pelvic floor physical therapy

RECENT POSTS

The Checkup: Yes, Really. One-Third Of Women Have Pain During Sex

A while back we wrote about a national sex survey that found one-third of women experienced pain during sex. There were skeptics back then who thought, nah, that can’t be possible, otherwise we’d be having a nationwide conversation about how to fix such a huge problem. But now, the lead author of that study, Debby Herbenick, a researcher at Indiana University, co-director of the Center for Sexual Health Promotion, and a sexual health educator at the Kinsey Institute, confirms those numbers in a follow-up survey.

The Checkup

We discuss these surprisingly high numbers, and other new findings, in the second episode of our new podcast, The Checkup, which is just out at Slate.com here. (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The theme of podcast #2: “Matters Below The Waist.” This segment features frank talk about sex problems — and some solutions. We delve into Herbenick’s fascinating research on pain during sex and more (including personal insights from one of our hosts…) and speak with a physical therapist who specializes in various treatment options that can help women deal with this rarely discussed but incredibly widespread problem.

Not to leave men out, we also explore a little-known disorder called Peyronie’s disease, in which the erect penis becomes crooked, sometimes making it difficult to have intercourse. (Yes, this came up during the Bill Clinton impeachment era, and there’s more on that in the podcast.)

Herbenick’s initial survey of sex in America was the largest nationally representative study of sex in the country; her team surveyed 6,000 men and women, ages 14-94, and asked them about their sexual behavior.

Results of the latest survey (which Herbenick says were presented at an International Society for the Study of Women’s Sexual Health annual meeting) are expected to be published in several months.

In the meantime here, lightly edited, is more from my interview last week with Herbenick, also the author of several books, including Read My Lips: A Complete Guide to the Vagina and Vulva and Sex Made Easy: Your Awkward Questions Answered-For Better, Smarter, Amazing Sex:

DH: We did another national survey of sex in America. And this time, knowing that we had this stark difference between how women and men experience pain during sex – only 5% of men reported any degree of pain, and most of theirs was mild, too. We did ask a series of follow-up questions. This time, for people who did experience pain, we collected information about how long the pain lasted, where in their body it was located, whether they told their partner, what they did in response to the pain, and we also separated it by vaginal and anal intercourse.

RZ: What else did you find?

So the first thing that was important is the 30% number is still there. And that’s important because it does show that it’s a stable and reliable estimate, which some people in the media had questioned [whether] it could really be that that number of people experienced pain — Continue reading

Special Report: My Quest For Pain-Free Sex, Part II

“Does your pain occur with ‘deep penetration’ or is it more like a ‘ring of fire,’ at the opening?”

This is the kind of question you get upon entering the world of pelvic floor physical therapy. That is, if you’re lucky enough to find out that the therapy even exists.

Recently, I wrote about my experience suffering from pain during sex, and how I found relief from pelvic floor physical therapy, a little-known treatment that is often overlooked by doctors. I got scores of comments from other women with similar problems — some who have lived with their pain for years. Like me, they’d never heard of pelvic floor PT, and they were thrilled to learn that there is an effective alternative to quietly enduring their extreme, often secret, discomfort.

Perhaps pelvic floor therapy might soon gain credibility: last week, a local physical therapist, Jessica McKinney, used my story as part of her Grand Rounds at Massachusetts General Hospital. She spoke to about 16 obstetrician and gynecology residents and medical students. They listened intently to her hour-long talk (edited and posted below) and when it was done, one young man walked over and asked, “What’s a Kegel?”

Pelvic floor PT is far more than Kegel exercises. So, in the spirit of enlightenment, here are a few more details (maybe too many) about my sessions at the Brigham and Women’s Hospital Department of Rehabilitation Services:

The First Visit

After my physical therapist, Rachael Maiocco, talked about the anatomy of the pelvis and relevant organs, she asked many questions about the nature of my pain. Was it deep or superficial? How intense on a 1-10 scale? Continue reading

Pain During Sex? There’s Hope In A Little-Known Treatment Option

About one-third of women experience pain during sex, says a new report. But treatment is available.

About one-third of women say they have pain during sex, according to a comprehensive new series of reports on the sexual lives of Americans published this week in the Journal of Sexual Medicine.

Debby Herbenick, one of the study’s authors, told me that number “surprised” her — she didn’t think so many women would report that kind of pain.

But it doesn’t surprise me — because I’m one of them.

Here’s my story:

Earlier this year, to put it bluntly, I started having pain during sex. For a while, I ignored it, telling myself it was probably just a passing problem that would resolve on its own. It didn’t.

I went to see my fantastic ob/gyn, Beth Hardiman, the woman who delivered my two children, and whom I trust with the most intimate details of my life. She did an exam and told me my vaginal muscles were locked in permanent spasm, like if you gripped your shoulders up to your ears and never let go.

“You need pelvic floor massage,” she said. (You can imagine what I envisioned.) “I’m giving you a prescription for pelvic floor physical therapy.”

Now, I thought I was a savvy health care consumer, having written on the topic as a journalist for the past 10 years. Plus, I’ve had two babies, so I thought I was fairly familiar with the pelvis. Wrong. I had never, ever heard of pelvic floor physical therapy. And I never realized how many complex systems — reproductive, urinary, gastrointestinal, neurological, psychological, and musculoskeletal — can be involved in pelvic pain.

Dr. Hardiman told me that many doctors hadn’t heard of it either. And if they did, they pooh-poohed the field as a bunch of amateurs blithely assigning kegel exercises to their patients. But she said so many of her patients complain of painful sex and related problems that pelvic floor physical therapy, as a specialty, should be far more recognized and respected. She gave me a list of 25 pelvic floor physical therapists in the region. The first five I called were completely booked and not taking new patients.

Then I found Rachael Maiocco, a pelvic floor physical therapist in Chestnut Hill, at the Brigham and Women’s Hospital Department of Rehabilitation Services. There was a three-month wait to see her, but eventually, I was scheduled for eight visits. Continue reading