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October is Domestic Violence Awareness Month

Hi friends! This week’s blog topic isn’t lighthearted, but it is one that needs to be talked about. October is National Domestic Violence Awareness Month. Did you know that in the United States 20 individuals are physical abused by an intimate partner each minute? That’s more than 10 million women and men each year! (NCADV) Domestic violence can present in many ways. It may include physical violence, sexual violence, threats, economic, and emotional/psychological abuse (NCADV).


If you, or someone you know, needs assistance with domestic violence call 800-799-HELP (7233) or visit www.thehotline.org. If you are in an emergency, be sure to call 9-1-1.


Why are we talking about domestic violence on a pelvic health blog? Those that experience domestic violence are often left with physical and/or psychological traumas that can impact how our pelvic floor works and lead to pelvic floor dysfunction. Many individuals who have experienced domestic violence or sexual abuse in the past develop some form of pelvic pain. This can also cause pelvic floor issues like incontinence and constipation.


Studies have linked past psychological and physical trauma with pelvic floor conditions like vaginismus (Lahaie, 2010), dyspareunia (pain with sex), interstitial cystitis/painful bladder syndrome (Chiu, 2017), and chronic pelvic pain. This can cause extreme anxiety and/or disgust with anticipation or attempt of sexual activity (Berman, 2005).


Why does this happen? Let’s start by saying that it is complicated, but the psychological symptoms of trauma and abuse can translate into physical symptoms, especially in the pelvic floor. Trigger points can for in the muscle from stress, anxiety, and trauma leading to chronic pelvic pain (Montenegro, 2008). The pelvic floor muscle can be come tight and shortened which does not allow them to work they way they were designed to. Our tissues can also trigger certain memories from a specific touch or body position, leading to pain and difficulty with intimacy with a new partner (Oschman, 2006).


If you are a survivor of trauma and abuse, the most important thing to remember is that this is not your fault. Trauma can affect many parts of the body and may take help from several providers. Going to counseling/psychotherapy can be a huge help in dealing with traumas.


However, if you have brought up your challenges to providers and they tell you to “just relax” or to “have a glass of wine” you might find this isn’t helping and start to feel hopeless. But there is hope when dealing with chronic pelvic pain and pain with sex. You may have guessed it: a pelvic floor physical therapist is great at addressing any pelvic issues you may be having. Pelvic floor physical therapists can help with pain with sex, vaginismus (difficulty/extreme pain with vaginal penetration like intimacy, inserting a tampon, or having a pelvic exam), chronic pelvic pain, constipation, pain with peeing, and more.


You can ask your healthcare provider for a referral to a pelvic therapist, or you can find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT. Learn more about what pelvic floor physical therapy is here.

Watch the interview below with Dr. Krystyna Holland to learn more about finding a provider with special training in helping those with past traumas.



Here are some great resources to help deal with pelvic pain:


For providers, check our online courses to help your clients with a history of trauma and pelvic pain. Consider joining our Ambassador Program and most of our courses are included with your membership!


Written by Emily Reul, PT, DPT


References

1. Statistics. National Coalition Against Domestic Violence website. https://ncadv.org/statistics. Accessed October 27, 2021.

2. Lahaie MA, Boyer SC, Amsel R, Khalife S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Womens Health (Lond). 2010;6(5):705-19.

3. Oschman, JL. Trauma energetics. J Bodyw Mov Ther. 2006;10(1):21-34.

4. Montenegro ML, Vasconcelos EC, Candido dos Reis FJ, Nogueira AA, Poli-Neto OB. Physical therapy in the management of women with chronic pelvic pain. Int J Clin Pract. 2008;62(2):263-269.

5. Chiu CD, Lee MH, Chen WC, Ho HL, Wu HC. Childhood trauma perpetrated by close others, psychiatric dysfunction, and urological symptoms in patients with interstitial cystitis/bladder pain syndrome. J Psychosom Res. 2017;93:90-95.

6. Berman JR. Physiology of female sexual function and dysfunction. Int J Impot Res. 2005;17:S44-S51.

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