Chronic pelvic pain in women (or anyone) can turn life completely upside down. Finding straight and thoughtful answers is hard—and, sometimes, getting qualified help feels like a challenge too. So, we took top questions about chronic pelvic pain and compiled info in one spot, with pelvic floor and pain expert and intuitive coach Dr. Sara Smith, DPT, RYT-200, CHC.
Who gets pelvic pain? Is it just women?
Chronic pelvic pain in women is more common than you think. One in seven women—across all ages—report chronic pelvic pain. Many cases aren’t reported at all. Some of the most under-reported cases involve other groups besides women. Males, transgender individuals, larger-bodied, and other marginalized individuals may be even less likely to seek help. This can be because of stigma. Or, it can be from mistreatment and disregard by partners, friends, healthcare, and society in general.
What does pelvic pain feel like?
Pelvic floor dysfunction symptoms and pelvic pain can feel differently for different individuals. Chronic pelvic pain can make you also experience lower back and abdomen pain too. You might strain to go to the bathroom or have leakage (from the vagina or anus). Feeling like you have to go pee all of the time is common. Some individuals have intense pressure or bulging in the pelvic area, suffer with painful intercourse, and/or get burning and stabbing feelings in the pelvis.
Can pelvic pain affect your whole body?
I work with women who have begun to have poor posture and aches in their back, neck, and shoulders when they move. They limit their social activities due to not being able to control gas or their bladder. They’re stressed from pain and everyday life, which contracts the pelvic floor more. And, also, what hardly ever gets talked about is how pelvic floor dysfunction makes you exhausted and makes it harder to think clearly.
Having pelvic floor dysfunction also puts you at a much higher risk for depression than women who don’t have pelvic pain. Pelvic floor dysfunction and all that’s associated with it (including trying to find good care) can lead to depressive symptoms. This issue compounds because then depression also makes it more challenging to address pelvic floor dysfunction. Depression also affects how we perceive pain and make any pain that we do have feel even worse.
Can stress cause chronic pelvic pain in women?
Yes. Constant or intermittent but persistent stress raises your cortisol level. This cortisol release causes muscular stress contraction. This protects us from harm. The issue is, our nervous systems cannot tell the difference between threat levels. A bear chasing us in the woods gets perceived as dangerous. And so does the job we feel stuck in, the news, or social media binges. Constant stressors, like trying to do it all, feeling silently unfulfilled or lonely, mom guilt, or juggling schedules send our cortisol levels up too. Too frequently, our hormones are pumping to attempt to reduce constant stressors.
As a result, pelvic muscles get tighter and tighter in an attempt to protect your body. This becomes a vicious cycle of emotions leading to pelvic floor constriction and pain. Then, chronic pelvic pain results in worsening anxiety and stress. But how can what’s going in your life manifest as pelvic pain? Think of your pelvis as a neurological hotspot. It houses past, present, and future stressors and traumatic occurrences. Ever found yourself eating your emotions over a bowl of ice cream and a Netflix fest? Not only do we stuff emotions into our abdomens, but these parts of our body are physiologically linked. The brain is well-designed to push stress all the way down deep–right into the pelvis.
I want to do physical therapy. Will that help and is it enough?
Learning when and how to correctly engage your pelvic floor and core musculature is vital to breaking free of silent pelvic suffering. Second, directly addressing stress and the cycle of thoughts and behaviors that come with it will transform your results. The emotional aspects, traumas, and stressors you have need to be worked on in talk therapy. Once you address these simultaneously, you can improve your quality of life in so many ways. Less pain and dysfunction. More energy. Better sleep. Improved clarity. Greater productivity. Improved communication. And a greater ability to be and feel like yourself.
Pelvic pain’s important! We compiled this post using info from Dr. Sara Smith’s other articles on hormonely.com. Read all the details and get more answers in her other posts: how emotional stress causes and worsens pelvic pain and the pelvic floor dysfunction symptoms that aren’t talked about enough.
Want to work with Dr. Sara Smith? Connect with her here.