Pelvic Health – Beyond the Physical Health
This blog has been prepared for you by provisional psychologist and placement student extraordinare, Sophie Bongers.
No doubt, pelvic health is an important part of our health – the pelvic floor (that is, the group of muscles and connective tissue that support the bladder, bowels and reproductive organs) help with so many daily functions like going to the toilet, having pleasurable sex, and engaging our cores during exercise.
Around half of Australian vulva owners report experiencing pelvic pain in a five-year period, and about one in four experience difficulties with their pelvic floor. These figures underestimate the true scale, as they do not include all genders (yes, everyone has a pelvic floor!).
Despite how prevalent pelvic health challenges are, it is common for people to feel isolated and ashamed, or even not believed when seeking help. Whether it’s bladder urgency, incontinence, erectile dysfunction, painful sex, or recurring UTIs, these issues can significantly impact how we see ourselves, how we relate to others, and our overall wellbeing.
When Life Gets Tense, So Does Your Pelvis
When thinking about managing pelvic health concerns, the physical symptoms, such as pain discomfort, or bodily changes, are often the focus. But there’s more to the story. The emotional, psychological, and social aspects of health also intersect with pelvic health and impact how we experience and manage pelvic health difficulties.
One way in which these aspects of health can intersect is reflected in our “fight or flight” response to stress. The “fight or flight” response results in our cortisol levels rising, digestion changing, and muscles, including the pelvic floor, tightening in our body. Experiencing this stress response for a long time can then cause inflammation and muscle tension, including in the pelvic floor. This can reduce your ability to control your bladder, bowels, and muscles, which then contribute to difficulties such as incontinence, bladder and bowel urgency, and pain. Moreover, experiences of some traumatic stress can result in protective physical responses, such as involuntary tightening of the pelvic floor and dissociation.
The impact of these stress responses on pelvic health can then feed back into our mental health, including through experiences of shame, social isolation, and pain. They can also reduce our capacity to engage in actions that support all types of health, such as movement, social connection, sleep, eating, and rest. It’s a tough cycle: pelvic health impacts mental health, which then impacts pelvic health!
Persistent Pelvic Pain
Persistent pelvic pain is another topic that would likely require its own blog post (A Sequel?) but is important to acknowledge here. Chronic pain is real pain, but the way we relate to it through our thoughts and feelings can change how we experience it. For example, thinking “this period pain will never go away” or limiting movement to avoid pain can actually turn up the volume on our experience of it. Similarly, our emotional state can affect our pain experience – like how stubbing your toe feels way worse after your husband’s affair is exposed via a Coldplay kiss cam (big ouch!). The context around our pain changes how we experience it.
Where Psychology Fits In
Pelvic health is complex, which means that you may benefit from a multidisciplinary approach, including pelvic floor physiotherapists and gynaecologists, to help manage challenges. Psychological support can also be a valuable part of turning down the volume on pain and managing pelvic health challenges. Psychologists can provide a space to explore how your internal world is impacting your health and how your health is affecting your life. Psychotherapy can support you to:
- Address relationship challenges, including sexual intimacy
- Navigate identity shifts that come with chronic health conditions
- Understand and manage stress and anxiety
- Process trauma and its impact on the body
- Learn ways to calm your nervous system
- Manage chronic pain
- Build trust and connection with your body again
- Improve sleep, mood, and overall quality of life
Working with a psychologist who has knowledge about pelvic health can be a real game changer. If you’re ready to take the next step, reach out! I’d love to hear from you.
To book an appointment with Sophie or any of our team of psychologists and psychosexual therapists head to https://havenpsychology.com.au/book/
