Although pelvic floor disorders are physically treatable, they can be emotionally exhausting.
Pelvic floor disorders–including vaginismus, loss of fecal and/or urinary incontinence, and pelvic organ prolapse–make sex incredibly difficult. Thinking about sex, especially with a new partner, can make anyone anxious and nervous already, so adding on a medical condition to that thought process makes it even harder. During occasions where people are comfortable discussing the intricacies of sex, those few conversations often center on cisgender male pleasure.
“Most people are not raised talking about sexuality and reproductive health around the dinner table,” sex and relationship therapist Mary Fisher told Helloflo. “Thus, most aren’t competent talking about it, and most feel very uncomfortable trying. An implicit message many people learn is that reproductive anatomy and physiology is taboo, unless it is packaged in a sexualized form for the enjoyment of others.”
Fisher added that those with pelvic floor disorders suffer higher rates of clinical depression and anxiety, understandably so. Additionally, many experience shame associated with their symptoms, therefore holding themselves back from sexual activities.
There are a few ways to treat the mental health aspect to pelvic floor disorders. First off, healing a pelvic floor disorder through surgery, physical therapy, and similar procedures helps alleviate the problem directly. Oftentimes, those with these medical conditions endure some type of pelvic trauma, such as complications during childbirth.
“Things like episiotomies, perineal tears during labor or an assisted delivery with a vacuum or forceps may lead to pelvic floor disorders,” explained pelvic floor therapist Rachel Gelman. “Pelvic floor physical therapy is helpful in treating scar tissue that may have resulted from an episiotomy, [which is] tearing during vaginal delivery, as well as scars from a Cesarean delivery. Pelvic floor physical therapy can address any myofascial dysfunction of the pelvic floor and surrounding structures that may be contributing to a patient’s symptoms.”
Additionally, as Reuters reported, pelvic floor disorders can manifest as a result from sexual violence.
Seeing a mental health professional can benefit those with these conditions. Specifically, one option within mental healthcare is sex therapy, which is a combination of traditional psychotherapy and interventions specific to reproductive health.
“Putting words to the shame, the anxiety, depression, and any other feelings you might have about your pelvic floor disorder, with someone who is safe, knowledgeable, and comfortable talking about sexual health is absolutely necessary,” Fisher mentioned. “Shame festers when we hide or deny it. Sex therapy should also include helping partners safely put words to their feelings about the impacts of the pelvic floor disorder, so those unarticulated feelings do not serve as a barrier to connection, and prohibit partners from being active supporters.”
Also, it’s important to remember you’re not alone in this struggle. According to the National Institute of Health, more than one-third of American women suffer from pelvic floor dysfunction. (That number likely ignores trans identities.)
“Having an untreated pelvic floor disorder can be excruciatingly lonely, and shame-filled,” Fisher added. “But humans are social creatures; we cannot survive alone.”