painful sex

How To Manage Pelvic Pain Over The Holidays

Hi friend. I’m gonna get straight up personal with you and if you don’t know me yet, allow me to introduce myself. I am Amanda Fisher, pelvic floor physical therapist with a history of pelvic floor issues from peeing my pants to pelvic organ prolapse to pelvic pain to postpartum issues from 3 cesarean deliveries.

Yes, I have experienced my fair share of pelvic floor dysfunction. Now I know it was God’s Plan for me to go through those times to help people like you.

Pelvic pain is a real thing and I can tell you first hand, I have HAD it and still HAVE IT from time to time.

After 10 years of having pelvic pain, I know what to start doing when I feel it creep back in (because let’s face it, we all get busy and fall off the bandwagon of habits we SHOULD continue because it is good for us…but I'm human too) and this time of year is the perfect time for it to come a knockin’. Who isn’t a tad bit stressed around the holidays?! Um…I think we are all raising our hands here.

So, how do I get a handle on my pelvic pain over the holidays?

First thing to do is find a pelvic floor physical therapist in person or virtually. Having a coach or a professional to chat with about your symptoms and give you support/ advice when you need it most is a MUST!! This also creates accountability for me to stay on top of my exercise regimen to kick pelvic floor symptoms.

Second, I schedule or plan out my week and month. I tend to do this on Sundays. I look at my week and plan out what days I can go to the gym (with or without my kiddos), what mornings/ evenings I can walk, and when I can do my pelvic stretches/exercises (I try daily). Writing it down in a notebook or planner makes my brain think that this is happening today and I almost never miss it IF I write it down.

Third, I get a journal and spend a few minutes EACH morning while sipping my coffee (before my kids wake up) writing five things I’m grateful for and 1-2 things I can do today for someone in my family/ friend circle and for a complete stranger. This helps re-wire the brain for positive thoughts. And we could all use a little more of this in our lives, am I right?!

Fourth, motion is lotion. The days I sit on the couch and binge watch Netflix are the days I feel worse. This could be because I am not staying hydrated, or eating more junk food, BUT mostly, it’s because I am sitting in one posture (bad) and not getting blood flow to the tissue. I have to move to feel better and you have to move to create energy and get the blood flowing. I feel so much better after working out, walking etc and then following it up with 1-3 quick pelvic floor stretches to lengthen tissue. So bundle up and get out! OR set a timer in your home and don’t stop moving until it goes off. Follow up with a happy baby stretch or a deep squat to stretch out the pelvic floor muscles.

Fifth, don’t cancel on myself!! This time of year is hectic with all the holiday parties and childhood gatherings, BUT I still make time for myself so I can continue to feel better. And you should too! It is easier to continue a habit I am doing consistently because if I stop it one day, it is much harder for me to get back on the horse and start again.

If you want more information on this or what else I am doing for pelvic floor issues, please email me amanda@empoweryourpelvis.com.

Sex After Baby

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Sex.  This can be a scary thing for women who have had a cesarean birth, who have torn vaginally, or who have had an episiotomy (or some kind of traumatic birth...or even just birthed a baby).  For one, some women find it hard to look at their cesarean scar, think their vagina appearance has changed or have a difficult time letting their partner look at them postpartum because they have lost muscle tone, have a stretched out belly, stretch marks etc.  

The scar tissue from the cesarean delivery and vaginal delivery (with a 3rd/ 4th degree tear and episiotomy) is still healing at your 6 week check up and will continue to heal for 6-12+ months, even if you are released at your 6 weeks check up and were told your incision was healed.  

Remember, sex should not be painful, but if it is, it would be wise to see a pelvic floor physical therapist to assess your scar tissue (vaginal or abdominal) and see if it might be causing some of your pain.  Most OBGYNs and Midwives recommend waiting until after your 6 week appointment to start engaging in sex again.  If your doctor has cleared you for intercourse, it is fine to start. There are many factors during pregnancy and delivery that can cause pain with sex.  Remember, painful sex is common and not normal.  Speak with your doctor about your pain and see a pelvic floor physical therapist to help improve your symptoms.  A pelvic floor physical therapist can evaluate your pelvic floor muscles for tightness, poor coordination and assess your scar tissue (cesarean or vaginal) to help address your pain.

If you are experiencing pain with sex, here are some things you can try:

  1. Water-based lubricant

    Hormone fluctuations can decrease the amount of lubricant your body produces, especially if you are breastfeeding.  Trying a lubricant that is water based is likely to last longer.  Here are some options (In no particular order) :
    1. Slippery Stuff

    2. SYLK lubricants

    3. Good Clean Love lubricants

    4. YES lubricants

2. Longer foreplay with deep belly breathing

-It may take a little longer to increase your arousal.  Adding in some belly breathing with foreplay can help calm down the tissues and get them ready for the fun!

3. Switch it up!

-A position that used to be comfortable, may not be anymore.  Try a new position out and see if that does the trick.  For example, on your back might be uncomfortable, but on top might cause less discomfort.

If pain continues, please seek the help of a pelvic floor physical therapist and your healthcare provider.