthen or relax the pelvic floor muscles, depending on individual needs. These exercises may include Kegels, which focus on strengthening the pelvic floor, or relaxation techniques to release tension in overly tight muscles.
    • Strengthening exercises help improve bowel control and support pelvic organs, reducing symptoms of constipation and pelvic pain. Conversely, relaxation techniques can alleviate muscle spasms and discomfort, promoting more comfortable bowel movements.
  • Biofeedback and Electrical Stimulation:
    • Biofeedback is a valuable tool used in pelvic floor therapy to provide real-time feedback on pelvic muscle activity. Sensors are placed on the pelvic floor muscles, and patients are guided to perform specific exercises while observing muscle contractions on a monitor. This visual feedback helps improve awareness and control of pelvic floor muscles.
    • Electrical stimulation may also be used in conjunction with biofeedback to enhance muscle activation and coordination. It involves the use of mild electrical currents to stimulate targeted muscles, aiding in muscle re-education and symptom relief.
  • Manual Therapy Techniques:
    • Pelvic floor therapists may incorporate manual therapy techniques such as myofascial release, trigger point therapy, and soft tissue mobilization to address muscle tightness, knots, or adhesions in the pelvic region. These techniques help improve muscle flexibility, blood flow, and overall pelvic floor function.
    • Manual therapy can be particularly beneficial for individuals experiencing pelvic pain due to muscle tension or dysfunction, providing relief and improving mobility.
  • Education and Behavioral Strategies:
    • Pelvic floor therapy sessions also focus on educating patients about healthy bowel habits, proper posture, breathing techniques, and lifestyle modifications that support pelvic health and alleviate constipation and pelvic pain.
    • Behavioral strategies, such as timed voiding, relaxation techniques during bowel movements, and dietary adjustments, are discussed to optimize bowel function and reduce pelvic discomfort.
  • Collaboration with Healthcare Providers:
    • Pelvic floor therapists often collaborate with other healthcare providers, including gastroenterologists, gynecologists, and pain specialists, to ensure comprehensive care and address underlying medical conditions contributing to constipation and pelvic pain.
    • They may also work closely with dietitians to provide dietary recommendations that support bowel regularity and digestive health.

In summary, pelvic floor therapy offers a holistic approach to managing constipation and pelvic pain by addressing muscular dysfunction, improving pelvic floor coordination, enhancing bowel function, and promoting overall pelvic health. It empowers individuals with the knowledge, skills, and tools needed to optimize pelvic floor function and achieve long-term symptom relief.

Fecal Accidents in Children

By Erica Mitchell, PT, DPT

“Fecal accidents” refer to unintentional bowel movements or leakage of stool. Pelvic floor therapy for kids, also known as pediatric pelvic floor therapy, is a specialized area of physical or occupational therapy that addresses issues related to the pelvic floor muscles in children. These muscles play a crucial role in controlling bowel and bladder function.

Fecal accidents in children can be caused by various factors, and identifying the underlying cause is crucial for effective management and treatment. Some common reasons for fecal accidents in kids include:

  • Constipation:
    • Chronic constipation is a frequent cause of fecal accidents in children. Hard and impacted stools can stretch the rectum, reducing its sensitivity and making it difficult for the child to recognize the urge to have a bowel movement.
  • Overflow Incontinence:
    • When constipation is severe, liquid or soft stool may leak around the impacted feces. This can result in fecal incontinence or accidents, commonly referred to as overflow incontinence.
  • Functional Gastrointestinal Disorders:
    • Conditions such as irritable bowel syndrome (IBS) or functional constipation can contribute to bowel control issues in children.
  • Pelvic Floor Dysfunction:
    • Dysfunction in the pelvic floor muscles, which play a crucial role in bowel control, can lead to fecal accidents. This dysfunction may involve muscles that are either too tight or too weak.
  • Anatomic Abnormalities:
    • Structural abnormalities in the digestive or pelvic region can affect normal bowel function and contribute to fecal accidents.
  • Neurological Disorders:
    • Certain neurological conditions, such as spina bifida, cerebral palsy, or nerve damage, can interfere with the nerves responsible for controlling bowel movements.
  • Emotional Factors:
    • Stress, anxiety, or emotional issues can affect bowel habits in children. Changes in routine, school-related stress, or emotional difficulties may contribute to fecal accidents.
  • Dietary Factors:
    • Inadequate fiber intake, poor diet, or insufficient fluid intake can contribute to constipation, impacting bowel regularity.
  • Medication Side Effects:
    • Some medications, particularly those affecting the gastrointestinal system, may lead to changes in bowel habits and contribute to fecal accidents.
  • Infections or Illness:
    • Gastrointestinal infections or illnesses can temporarily affect bowel function and contribute to fecal accidents.

Treatment approaches may include dietary changes, behavioral strategies, medications, and, in some cases, pelvic floor therapy.

Pediatric pelvic floor therapy is a specialized area of physical & occupational therapy that focuses on addressing issues related to the pelvic floor muscles in children. The pelvic floor muscles play a crucial role in controlling bowel and bladder function, as well as providing support to the pelvic organs. When children experience problems such as urinary or fecal incontinence, constipation, or pelvic pain, pediatric pelvic floor therapy can be recommended as part of their treatment plan.

