Tensed Pelvic Floor? We’ve got you covered.
Imagine being late for your classes, and rushing to catch your bus, only to realise, you need to pee. Remember how you tense up and barely manage to hold the tension, looking frantically for a washroom, clenching all the muscles in your body?
Now imagine feeling like that, most of the time, 24×7, unable to pee. Or poop. Or have sex.
That’s what patients experiencing hypertonic pelvic floor or non-relaxing pelvic floor dysfunction feel daily. Yikes.
What is a Hypertonic Pelvic Floor?
Continence.org.au defines it as:
“A hypertonic pelvic floor occurs when the muscles in the pelvic floor become too tense and are unable to relax. Many people with a tense and non-relaxing pelvic floor experience pelvic health concerns such as constipation, painful sex, urgency and pelvic pain. A hypertonic pelvic floor may also be accompanied by tension in surrounding hip and pelvic muscles such as the piriformis, obturator internus, coccygeus and hamstrings.”
It might feel akin to a rubber band stress ball, with the sensation feeling tighter and tighter. While the exact cause for this condition is not determined, medical professionals and therapists suggest that many factors such as emotional stress, trauma, and physical conditions such as PCOD, vaginismus and prolapsed pelvis do play a role in a non-relaxing pelvic floor condition.
It is due to many reasons:
- Trauma, either physical trauma such as injury near the sacral lumbar region, pelvis etc. or psychological trauma due to any event
- Gynaecological: Endometriosis, Fibroids, PCOD, Pelvic Inflammatory Disease, Pregnancy
- Genitourinary: Interstitial Cystitis, Cystocele, Prostatitis, Sexually Transmitted Disease
- Gastrological: Irritable Bowel Syndrome, Chrons Dz, Ulcerative Colitis
- Colorectal: Haemorrhoids, Anal Fissure, Proctalgia Fugax, Hx Colectomy
- Neurological: Pudendal Neuralgia, Migraines, HSV, Shingles, MS
- Rheumatic: Ankylosing Spondylitis, Fibromyalgia, Connective Tissue Disorder with Hypermobility
- Musculoskeletal: Labral Tear Hip, Lumbar Radiculopathy Coccyx Injury
The symptoms can manifest in multiple ways, some of which are:
- Incomplete Emptying Of The Bowels
- Straining When Emptying The Bowels
- Pelvic Pain
- Low Back Pain
- Hip Pain
- Coccyx Pain
- Painful Sex
- Urinary Incontinence
- Incomplete Emptying Of The Bladder
- Slow Flow Of Urine
- Hesitancy Or Delayed Start Of Urine Stream
- Urinary Urgency or Urinary Frequency
- Painful Urination
During pregnancy, it is hypothesised that tight pelvic muscles can cause uneasy labour or delivery. Hence, doctors and other medical professionals suggest that pelvic floor strengthening and mobility exercises should be done from the second trimester of the pregnancy (of course, it varies on a case-by-case basis). However, there seems to be no conclusive data regarding how the two are directly correlated with each other.
Moreover, pregnancy can itself be a factor causing tightness in the pelvic floor muscles due to scar tissue and birth trauma. The pain and scarring from perineal or vaginal tearing might lead the pelvic floor muscles to contract in a protective manner. It can also occur along with Pelvic Organ Prolapse or POP, a common condition many vagina owners face during postpartum. If the muscles can’t relax, they cannot respond to changes appropriately. Sucking in the stomach forcefully or emotional stress are also a few of its major causes.
So, how does the pelvic floor facilitate sex? Although every biology class or anatomy lesson about reproduction has failed to mention this term, its role cannot be brushed off so easily. A healthy pelvic floor is essential for maintaining a happy sex life. Expanding and relaxing pelvic floor muscles assist in pain-free vaginal penetration, optimise the blood flow to promote orgasms, and also help in increasing vaginal lubrication for females. Meanwhile, in males, the pelvic floor is mainly responsible for erectile function during intercourse.
A lot can go wrong during sex with a hypertonic pelvic floor. Sexual dysfunction is a major consequence faced by people suffering from this problem. From difficulty in achieving orgasms, a ripping, tearing, or burning sensation during penetration to bladder leakage, it has a significant impact on a person’s libido and sexual arousal. Evidence also suggests that it can be a leading cause of erectile dysfunction as well as premature or painful ejaculation. To be very succinct, it can make your sex life extremely off-putting and unpleasant.
If you suffer from this condition, don’t hesitate to seek help. You don’t have to put up with it. You can take several steps with the help of a professional or at home to relax, manage and treat your pelvic floor muscles.
- Physical Therapy – The primary form of treatment for hypertonic or overactive pelvic floor syndrome is pelvic floor physical therapy. Through a tailored treatment plan, the physical therapist manipulates pelvic floor muscles to restore their strength and function. Issues such as pelvic pain, incontinence, bowel issues, postpartum issues, and abdominal issues can also be resolved through this method.
- Exercises – This is the most commonly suggested technique to help with the hypertonic pelvic floor. It’s important to take your time with them and breathe correctly while doing them, so the pelvic floor gets a chance to fully relax. Additionally, pelvic wands or dilators may also be effective in improving the elasticity of the muscles. Of course, do consult with your physician before trying out any of these exercises or implements. You can also check out the blog on our website for an extensive and detailed guide on the same. But here are a few effective exercises you can experiment with: Butterfly – to aim for your adductors, Squat – to aim for decreasing the tone of your pelvic floor muscles, Child’s pose – opens adductor and glute muscles.
- Medications – To address immediate symptoms and alleviate pain or spasms, you can have muscle relaxants or anti-inflammatory medications prescribed to you by a medical practitioner. However, it is imperative to treat the root cause of the syndrome for long-term benefits.
- Cognitive Behavioural Therapy (CBT) – CBT, sex therapy and counselling are recommended as viable treatment options to tackle any underlying trauma or emotional distress associated with having a hypertonic pelvic floor.
A hypertonic pelvic floor can be a serious issue affecting your quality of life. It is appalling how such disorders concerning the pelvic floor have been normalised and often go unnoticed. Exercising, having sex, giving birth, breathing, and many other activities all depend on your pelvic floor. Why aren’t there more conversations about it?
This points to the greater issue of lack of awareness and the inadequacy of sex education imparted. The condition largely goes undiagnosed despite being so common that it plagues one in ten people. The larger picture also suggests the hush around painful sex and pregnancy to be a principal factor in people putting up with the symptoms. A hypertonic pelvic floor is completely treatable with time and patience and you shouldn’t stay silent about it. You can also reduce your risks with certain exercises to strengthen your pelvic floor and practicing mindfulness and relaxation techniques. Remember to pay attention to your body and what it is trying to tell you.
Written by Baishali and Arushi