Heal The Gut!

My patients ask me on a regular basis if diet affects their pelvic pain. The answer is Yes! While it is easier for some to understand how diet and fluid intake affects their bowel and bladder function, it’s more difficult to see how diet may be contributing to their pelvic pain. So here’s my attempt at explaining it!

Bottom line is your diet influences your hormone balance. If there is a depletion of essential nutrients then the body cannot build the hormones it needs including estrogen, progesterone, and testosterone. Low levels or depletion of these hormones negatively affects the pelvic floor muscles and can lead to not only pelvic pain, but bowel and bladder dysfunctions (think constipation, IBS, and incontinence!).

Food sensitivities (gluten, dairy, lactose, soy, sugar) or a diet that consists of too much sugar, especially high fructose, leads to systemic inflammation. Inflammation affects the brain and neuron activity, lowering the threshold of pain tolerance. It also affects the natural flora and bacteria in our gut. You know what else is in our gut? Hormone receptors for serotonin and dopamine! Those are our feel good hormones. So we need a healthy gut environment for our hormones to be properly received and built.

It is possible to restore proper hormones (build up estrogen, testosterone, progesterone, and lower cortisol—the stress hormone) by not eating foods that cause the immune system to react.

Can you see the cycle that can occur? It’s no wonder that my patients often have overlapping symptoms or conditions including pelvic pain, incontinence, GI disorders, fibromyalgia, thyroid dysfunction, gall bladder removed, endometriosis…..the list goes on.

How do you know what foods might be negatively affecting your body’s ability to function normal? The IC or Endo Diet can be used as a guide but they’re not individualized and can lead to frustration as well as unnecessary elimination of healthy foods. The first step in restoring digestive function is to get tested for food sensitivities or allergies. The next step may be the Elimination Diet which is best implemented under the guidance of a Registered Dietitian.

It is important to remember with most conditions there isn’t ONE thing you can do to ‘fix’ it. It’s a matter of putting all the pieces together. Diet, exercise, physical therapy including bowel and bladder retraining, sometimes even medicine for pain management to break the pain/spasm cycle may be needed. Simply trying one thing when everything else is still out of balance doesn’t get you very far. Remember other factors that influence hormones include menopause, postpartum, and intense exercise or sedentary lifestyles.

If you are interested in consulting with a Registered Dietitian, I work closely with Megan McNamee, MPH, RD. Not in the phoenix area? She is available via phone and Skype as well. Megan works with a food sensitivity testing program for a more individualized elimination diet approach if indicated. Check out her website http://www.findyourtransition.com.

“Just Have A Glass of Wine and Relax”!?

I don’t think there could be a more insensitive comment to say to someone struggling with intercourse.

I’ve been a pelvic therapist for over 4 years and I cannot count how many times a woman has come in to my office and told me this is what their physician or mom or friend or even partner told them. Another comment was “You’re lucky to have your partner”. That is a shameful remark to say to a woman suffering with painful intercourse, as if she should just feel lucky that her partner hasn’t left her yet.

But for thousands of woman this is the reality. They go from doctor to doctor trying to understand why sex hurts (if they’re even able to tolerate penetration at all). They’ve taken every pill, cream, and vaginal suppository they were prescribed, and yes, even had a glass of wine and nothing has worked. Numbing the pain or mind doesn’t help. They start feeling like it is their fault or feel some sort of shame or guilt for not being able to have intercourse anymore or in some cases even consummate their marriage. This is a debilitating condition and effects the women’s self-esteem, confidence, and ultimately can destroy their marriage or relationship. I’ve even had women tell me they gave permission to their partner to have sex with someone else since they could not satisfy them. They are so lost and tired of fighting their body and it consumes them.

Then comes the lack of desire. It usually doesn’t start out that way—they want to and try to have sex but after several failed attempts they’re mind turns against them. They start thinking maybe it is in their head (it’s not!) but who wants to have sex when it hurts?! The body is trying to protect itself. The mind and body are eventually going to stop desiring it no matter how much they love or are attracted to their partner! And of course the partner can’t help but internalize it and start to feel they’re not attractive anymore. Do you see the cycle?

I’ve seen it for years and all I can say is that there truly is hope. I was once there and I had all those thoughts too. I enjoyed my sexuality and I felt a piece of me had died. The shaming begins: What did I do? Why did this start happening? Last week I was fine and this week I cannot even think about having sex. Will this destroy my relationship?

But that’s not my story anymore. I was able to get the help I needed through physical therapy and you can too. It’s a safe place you can go, divulge all your secrets, even the ones you don’t tell your best girl friend (she doesn’t get it—her and her partner have sex 3 times a day!) The thoughts you have and the questions can be shared and answered by a professional and the healing can begin. The hope of having a normal sex life again is there!

Read more about Pelvic Floor Dysfunction, Vaginismus, and Dyspareunia and how physical therapy can help you or a loved one.

Vaginal Weights!

I originally wrote this on my Facebook page in April 2015 but the topic came up again at the ISSWSH conference that I spoke at this past Saturday. I was invited to speak to Physicians on the importance of physical therapy for Pelvic Floor Dysfunction and when, where, and how to refer to a credentialed Pelvic Floor Therapist. So I decided I would repost to get this blog started:

I recently was watching an episode of Botched–following the episode was a talk show with Terry Dubrow (one of Surgeons on Botched). They did a spot on Vaginal Weightlifting! I believe they called it Vaginal Kung Fu.

I have to say something about it because I’ve been disturbed since watching these ladies in class carry gatorade bottles and pickle jars from their vaginas (!!!). Your pelvic floor muscles are skeletal muscles like the other muscles in your body (biceps, hamstrings), as Dr. Dubrow stated, however, the big difference (that he did not clarify) is that they are SMALL muscles and are not designed to be WEIGHT LIFTERS. Less is more with these muscles! There is no Pelvic Floor Olympics—no need to train your pelvic muscles to carry 31lbs (world record apparently)! There is NO functional gain in that and can lead to over training, which can lead to other problems including pelvic pain.

Exercising your pelvic floor has many benefits especially in regards to bowel, bladder, and sexual health. However, not everyone is a candidate for KEGELS (pelvic floor exercises) especially if you’re adding weights.

A reported 30% of the female population have pelvic pain. It is a serious and debilitating disorder and is in desperate need of public awareness. As a general rule of thumb if you have any pelvic pain (abdominal, groin, bladder, etc.) you should not perform Kegels unless you’ve been examined/instructed to by a pelvic floor specialist.
And for the record being “tight” does not equal “strength” and there is much more to the function of your pelvic floor muscles!

Read more about this: #vaginalweightsnotrecommended