I have mentioned in previous posts that I have something called hypertonic pelvic floor muscle dysfunction. That is kind of a long and complicated name, so I want to take a moment to explain what it actually means. I ask for some grace from any physical therapists or doctors out there who are reading this as I may not be perfectly accurate in some aspects of my definition. And, I encourage those of you who do not yet have an accurate diagnosis to do some additional research from a more medically based source (and Wikipedia doesn’t count). However, this should provide you with a good introduction based on my personal understanding and experience with hypertonic pelvic floor muscle dysfunction.*

The first place we need to start is in recognizing what the pelvic floor muscle is and what it does. Unlike most oddly named muscles, its name is actually quite descriptive—it is literally the floor of your pelvis. It is a sling-like muscle that extends from the pubic bone to the tailbone (also called coccyx) and it is responsible for holding all of your organs, such as your bladder and uterus, in place. There are openings in the muscle for your urethra, vagina, and anus.  The pelvic floor muscle is what allows you to “hold it” between bathroom breaks as well as what contracts during an orgasm. In short, it’s a very important muscle which we often neglect.

Some of you may have heard of pelvic floor disorder, but the typical descriptions you’ll find in searching online is for things like pelvic organ prolapse—where the pelvic floor muscles are so weak that the internal organs (like the uterus) actually start “falling out” so to speak. Other typical effects of weak pelvic floor muscles are incontinence or urine leakage. And, probably a lot of you have heard about Kegel exercises, which are meant to strengthen your pelvic floor. What is not so often discussed is the opposite end of the spectrum when the pelvic floor muscles are actually too tight, which brings me back to my definition.

Hypertonic pelvic floor muscle dysfunction occurs when the muscles of your pelvic floor are chronically tightened and shortened. Truly the best description I have been given is to imagine squeezing your hand into a fist as tight as possible and then hold it like that—for days, months, even years—without letting go. The tension in your hand’s muscles will become so severe that even when you do let go of the fist you won’t be able to open it back up to its normal state (to say it would be painful is an understatement). The same is true of your pelvic floor muscle with this condition. The muscles have been chronically tightened, kept in a constant state of tension, to the point that they have actually shortened.

Following the example of a tightened fist, imagine that, after squeezing your hand so long it hurts, someone comes up and tries to poke it with their finger. You would probably sock them with the other hand because the pain would be so bad. Now imagine that same person tries to insert their finger in the middle of your tightened fist. The pain would be excruciating. And that is exactly what sex is like with hypertonic pelvic floor muscle dysfunction—excruciating. Some women have such severe tension that insertion of even a tampon is not physically possible (this is called vaginismus).

The good news is that hypertonic pelvic floor muscle dysfunction is treatable—curable even! If you suspect that you may have this disorder I recommend you find a qualified pelvic floor physical therapist. Any other type of physical therapist just won’t be able to treat the source of the problem (and you don’t want anyone less than an expert of the pelvic floor poking around in there—they can cause more harm than good!). Pelvic floor physical therapy is definitely not a quick fix (as in the example of the tightened fist, letting go and returning to a normal state is not easy). However, it is something that can provide real healing to someone suffering from hypertonic pelvic floor dysfunction. I can speak from personal experience that pelvic floor physical therapy works!

*Please keep in mind that I am not a medically licensed “anything” and cannot take the place of sound advice from your doctor or therapist.  I can only share my own personal experiences in hopes that it will help you ask the right questions and seek appropriate medical help.