Here are key components of pediatric pelvic floor therapy:

  • Assessment:
    • A thorough assessment is conducted to evaluate the child’s pelvic floor function. This may involve assessing muscle strength, tone, coordination, and flexibility.
  • Biofeedback:
    • Biofeedback is often used as a tool to help children become more aware of and control their pelvic floor muscles. This can provide visual or auditory feedback, helping the child understand how to properly contract or relax these muscles.
  • Pelvic Floor Exercises:
    • Specific exercises are prescribed to address the individual needs of the child. These exercises may focus on strengthening weak pelvic floor muscles or relaxing overly tight ones.
  • Education:
    • Children and their parents receive education about normal pelvic floor function, proper toileting habits, and lifestyle modifications that can support pelvic health.
  • Behavioral Strategies:
    • Behavioral interventions may be recommended to establish regular toilet habits, address anxiety related to bowel or bladder issues, and promote healthy pelvic floor function.
  • Manual Therapy:
    • Hands-on techniques may be used by the physical therapist to address muscle tension, trigger points, or restrictions in the pelvic floor muscles – always external.
  • Dietary Recommendations:
    • Dietary advice may be provided to ensure a healthy and balanced diet that supports optimal bowel function.
  • Home Exercise Program:
    • A customized home exercise program is often given to the child and their family to continue the therapeutic interventions at home.
  • Collaboration with Other Healthcare Providers:
    • Pediatric pelvic floor physical therapists often work closely with other healthcare professionals, including pediatricians, gastroenterologists, urologists, and psychologists, to provide comprehensive care.

Common conditions that may benefit from pediatric pelvic floor therapy include:

  • Fecal incontinence
  • Constipation
  • Enuresis (bedwetting)
  • Urinary incontinence
  • Pelvic pain

It’s important for parents to communicate openly with healthcare providers if they suspect their child may benefit from pelvic floor physical therapy. A healthcare professional can assess the situation, determine the appropriate interventions, provide guidance tailored to the child’s specific needs, and refer to pelvic floor therapy.

Erica Mitchell, PT, DPT, has had extensive education in treating Pelvic Floor Dysfunction in both children and adults.

Postpartum Pelvic Pressure & Heaviness

Pelvic pressure postpartum can have various causes, ranging from normal postpartum changes to more serious complications. Here are some possible causes:

  • Uterine involution: After childbirth, the uterus undergoes a process called involution, where it gradually returns to its pre-pregnancy size. This process can cause sensations of pressure in the pelvic area as the uterus contracts and shrinks.
  • Perineal trauma: Tears or episiotomies during childbirth can cause discomfort and pressure in the pelvic area as they heal. This discomfort is typically temporary and improves as the tissues heal.
  • Prolapse: Pelvic organ prolapse can occur when the muscles and ligaments that support the pelvic organs weaken, causing one or more of the organs (such as the uterus, bladder, or rectum) to drop down into the vagina. This can lead to sensations of pressure or fullness in the pelvic region.This can last well past the immediate postpartum period and is best treated by a Pelvic Floor Physical or Occupational Therapist.
  • Hemorrhoids: Hemorrhoids, swollen veins in the rectal area, are common during pregnancy and can persist or worsen postpartum. They can cause discomfort, pain, and a feeling of pressure in the pelvic area.
  • Constipation: Constipation is common after childbirth, particularly if you had a cesarean section or are taking pain medication. Straining during bowel movements can increase pelvic pressure and chronic straining can lead to prolapse.
  • Engorgement: Breast engorgement, which occurs when the breasts become overfilled with milk, can cause discomfort and a feeling of fullness in the pelvic area, especially if lying down.
  • Infection: Infections such as urinary tract infections (UTIs) or pelvic infections can cause pelvic discomfort or pressure. Symptoms may include pain or burning during urination, increased frequency of urination, fever, or abnormal vaginal discharge.
  • Retained placental fragments: In some cases, fragments of the placenta or membranes may remain in the uterus after childbirth, leading to pelvic discomfort or pressure. This can sometimes be accompanied by abnormal bleeding or discharge.
  • Muscle strain: The muscles in the pelvic area may experience strain during childbirth, especially if the delivery was prolonged or if forceps or vacuum extraction were used. This can cause temporary pelvic discomfort or pressure.

Pelvic floor therapy can be highly effective in addressing pelvic pressure postpartum. Here’s how pelvic floor therapy can help:

  • Assessment: A pelvic floor physical or occupational therapist will conduct a thorough assessment to evaluate the strength, flexibility, and coordination of your pelvic floor muscles. They will also assess any other contributing factors such as posture, muscle imbalances, or scar tissue from childbirth.
  • Pelvic floor exercises: Pelvic floor therapy typically includes exercises to strengthen and improve the function of the pelvic floor muscles. This may include pelvic floor contraction and relaxation techniques to help release tension in the pelvic floor muscles.
  • Education: Pelvic floor  therapists educate patients about pelvic anatomy, proper toileting techniques, and strategies to optimize pelvic floor function. They may also provide guidance on posture, body mechanics, and breathing techniques to support pelvic floor health.
  • Manual therapy: Hands-on techniques such as soft tissue massage, myofascial release, and trigger point therapy may be used to address muscle tension, scar tissue, or other sources of pelvic discomfort.
  • Biofeedback: Biofeedback techniques can help you learn to better control and coordinate your pelvic floor muscles by providing real-time feedback about muscle activity.
  • Behavioral modifications: Pelvic floor therapists may recommend lifestyle modifications to reduce pelvic pressure, such as avoiding heavy lifting, improving bowel habits, and managing constipation.
  • Progressive exercises: As you progress in your pelvic floor therapy program, your therapist may introduce more challenging exercises to further strengthen and stabilize the pelvic floor muscles.
  • Collaborative care: Pelvic floor therapists often work closely with other healthcare providers, such as obstetricians/gynecologists, urologists, and colorectal specialists, to ensure comprehensive care and address any underlying medical conditions contributing to pelvic pressure.

It’s important to seek guidance from a qualified pelvic floor therapist who can tailor a treatment plan to your specific needs and goals. With consistent effort and guidance, pelvic floor therapy can help alleviate pelvic pressure postpartum and improve overall pelvic floor function and comfort.