Pelvic Pain and Dysfunction

By Amy Heard, PhD

Chronic pelvic pain (CPP) and pelvic floor dysfunction (PFD) are common in both women and men. Both CPP and PFD have an impact on daily functioning and quality of life. Pelvic floor dysfunction is a varied syndrome that can cause CPP, pain only with touch, and/or pain with various activities (including sex). It can affect multiple systems including gastro-intestinal, urinary, reproductive, muscular and even skeletal. It can be associated with interstitial cystitis, dysmenorhhea (painful periods), incontinence, constipation, pelvic organ prolapse, and painful sex.

Pain and dysfunction can originate from infection, injury, endometriosis, hormonal imbalance, and skeletal misalignment. For many people, it can take some time to get a diagnosis and begin treatment. In the meantime, they have less time and energy to spend on family and work activities.

There is good news, in that more physicians are learning how to diagnose and treat these issues. Starting treatment early can be helpful, since many factors can make the problem worse, including stress and tension in the muscles. This tension can aggravate the nerves, contribute to poor alignment, and increase the experience of pain. Pain can also result in feeling depressed, anxious or hopeless, and finding positive ways to cope can improve quality of life for people with PFD as they work through treatment.

Research shows that an integrated care approach works best with pelvic floor dysfunction and pain. This means coordination among health professionals such as the OB/GYN, urologist or uro-gynecologist to diagnose and treat infection or other conditions; a physical therapist to address muscular tension using techniques like biofeedback and myofascial release; and often a clinical psychologist or other specially trained therapist to address individual and couple problems that may result from stress, pain, and changes in sexual function.

Patient engagement is a very important component in healing pelvic floor dysfunction and pain. Patients benefit from

Learning about what is happening in their body

Advocating for their health and effective treatments

Examining how pain is impacting their life

Understanding the treatment recommendations

Following through with medications, procedures or exercises

Managing stress with mindfulness, social support and self-care

All of this is good news for everyone who is dealing with pelvic floor dysfunction and chronic pelvic pain. The most important thing to remember is that there are answers; you just need to be willing to keep searching for a provider who can help you find them.