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Pelvic floor disorders can be painful, disruptive, and emotionally stressful and upsetting. If misdiagnosed, as they frequently are, they may lead to unnecessary and therefore destructive drug therapies or even surgical procedures. Even without such extreme effects, these disorders can cause life-changing results—including organ prolapse, incontinence, skin disorders, and sexual dysfunction.
Prolapsed Organs
Organ prolapse takes place when the pelvic floor musculature and tissues become so strained from irritation, infection, inflammation, weakness, or trauma that the organs of the pelvis literally fall. In both men and women, the rectum may fall into the back wall of the pelvis. In women, the bladder may collapse downward and backward into the front wall of the vagina. The uterus can descend, and it can take the vaginal vault with it. The urethra may collapse as well.
The pouch like space between the rectum and the back wall of the uterus might be displaced, potentially causing pressure, pain, or the feeling that something is actually falling out of you. Often with prolapsed organs, the pain is not immediate and not severe or nonexistent, so people may have no idea they have the condition.
Incontinence
Incontinence of both bladder and bowel can be a common result of pelvic floor disorder, mostly resulting from weakness or shortening of the muscle. It comes in several forms.
In urinary stress incontinence, a cough or sneeze, lifting, or running can cause sudden involuntary urine loss. As many as 38 percent of women engaging in high-impact athletics experience stress incontinence during the athletic activity.
Different from stress incontinence, urge incontinence is characterized by a quick warning that precedes the strong desire to void that results in the involuntary urine loss. A great many women and men also suffer from a combination of both stress and urge incontinence. And many also experience fecal incontinence, typically due to weak or shortened muscles in the pelvic fl oor.
Skin Conditions
A cascade of skin conditions, such as lichen sclerosus and lichen planus, can result in pelvic floor disorder, and pelvic floor disorder may contribute to the discomfort of such skin conditions. It’s another case of the revolving door effect—the vicious circle of pel-vic floor disorder. These skin conditions may derive from a compromised immune system, from sexually transmitted diseases, and sometimes from the inappropriate use of vaginal creams. Or, the condition may be congenital—that is, you’re just born with it.
Whether a contributing cause of pelvic floor disorder or a result of it, these conditions can be unpleasant, painful and disfiguring.
Sexual Dysfunction
Pelvic floor disorders cause a range of sexual dysfunctions. To begin with, these disorders can greatly decrease libido in both men and women. If arousal does happen, both men and women may find it difficult or even impossible to achieve orgasm due to weak or overly shortened muscles.
In a condition known as dyspareunia, women may feel pain during intercourse. This pain is in the initial penetration, or with deep penetration, or from the thrusting motion, or from a lack of lubrication. Superficial scarring, adhesions, skin irritation, or muscle tenderness may all contribute to the pain and discomfort.
In men, erectile dysfunction can be a direct result of pelvic fl oor muscle tension, weakness, or pelvic congestion. Or it may result from experiencing pain during or after intercourse.
EALING YOUR PELVIC FLOOR DISORDER
It is essential to get a proper diagnosis from a specialist in pelvic floor dysfunction, because, as you can see, the list of things that can go wrong with your pelvic floor is a long one, covering a varied range of complex signs, symptoms, and dysfunctions. I’ve included such a list as Appendix A to this book. Consult it about any sign or symptom that you think may be related to or radiating from the core of your body—and take action accordingly.
Whatever kind of pelvic pain you’re suffering, and whatever the particular pelvic floor disorder that afflicts you, I’m certain you’re eager to start the natural healing that can ease the pain and alleviate the disorder.
There are two separate exercise programs, depending on whether your problem is pain—and the accompanying bladder or bowel discomfort—or weakness. Each of these programs consists of different exercise routines and each progress in phases. The first program is the End-the-Pain routine, a three-phased course that focuses on what I’m sure is most important to you right now—your pain. The entire End-the-Pain routine must also be accompanied by the external and internal massages described in Chapter 5. Do these two therapies together to ensure an end to your pain
The Second One
The second exercise program addresses the problem of weakness—specifically, bladder and bowel incontinence and decreased sexual pleasure. The Strengthen-the-Muscles routine is in four phases. For both exercise programs, you’ll progress from one phase to the next only after you’ve become comfortable with the earlier phase and have begun to feel its benefits. The Symptoms Monitor at the end of this chapter is your tool for assessing when it’s time to move on.
Be sure also that you take note of any negative responses as you change exercises or increase the intensity of any exercise—for example, by doing more repetitions or by adding resistance—or as you move from phase to phase in a routine. By negative responses, I mean an increase in the level of pain or a worsening of the disorder’s symptoms. If such responses do occur, first check your posture and alignment; that is, make sure you’re doing the exercise correctly. Then, cut back on the intensity of the exercise: do fewer repetitions or use less resistance. If you still feel the negative response, go back to the earlier part of the End-the-Pain routine. If none of this helps, you should by all means contact your health-care provider.
Chances are you won’t have any negative responses. If you follow the phased programs carefully, your healing will progress. The pain will diminish and then end, and your weakness will turn to strength.
I’m sure you’re eager to get started. Task number one is to fill out the following Symptoms Monitor. It’s a questionnaire that asks you to pinpoint where it hurts, how much it hurts, and what effect the pain or incontinence and other symptoms are having on your life. You’ll use this Symptoms Monitor over the next weeks and months as a guide to advance from phase to phase in each program. With today’s assessment, you’ll create a baseline. Come back to the Symptoms Monitor four weeks from now to reassess your symptoms. If your symptoms have improved by 50 percent or more, you are ready to move to the next phase of the program. If your improvement is less than 50 percent, wait another four weeks, then try again. Keep reassessing your pain and symptoms every four weeks as you do the natural healing exercises and other therapies of this book; you’ll see as well as feel the improvement.
SYMPTOMS MONITOR
The following questionnaire is reproduced with permission from the International Pelvic Pain Society, http://www.pelvicpain.org/.
Stay tuned for part 3. Check back often, but part 3 should appear sometime in April. |
