Pelvic Pain and Stress

2020 has been stressful, ya’ll!! HELLO 2021 with open arms. Have you met anyone that did not have some form of stress in their life this year? Stress has always made an impact on the pelvic pain patients that I see but, in 2020, stress was comfortable in the driver’s seat and we were mostly all hanging on to the “oh crap” handle, flying 150mph on the COVID train. 


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Cleveland clinic defines stress as the following “Stress is the body’s reaction to a change that requires an adjustment or response.  This can be physical, mental, emotional, or a combination” This can be positive or negative from a change that came from your environment, your body, or your thoughts.  Reaction to stress is meant to protect you and the response serves a purpose…survival. 

The biggest culprit for negative affects of stress is the hormone cortisol.  Cortisol releases glucose into the bloodstream, helps substances repair tissues, and turns off non-priority systems for survival (digesting, immunity, reproductive, and growth). When survival is the goal, there is no time for absorbing food, arousal, or sleeping peacefully. As we face the demands of daily life or you know, the challenges of a global pandemic, your body sees these demands as threats. Chronic stress (from negative changes) or “fight or flight” mode can lead to problems in sleep, mood (depression/anxiety, motivation, and fear), digestion/mal- absorption, reduced immunity, increased inflammatory processes and hypersensitive nervous systems leading to pain.

Stress can ignite or amplify pelvic pain.

What is pelvic pain?

Pelvic pain can be an acute or chronic condition that affects both men and women.  Symptoms of pelvic pain can arise from the functions of the urinary, reproductive (vaginal or penile tissues), gastrointestinal, and musculoskeletal system (pelvic floor, spine, hips, and abdomen).  Some examples of pelvic pain may be present when you urinate, have a bowel movement, engage in sexual activities, or even at rest.  Dysfunction and discomfort in the pelvis can greatly affect function and overall quality of life.

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Some examples of pelvic pain diagnoses:

  • Male Pelvic Pain (Prostatitis, Testes, Penis)

  • Vaginismus

  • Vulvodynia

  • Vestibulodynia

  • Dyspareunia

  • Painful Scar Tissue Postpartum

  • Interstitial Cystitis

  • Painful Bladder Syndrome

  • Pudendual Neuralgia

  • Endometriosis

  • Fibromyaglia

  • Chronic Constipation

  • Irritable Bowel Syndrome

  • Abdominal Pain

20% of women will suffer from pelvic pain at some point in their lives. (3)

Up to 2 million men in the United States meet the diagnostic definition for persistent pelvic pain. (4)

When you are in pain it is typically all you can think about. This pain forces you to be mindful but not usually in a positive regard.  Often with pain, fear is present and we can become overwhelmed with what the pain could be or mean, the result, secondary mindful suffering. No FUN!  Psychologically, we then further induce the stress cycle. 

Concentrating on improving your mental health is a key component to your healing. Nurturing a positive mental health experience comes from inner reflection and stress management.  If you don’t know where to begin, I’m a huge advocate of seeking out mental health professionals to help guide you on this journey to identify the stressors in your life. 

This is a great resource on tips to begin stress management approaches:

https://www.helpguide.org/articles/stress/stress-management.htm

Pelvic floor physical therapy can help to approach and intervene on the balance of mind-body influences of pelvic pain.  We address the underlying “why” to treat you holistically for a path of healing. 

Every storm runs out of rain.  Lets bring the sunshine back!

Resources:

https://my.clevelandclinic.org/health/articles/11874-stress   

https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

3. G Apte et al. “Chronic Female Pelvic Pain: Part !” Clinical Pathoanatomy and Examination of The Pelvic Region,” Pain Practice 12(2012): 88-110

4. G. Habermacher, J Chason, and A Schaeffer, “Chronic Prostatitis/Chronic Pelvic Pain Syndrome, “ Annual Review of MEdicdine 57 (2006): 195-206

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