By: Riley Fortier, M.Ed.
What is pelvic pain?
Pelvic pain is pain in the pelvic area, originating in the genital area or around the pelvis, or due to psychological stressors like PTSD and trauma. It can either be acute or chronic. Acute pelvic pain is sudden and severe, or chronic, meaning the pain comes and goes, or is constant, lasting for a period of 6 months or longer.
What causes pelvic pain?
The general causes are:
- Inflammation or direct irritation of nerves caused by injury, fibrosis, pressure, or intraperitoneal inflammation
- Contractions or cramps of both smooth and skeletal muscles
Some of the more common sources of acute pelvic pain, or pain that happens very suddenly, may include:
- Ectopic pregnancy (a pregnancy that happens outside the uterus)
- Pelvic inflammatory disease (also called PID, an infection of the reproductive organs)
- Twisted or ruptured ovarian cyst
- Miscarriage or threatened miscarriage
- Urinary tract infection
- Ruptured fallopian tube
Some of the conditions that can lead to chronic pelvic pain may include:
- Menstrual cramps
- Uterine fibroids (abnormal growths on or in the uterine wall)
- Scar tissue between the internal organs in the pelvic cavity
- Endometrial polyps
- Cancers of the reproductive tract
How can this affect people?
Pelvic pain can show up in people’s everyday lives. It is very common to have localized pain, cramping, or pain in the entire abdominal area. These symptoms can happen at any time, and make daily tasks very difficult to complete.
It can also show up in penetrative sex. Folks may not be able to be vaginally penetrated at all, or can but have intense pain during and/or after the sexual act. Again, this pain can be localized, or can be the entire abdominal area.
Ways to increase pleasure
Pelvic floor therapy
Pelvic floor therapy is physical therapy for your pelvic floor. A specialized physical therapist in pelvic floor does both external and internal work to help relax and loosen the pelvic muscles over time.
There are accessories that folks can use during sex that can increase pleasure. The Ohnut is a tool used to decrease the length of the insertable part of a dildo or penis. This is done by putting body safe, silicone rings at the base of the shaft.
Dilators are used to help with vaginal penetration. They come in a set, usually 4 or 5, with gradually increasing diameters and lengths. These are used daily or every other day with lubricant to slowly stretch out the muscles surrounding the vaginal opening, with the goal of tampon insertion, penetrative sex, or another goal the patient has.