- How I Recovered from Postpartum Painful Sex, Part 1
- How I Recovered from Postpartum Painful Sex, Part 2
- What It’s REALLY Like to Get Physical Therapy for Painful Sex & Pelvic Floor Disorder
- Real Hope: Pelvic Floor Rehab at Home
- Mind-Body Rehab for Painful Sex & Pelvic Floor Disorders — The Ultimate DIY Guide
- Step-by-Step: How to Find Help for Painful Sex or Pelvic Pain
It’s Called Pelvic Pain
After re-reading Katy Bowman’s blog post on internal physical therapy, I spent hours online trying to find resources. Umpteen search terms later (no, “internal physical therapy” didn’t work), I finally ran across the term “pelvic pain.” That was the key. “Pelvic pain” opened up a Google gold mine. While I didn’t come across any happy endings like the one I’m writing now, I finally found the Pelvic Health & Physical Therapy Center in Houston, Texas.
I also discovered that millions of women are out there suffering with pelvic pain of one kind or another, much of it painful intercourse. This kind of pain does not always start after pregnancy and birth either; sometimes it’s spontaneous. (Sobering tidbit: The physical therapists told me that large studies have now demonstrated a link between hormonal birth control [e.g., the Pill] and spontaneous pelvic pain, and that they’ve seen this correlation in their own practice. That’s scary given the number of women out there using these forms of birth control.)
What the Physical Therapists Said
I gathered my courage and booked a first appointment with the PH&PTC, a 2.5 hour ordeal. I filled out reams of paperwork in excruciating detail about my most private experiences. I signed consent forms acknowledging that treatment could be painful. On the big day, I was so sick with shame and fear that I almost threw up in the waiting room. I excused myself to the bathroom and used an emotional acupressure technique to calm down (similar to the TAT but better for out-and-about emergency situations; I’ll share it later in the Healing for Life series). [Edited: Here’s the tapping technique I used.] Whew!
The nurse practitioner who governs the practice sat me down for a talk. What a relief. She talks to women just like me all day, every day–and helps them too. Kleenex abounded, and I took full advantage of them. My pain levels were a 10. My fears about the future were a 10. My sexual frustration was a 10.
The NP very compassionately listened to my history and my doctor’s conclusions, how I was feeling, the kind of support I had, and then shared her thoughts. She said that nerve entrapment was the least common cause of my symptoms, that she had some strong suspicions about what was really going on, and told me that I’d be working with a biofeedback specialist as well as one of their physical therapists.
I then moved on to my appointment with the biofeedback specialist, where we had quite a bit of difficulty inserting a vaginal probe, although she was so gentle and kind throughout. The probe connected to a computer and showed on-screen readings from my pelvic floor muscles. (These are the muscles that form the “floor” or bottom of the pelvic opening. They hold up all of your pelvic organs and surround all orifices.) The readings were high, really high. My pelvic floor muscles were in a constant spasm! No wonder inserting anything in there was excruciating.
Now, I would never have described my pain as muscular–never–but the biofeedback readings convinced me that at least part of the problem was in the muscles after all. Extreme pelvic floor tension can happen for a variety of reasons. In my case, the trauma of birth appeared to trigger an overreaction in the muscles.
I was still very concerned about my scar, however, as was the biofeedback specialist.
Finally, they marched me up for a quick talk with the MD, a colorectal surgeon, who oversees the whole PH&PTC practice. He confirmed that surgery can sometimes be necessary but was highly unlikely for my case. Talk about exciting news!
When I first saw their goddess of a physical therapist the following week, she noted that my pelvic muscles were indeed in a spasm. She worked gently and found many “trigger points” in different levels of my pelvic floor muscles. The session was stressful and uncomfortable but also felt productive.
After all of these assessments, these goals came to the forefront:
- Teach me to connect with my pelvic floor (PF), to be able to feel its tensed or relaxed state (I was oblivious at this point)
- Teach me to consciously relax my PF
- Retrain my PF to live in a relaxed state without conscious effort
- Release trigger points and fascia restrictions
- Gently stretch and retrain the PF to have some elasticity
- Break up scar tissue and reduce its sensitivity
- Strengthen muscles that work cooperatively with the PF
- Strengthen the PF muscles themselves
The Game Plan
Here’s the prescription they gave me:
1) Weekly biofeedback sessions to help me connect with my PF and learn to relax it
2) Weekly physical therapy sessions to help release trigger points, fascia restrictions, retrain my PF, and correct whole-body imbalances
3) Lots of homework!
My daily homework:
- General relaxation exercises
- Dilator and vibrator exercises
- Scar and perineal massage
- Exercises to close my diastasis recti and strengthen my core
- Exercises to strengthen my glutes and lateral hip muscles
- Stretches to release tension throughout my core, hips, and legs
- Walking daily
- Standing up at least every 30 minutes
I spent 30 minutes meditating each morning as soon as the baby went down for his first nap, and after his bedtime in the evenings, I spent 2 hours on everything else. I was M.O.T.I.V.A.T.E.D. (If you’ve ever wonder what on earth I was doing from months 3 to 6 postpartum, now you know.)
After just 3 PT and biofeedback sessions in 2 weeks, I was 70% better! We were beyond ecstatic. This was enough improvement for intercourse. The next 20% happened within a few more weeks. All told, I had 8 sessions of PT. The final 10% of healing took several more months after my PT and rigorous homework ended, but I’ve now been having pain-free sex for months. Even my scar tissue seemed to dissolve. What was once a rock-hard, thick mass of tenderness is just . . . gone.
Wow. I never thought I’d be able to say those words!
(Did I mention that no surgery was involved?)
(Did I also mention that the way I was sewn up had nothing to do with my return to pain-free intercourse?)
(Did I further mention that the things I learned about my body along the way have been life-changing, and now I’m so grateful for this experience? I sidestepped some major health issues down the road by having such an attention-getting symptom early in my life!)
A Hidden Advantage
The remarkable speed of my recovery–that initial 70% improvement in only 2 weeks’ time–owes to my previous biofeedback, mindfulness, meditation, and relaxation experience. I had already spent 2 years practicing how to connect with my body, to notice what was happening without judgment, to bring my mind to center, and to relax. I also had worked with HRV biofeedback equipment at home, plus biofeedback and neurofeedback in a professional setting with Victoria Harrison (Houston, TX). I just needed to learn how to connect with a new area of my body. I also believe that meditating for extended periods every day helped facilitate the recovery.
I still would have recovered without this prior experience; it just would have taken longer.
Tomorrow is Part 3, where I’ll dive into exactly what biofeedback and physical therapy mean in this context, what my homework entailed in more detail, and tools and resources that might be helpful to others suffering similarly, or even to any postpartum mom. [You can now read Part 3 of this series here.]
This October, I’m writing (nearly) every day about holistic healing.