By: Hannah Dwyer
Pelvic pain can be an extremely difficult thing to deal with on a lot of levels. It can make it hard to experience the joy of living in your body and lead to a chronic dissociative state, it can throw up roadblocks in your ability to enjoy sex and create sore spots to navigate in your relationships with sexual partners, it can lead to back problems, inability to exercise and resulting mental health struggles. And it can be caused by so many things: trauma, endometriosis, adenomyosis, fibroids, sitting all the time, digestive inflammation, hormonal contraceptives, or any kind of microbiome imbalance. Most often, it is a combination of these things.
While I am not a doctor, I am a doula, reproductive health educator, and I have had debilitating endometriosis for a decade. I have been around the pelvic care block quite a few times. I have researched from so many different kinds of sources and tried so many different kinds of care providers and self-help practices and I want to share what I have learned with you so that maybe your path to discovering the self-care regime that works for you can be a little less bumpy and winding and frustrating (and lonely, sad, excruciating, scary, expensive, the list goes on…) than mine.
Pelvic pain can be referring to quite a few things, and I have experienced most of them. Pain around the time of ovulation, pre-menstrual and menstrual pain, pain while peeing, pooping, or having sex (called “functional pain” by docs), digestive inflammation that sits low and hot and puffy in the abdomen, low back tension that sticks your uterus in a tilted position rather than letting it be a freely moving, expanding and contracting, strong and supple muscle like it’s made to be. There are many new and interesting ways for pelvic pain to show up, you may think you’ve felt them all and then one day, wow, life always has more surprises. There is the pain that feels like a dagger in the perineum, the one that feels like one long, hot, ever tightening fist of internal muscles, the persistent heavy and sore feeling that makes it hard to imagine jumping even one inch off the ground, and so many more. Starting to recognize thetriggers, or patterns of when your pain shows up and how can be a great first step in bringing mindful awareness to what you are experiencing and enhance your feeling of connectedness with your body and agency in navigating the situation.
It can be so hard to love a body that is hurting you, but it’s worth the effort. Your body is communicating with you, and when you learn to understand its language, you will be able to listen to its messages and give it what it needs before a whisper turns into a shout.
So, what might it need? I will share with you some of the ways that I tend to my body to keep pelvic pain at a minimum, and I hope it will spark some recognition or lead you into some fruitful inquiry with your own body.
When I feel an endometriosis flare up coming, the harder I try to push through it, the worse it ultimately gets. If I resist the conditioning that says I need to be as productive as possible, I need to keep that appointment I made, and instead listen to my inner wisdom that I deserve to and must ease off when my body asks, I can enjoy my period of intentional rest rather than struggle through my period of forced incapacitation.
2. RELAXATION / MINDFULNESS PRACTICE.
This I learned from my awesome pelvic floor physiotherapist: a lot of people with pelvic pain have chronically tensed up pelvic floor muscles, and instinctively hunch and clench around the pain, of course leading to more of it ☹. She taught me to lie on my back with my hands on my low tummy, feet together, knees falling out, and with each inhale imagine all of my pelvic tissues expanding and relaxing, my vagina opening like a flower. With the exhale, the diaphragm recedes upward and the organs naturally go with it, with the inhale I expand, open and release again. Trying to keep up this practice for a few minutes every day has been hugely helpful. I do it when I am in intense pain and I am able to at least short circuit the cycle of clenching and tensing and worsening the pain, getting more upset about it, tensing more and worsening it more, and on and on. Having this ability to find a place of calm within myself even when pain is present makes me feel hugely proud of myself. This can also be a good practice to use for 5 minutes before sex, to drop into my body, relax the muscles that are prone to seizing up when “threatened” (ow), and feel the energy flowing through me in a healthy way.
3. WATER, WARMTH, AND HERBS
I use many combinations of these three healing elements together, so I thought it silly to separate them here. Baths with herbs and Epsom salts, herbal teas, hot water bottles, tinctures, wrapping my torso with a tight, warm blanket, vaginal steaming (https://www.steamychick.com/testimonials/)– these are all ways to bring tender, loving care to myself with the help of my allies in the natural world. Your herbal allies will be different from mine, so I will leave that exploration to you, but I have confidence that if you are open and looking for them you will meet plant friends that make you feel soothed, held, warmed, strengthened – whatever it is you need.
4. GATE CONTROL THEORY OF PAIN
This is a theory that says that because the neural pathways that communicate pain are the same as the ones that communicate pleasure, you can decrease the perception of a pain stimulus by introducing a pleasurable stimulus as well. This can mean a gentle belly rub with some soothing oils like Moondance, wearing and enjoying your softest possible clothes and blankets, eating something delicious, listening to beautiful music, having a friend play with you hair, and of course, sexy stuff! Listen to your body and learn to experience the pleasure as well as the pain.
5. INFORMED DECISION MAKING ABOUT WHAT I PUT IN AND ON MY BODY
This doesn’t mean compiling a huge list of “don’ts” and “can’ts”, but rather having all the information and taking full responsibility for your decisions. I know that ice cream is inflammatory for me, and I know that inflammation tends to get out of hand and become a debilitating problem the later I am in my cycle. So maybe I will have a small scoop of ice cream at a certain time of month and know that as long as I’ve eaten my veggies and drank my water I’ll probably be fine, but during another time of month I would just have to accept that if I choose to eat that ice cream I would be hurting myself and I love myself so I won’t do that. That’s me, some other things that can contribute to pelvic pain that you may want to be aware of are diet/nutrient deficiencies, hormonal contraceptives, lube with glycerin ( Smooth Operator and Wild Thing are safe😊 ), and sexual penetration that is out of alignment with your true needs and desires.
If you are dealing with pelvic pain, my heart goes out to you. Give yourself some credit for doing the work of being here looking for solutions. I hope that this list has given you some ideas for troubleshooting your own journey to a more enjoyable embodied life. Feel free to reach out to me if you are looking for support or more information about any of this ( https://dwyer96.wixsite.com/hannahhyamslifedoula ) Stick with it <3.
https://fertilityfriday.com/6-reasons-why-you-shouldnt-take-the-pill-long-term/ (this blog post doesn’t list her scientific research citations but her book, The Fifth Vital Sign by Lisa Hendrickson Jack shares this information and much more with extensive and detailed citations)