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In April 2023, I was in the intensive critical care unit two days after I underwent a complete hysterectomy.
Before being admitted, I felt weak and was unable to keep food down. After several tests, doctors discovered I had not only developed sepsis but also a large abscess on my vaginal wall that required immediate drainage. Unbenounce to me, this would also drastically affect the function of my pelvic floor.
This life-altering experience left me grappling with numerous challenges. Including surgical menopause before the age of 40, hot flashes during the day, and night sweats each night. The worst part was the vaginal atrophy. My doctor took a look and said everything was fine, but sex was so painful it didn't make any sense, and I didn't know the right questions to ask. My doctor put in a referral for me to see a Pelvic Floor Therapist; it took me a whole year to build up the courage to book an appointment with a pelvic floor therapist.
I still recall my first visit. The therapist asked what I hoped to achieve from our session, and I felt vulnerable as I responded, “Just getting here was hard for me, and I was hoping you would let me know what I am supposed to do.”
Throughout my whole life, I have experienced discomfort during every gynecological check-up, throughout my pregnancies, and even during intimate moments with my husband. It wasn’t until I was 37 that I learned about pelvic floor therapy.
If any of this resonates with you, keep reading.
What Exactly Is Pelvic Floor Therapy?
Pelvic floor therapy is a type of physical therapy designed to strengthen and improve the functioning of the pelvic floor muscles and so much more. In general, these muscles are crucial for bladder control, bowel function, and sexual health. Although this specialized therapy has similarities to yoga, they are not the same thing. However, together, they connect to the whole person, mind, body, and the Holy Spirit.
You will not be treated as you would in an OBGYN's office; despite the medical table you will be lying on, there are no stirrups to awkwardly place your heels to open your legs. Instead, an experienced therapist will teach specific techniques, such as diaphragmatic breathing, that can take your nervous system out of the sympathetic nervous system and into the parasympathetic system. Much like your yoga practice, your pelvic floor doctor will educate you on proprioceptive awareness of the intrinsic muscles, ligaments, bones, etc., of the vagina within the pelvic floor, then she will guide you into a practice of mindfulness to relieve pain and enhance your pelvic well-being.
It’s essential to approach this therapy with openness and a focus on understanding your body, as every patient's needs are distinct.
Do Your Research: Finding the Right Therapist
When selecting a pelvic floor therapist, it's important to know that not all are equally qualified. You'll want someone who makes you feel comfortable and safe. Start by checking your insurance network, but be open to exploring options outside of that if necessary.
If your first appointment doesn’t leave you feeling safe and understood, don’t hesitate to seek another therapist. Your comfort is paramount in this health journey.
Communication is Key: Your Needs Matter
Your voice matters in these appointments. Therapists recognize how sensitive this topic can be, and they are there to support you.
For instance, if your therapist offers a sound machine for background noise, say yes. If not, you might ask if they could use some calming music from their music app (I prefer brown noise over white). If the overhead lighting feels harsh, don't hesitate to ask for a towel to cover your eyes.
Remember, pelvic care is a vital form of self-care. It is entirely okay to express your needs and preferences.
Easing into Each Session
Expect a relaxed environment when you arrive for your appointment. Your therapist will often start the session with a casual conversation to help ease any initial tension.
Use this opportunity to share your experiences, goals, and fears. Being open with your therapist allows them to tailor the sessions to suit your specific needs.
“Pelvic floor disorders are often dismissed as a ‘normal’ part of aging, but it’s not something you have to live with. Treatments do exist,” said Dr. Donna Mazloomdoost,
What to Expect During Your Sessions
Initially, your therapist will conduct a thorough evaluation to understand your issues and medical history. This will often involve gentle assessments and a discussion about your experience with pelvic pain.
Let's get personal, after my initial assessment, my doctor educated me on how the body will remember past trauma even if our brain has processed it. My trauma stems from my very first Pap Test when I was 18. My family doctor did not adequately prepare me for what to expect, and then when I was rightfully startled by him putting his finger inside of me to feel my cervix, I was alarmed and scooted my whole body abruptly to the top of the bed. My doctor (not an OBGYN) then proceeded to tell me that I was not ready for this particular test and left the room. I do not remember having a chaperone; I just remember feeling ashamed and guilty for offending my doctor.
From that experience on, I have always felt shame and guilt whenever anyone touched me "down there." Along with those emotions came physical pain, and my body would subconsciously jerk in a trauma response anytime anyone touched me, whether it was my husband or a gentle OBGYN preparing me for the birth of my children. It's hard to say and even harder to imagine, but I think having Cancer was the best and worst part of my life. Despite all the setbacks, this illness has given me a reason to address personal issues I may have never chosen to address had I been healthy. Over time, I thought the pain in my pelvic floor was normal, but it turns out it's not, and I am not the only one.
Every session is a step toward healing, so be kind to yourself; recovery takes time.
"Chronic pelvic pain syndrome is estimated to affect nearly 15 percent of the general population and is associated with decreased quality of life, loss of productivity and increased health care use."This knowledge empowers you to take control of your health. You’ll learn exercises to strengthen your pelvic floor while relieving built-up tension. -Amber Snyder
Understanding Your Body: Empowerment Through Education
Education about your own body is a core component of pelvic floor therapy. Your therapist will help you recognize how your pelvic floor functions and how both emotional and physical factors contribute to your symptoms.
Self-Care Beyond Therapy
Pelvic care goes beyond therapy sessions. It's essential to incorporate healthy self-care habits into your routine. Consider integrating relaxation techniques like deep breathing, yoga, or meditation into your daily life. Each of these practices can positively impact your pelvic health.
Recently, my friend, Dr. Autumn Smith, PT, DPT, offered a Women's Health Workshop emphasizing the pelvic floor. This was a 90-minute class where we broke down the stigma of Pelvic Floor Therapy. First, Dr. Smith educated the class and answered questions about the importance of diaphragmatic breath work, the vagus nerve, and good posture. For the remainder of the class, I guided the class through a series of active and restorative poses that offered personal application and newfound awareness of this vital part of the body.
The Road Ahead: Continuing Your Journey
While my experience with pelvic floor therapy began after a medical crisis, it has transformed my approach to self-care. With patience and the right support, you, too, can find relief from discomfort and rebuild your confidence in your body.
Whether you're dealing with lingering pain or seeking guidance for pelvic health after pregnancy, know that you’re not alone.
Taking steps to prioritize your well-being, specifically the well-being of your pelvic floor, is a powerful choice. Dedicating time and effort to your journey can lead you to rediscover joy and comfort in your life.
Tightly Wound the Film <<< Watch this short film (cartoon) for more information on what to expect at a pelvic floor appointment, maybe you will relate to this woman as I do.
If you are local to Clarksville, TN, and are in search of your own Pelvic Floor Doctor, I highly recommend Dr. Smith at Empower Pelvic Therapy.
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