Tag Archives: hypertonic pelvic floor muscle disorder

Relating to hypertonic pelvic floor muscle disorder, also referred to as hypertonic pelvic floor dysfunction, a disorder that can cause sex to be painful

Don’t just suffer through it

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For those of you who are dealing with painful sex, I beg you, please don’t just suffer through it!  As I retell my story and relive those earlier years of pain I am dumbfounded at how I just suffered through it for so long.  I know now that I actually made things worse by allowing the pain to continue unabated (with hypertonic pelvic floor muscle disorder, the more trauma there is to the muscles the tighter they become and the longer the healing process takes).  More than that, I think about how much time was wasted and the emotional damage of suffering for so long.

sex is not supposed to hurt - when sex hurts there is hope

At first I just dealt with it because I wasn’t really sure what was wrong, or if there really was something wrong at all.  If you are having any similar types of doubts, let me make it very clear—sex is not supposed to hurt!  Continue reading →

The long road to healing (this is my story…part 5)

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That first physical therapy session was certainly an experience.  If I had to use three words to describe it I would say it was awkward, painful, and enlightening.  Awkward might be a bit of an understatement.  I’ll just sum it up by saying that the most effective way of reaching the pelvic floor muscles is internally (and anyone who knows basic female anatomy should realize that leaves only two options).  Certain aspects were painful, but it was a different kind of pain.  By painful, I mean it literally felt like she was digging her fingernails into me, even though she was barely applying gentle pressure with her soft fingertips.  And by different, I mean the pain was not excruciating, and it was the type of pain that was beneficial.  It is like the pain you feel when someone is massaging a knot out of a tight muscle—it’s a healing pain.

Overall that physical therapy appointment was incredibly enlightening.  Between the painful trigger points (aka muscle knots), clear referral patterns across muscle groups, and the histamine release just from skin rolling, I pretty much fit the textbook description of hypertonic pelvic floor muscle disorder.*  It was amazing to finally find a right diagnosis!

But physical therapy is not an overnight fix—it has truly been a long road to healing.  I began weekly sessions, but had flare ups of my sciatica which would leave me with back pain for days after each appointment.  Eventually I started taking Lyrica, which helped to calm my nervous system and allowed me to continue physical therapy without the painful flare ups.  My physical therapist also showed me how to continue therapy between sessions through self-treatment techniques such as skin rolling, effective stretching, and using dilators.  After a year I was eventually able to reduce my PT appointments to once a month and even stopped taking Lyrica several months later.

Most importantly, I was finally able to have pain-free sex!

*If you aren’t sure what trigger points, referral patterns or histamine release are, don’t worry.  I’ll go into more detail about skin rolling and other aspects of my physical therapy treatment in later posts.

The path to a right diagnosis (this is my story…part 4)

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The pain continued, and in some ways seemed to get worse.  But in the end it wasn’t the pain itself that led me to start my search again.  By now the far reaching effects of sexual pain had imbedded themselves into my subconscious.  Sex always led to pain, and physical affection often led to sex.  Thus, I eventually started avoiding affection altogether.  My husband took about as much as he could handle and finally confronted me about it.  It was this reminder and realization that my marriage lay in the balance which gave me the momentum to begin my journey again.

With the psychological effects becoming clear, the next step on my path was to see a sex therapist.  She had some positive advice on how to start the process of unraveling the psychological aspects of prolonged pain association.  The relaxation techniques she taught me were very helpful, but it became clear that we couldn’t make any real progress without first addressing the medical cause of my pain.

She referred me to a gynecologist who specialized in sexual issues.  He was definitely more knowledgeable on the subject than the doctors I had seen in the past, but I did not relate well with him at all.  I remember coming home from my first appointment, crawling into bed, and just sobbing.  Having to tell my whole story all over again of everything I had already been through—all of the unsuccessful tests, treatments, surgery, and the reality that I was still no closer to a diagnosis—just left me in a state of depression.  Fortunately, that doctor referred me to another urologist, who diagnosed hypertonic pelvic floor muscle dysfunction* and referred me to a pelvic floor physical therapist.

That first appointment with my physical therapist was the turning point in my story.

*Here’s my definition of hypertonic pelvic floor muscle dysfunction: when your pelvic floor muscle (that’s the extremely important, often neglected, sling-like muscle that holds all of your internal organs in place and allows you to “hold it” between bathroom breaks) is chronically tightened and shortened.  The best description I have been given is that it is like if you were to take your hand and make a fist as tight as you can and then hold it like that—for days, months, years—without letting go.  Even when you do let go it is likely that your hand will not open back up to its normal state very easily, and it will be incredibly painful.  This is similar to what happens to someone’s pelvic floor muscle who has this disorder.