Heal Pelvic Pain - by Amy Stein, New York, NY

Frequently Asked Questions

What is pelvic floor dysfunction?

Pelvic floor dysfunction is a disorder in the muscles and/or nerves of the pelvic floor, or in the surrounding skeletal structure. It is extremely common to have a dysfunction in the pelvic floor: The pelvic floor muscles surround the urethra, rectum, vagina and prostate; therefore, if there is a dysfunction in these muscles it can result in urinary, bowel or sexual dysfunction in men, women and children.
How does one get pelvic floor dysfunction?

The occurrence of pelvic floor dysfunction is typically multi-factorial and difficult to identify. It can be the result of a traumatic fall or childbirth or from abdominal or pelvic surgery. It can occur due to poor posture, muscle incoordination, disuse atrophy, a chronic holding pattern in the pelvic floor, from a urinary tract or yeast infection or from a skeletal malalignment.
Who should one see to get a proper diagnosis?

It is essential to get a proper diagnosis and that would come from a healthcare practitioner that specializes in pelvic floor dysfunction/pelvic pain. Too often I have had patients come to my office and say they have been to 10 different doctors and healthcare providers and their symptoms have not improved, or have worsened. Also, many healthcare providers will state that "it is in your head". They do not assess (or they do not know how to assess) the pelvic floor muscles and nerves.
Why do you think healthcare providers have difficulty diagnosing pelvic floor dysfunction?

Part of this is due to the fact that there has been little research on the subject. Although in the past 10 years an abundant amount of research has been published and now a lot more schools are starting to teach the medical students and healthcare students what pelvic floor dysfunction is and how to diagnose it.
Why should people read this book?

There are no books out like this one, that is so helpful and user friendly to the lay person. People who suffer from any of the above-mentioned syndromes or symptoms will benefit from the program in this book: from the massage and stretching to the self-care and nutrition. It is also beneficial for prevention of pelvic floor dysfunction, incontinence and to enhance sexual activity for women and men. The book and the exercises in the book are clear and easy to follow. It also offers helpful resources for the various diagnoses.
Explain the exercises that you prescribe and whom they will help.

There are 2 different Programs:
#1: refers to those that experience pelvic, abdominal, hip and/or back pain and any disorder that has an increase in the pelvic floor muscle tone. Both of these can result in tight or spasmed muscles which commonly results in an inability to relax the pelvic floor muscles. In turn this can affect bladder, bowel, and/or sexual function. The exercises to help with this diagnosis are described in Chapter 3-End the Pain and Chapter 5-Massage
#2: refers to pelvic floor and possibly core muscle and tissue weakness resulting in incontinence, pelvic organ prolapse (organs dropping) and/or decreased sexual response. Chapter #4 will help, and/ or completely eliminate these problems through strengthening the pelvic floor and core muscles.
How does one know if there is improvement from the exercise programs?

In Chapter 2, there is a "symptoms" monitor which allows you to track your symptoms through the programs. There are also recommendations of how and when to advance each program according to how you are progressing.
How is sexual activity affected?
Sexual activity can be affected in 2 different ways, similar to what is described above:
#1: pain or discomfort with sexual activity may be the result of tight pelvic floor muscles, irritated vaginal tissue, and more. Chapters 3 and 5 offer techniques to cure this type of sexual dysfunction.
#2: weakness resulting in decreased libido and sexual response. Chapter 4 discusses pelvic floor and core strengthening to enhance sexual function.
At what age does this occur?

Pelvic floor dysfunction can occur as early as 4 years old and into the elder years. For children, it is common to suffer from pelvic floor muscle incoordination whereas the elderly tend to suffer from weakness due from disuse; although, all ages can be diagnosed with any of the diagnoses described in this book.
Are there any nutritional guidelines offered in the book?

The book offers basic tips for better bladder and bowel health, which in turn results in a healthier pelvic floor.
Whom would you recommend this book to?

Anyone that suffers from any type of pelvic floor disorder: men, women or children. As well, the book discusses preventative measures for overall good health and wellness.