I t’s a lucky thing for me that I have had a few sports injuries, otherwise I may have suffered pain during sex for the rest of my days – or possibly even given up sex.
Sounds like my sex life was athletic and I tore a muscle or something! No, it’s just that was having a little moan about the pain while my physio was treating a torn ankle ligament, and he told me that it could be caused by hyper-toned pelvic floor muscles.
Who knew?! Normally we women are worried that our pelvic floor muscles aren’t strong enough!
Turns out that he was able to treat the pelvic floor muscles in much the same way as a sore back or pulled hamstring. Muscles come in pairs that work together. For instance, when one muscle at the top of the arm is contracting/shortening to bend the elbow, another one at the other side is extending/lengthening to allow that bend to happen. Sometimes a muscle gets stuck in the contracted phase, often when it’s been working too hard or an injury has occurred, it needs to be released to stop it being too tight (hypertonic). Physios work with contracted muscles and ones that are stuck in the extension phase as a consequence to relax them and restore their normal function.
Of course, there’s one critical difference between, say, your quads and your pelvic floor. Rubber gloves.
Now, it’s one thing having an internal examination from your GP or a nurse – any medic, in fact, you get used to that over the years. But when the guy who normally shares jokes about family life and sports events dons a pair of rubber gloves, that’s a moment to steel yourself, maintain eye contact and keep the chitchat flowing!
We may both have been embarrassed but he was the model of professionalism, explaining the structures affected.
He also used a hand-held ultrasound device which showed the outline of the bladder and how it moved with the action of the pelvic floor as I engaged the muscles.
The majority of women have stress urinary incontinence (SUI) because of weakened pelvic floor muscles which can’t hold on to the pulling up required but I had the opposite problem. I could pull up and hold my muscles really well, but was involuntarily unable to let them go again. Why? Not sure. Certainly, it was something that had become established as a habit, but what started it is something of a mystery. Could be related to anxiety initially, in a similar way to people being ‘anally retentive’ – unable to let go. For sure, when sex becomes painful you start to tense up in anticipation of that, which reinforces the problem.
I was lucky that it didn’t reach a stage where I had psychological complications. I’d been seeking help from my GP and sexual health clinic for about a year without getting an explanation let alone a solution, and it definitely had an impact on my sex life, but not in a big way, and it didn’t affect my relationship. That must be harder to treat because there are layers of difficulty that have to be addressed – my physio says they sometimes go on a regime of non-penetrative sex and build up gradually as sex becomes re-associated with pleasure not pain. Sounds like a good plan.
Some women live with pain for a long, long time, assuming it’s normal. It’s amazing how many of my friends have admitted it since I opened up to them about my situation. That’s why I’ve put my story here, because more women need to know it’s not normal and actually it can indicate really serious health conditions. But if they are ruled out, don’t give up, get a good physio!