Physiotherapy for the Genitals: How to Exercise to Improve Sex and Health
If you are experiencing sexual pain , menstrual pain, or a lack of bladder or bowel control, specialized physical therapy can help heal your ailments. Yes, you can get genital physiotherapy. And the results can be life-changing.
Let’s go over the basics first. The pelvic floor is made up of a group of muscles that rest on the base of your pelvis to form a kind of hammock. It has many functions, including keeping many of your organs in place, helping to contain urine and feces until you are safe in the toilet, and helping with childbirth. These muscles contract involuntarily during orgasm and can play a role in the strength and timing of orgasm. Like any muscle, the pelvic floor muscles can be weak to strong and can hold back tension or inflammation.
I spoke with Liz Miracle , a San Francisco-based physical therapist, to get detailed information on what this type of physical therapy is, what it can be treated with, and what to expect.
How to know if pelvic floor physiotherapy is right for you
There are many different things that can go wrong both in and around your pelvic floor, so pelvic floor physiotherapy can address a surprisingly wide range of problems, including:
- Conditions of sexual pain , including vulvodynia (pain in the vulva) and vaginismus (pain in the vaginal canal).
- Pain associated with menstruation or endometriosis.
- Problems with sexual activity, including difficulty getting or maintaining an erection and timing of orgasm.
- Frequent urination.
- Pain when urinating, including interstitial cystitis .
- Leaking urine, stool, or gas.
- Painful stools.
- Preparing for or recovering from childbirth.
Miracle says: “… basically, if it happens below the waist, the pelvic floor can be involved.” While your initial instinct may be to see an obstetrician / gynecologist or urologist, many doctors are not trained to deal with the complexities of the pelvic floor. This is especially true when it comes to sexual pain and performance issues. I have worked with a number of clients who have been advised by doctors to “relax,” “have a glass of wine,” or “take Advil.” Because Pelvic Physiotherapists focus on these muscles, many of them have a lot more training, experience, and sensitivity.
How to find a physiotherapist
Your best resource is theAmerican Physical Therapy Association . They have a therapist search tool that can help you find someone in your area. Miracle advises choosing a therapist who is Certified in Pelvic Physiotherapy (CAPP-Pelvic) or has been recognized by the American Board of Physiotherapists as a Clinical Women’s Health Specialist (oddly enough, despite the name, the name requires experience with male problems. also). Since they are clearly dealing with a sensitive area of the body, you can ask for recommendations or read online reviews on Yelp or ZocDoc .
What to expect from the first meeting
Before your first appointment with a physical therapist, gather as much information as possible about your concerns. Write them down so you don’t forget . What are your symptoms? When did they start? Is there anything that makes them worse or better? What questions do you want to ask your therapist? Your therapist will also have many questions about your medical history.
Physical therapy, as the name suggests, is physical in nature. Your pelvic physical therapists will want to do a vaginal and / or rectal physical exam to understand what’s going on with your pelvic floor. This will involve inserting one or two gloved fingers into the vagina and / or rectum for a few minutes and feeling the muscles. Ladies, you will be delighted to know that physical therapists do not use dilators or stirrups, so the exam is not as bad as a regular obstetrician-gynecologist’s appointment. A good physical therapist will ask how comfortable you are during the exam and will allow you to bring a friend or family member into the room if you need additional support. If you don’t like the physical exam, are having your period, or are in too much pain, you can share your medical history, learn more about physical therapy, and ask questions. Your therapist may also suggest behavioral changes that you can work on until you feel comfortable with the physical exam.
From there, your therapist will provide you with recommendations and a game plan for solving your problems, which may include exercises you must do on your own, ongoing physical therapy, or meetings with other professionals. Expect this first meeting to last between 45 minutes and an hour.
What to expect from physiotherapy sessions
The treatment plan depends on your specific condition, but you can expect to see a GP on a weekly or biweekly basis for 30 minutes to an hour and a half. Your physical therapist can do a massage or trigger point work (targeted massaging of any knots in your muscles). Or they can walk you through pelvic strengthening or relaxation exercises that you do yourself, such as Kegels.
Sure, the idea that someone is massaging your private parts may be uncomfortable for some, but physical therapy can be a surprisingly effective treatment. If you are unable to enjoy an intimate relationship with your partner or are worried about not having enough bladder control, the potential benefits of physical therapy are worth a little embarrassment.