What is the Pelvic Floor and why should you care?
What is the pelvic floor?
It is a group of muscles that everyone has in the shape of a hammock but that acts more like a trampoline (in other words, this muscle group shouldn’t sag like a hammock, but should have more flexibility like a trampoline).*
The muscles of the pelvic floor are some of our hardest working muscles: they barely ever get a break. While you can sit down and rest your legs, your pelvic floor is still holding you upright and holding your organs in place, pretty much never fully at rest.*
What is pelvic pain?
“Pelvic pain” is a catch-all term for any long-term pain or discomfort someone may experience in the genitals, pelvis, and surrounding areas. It can include sexual pain, but you don’t need to be sexually active in order to experience pelvic pain.*
Who can experience pelvic pain?
Anyone who has a pelvis can experience pelvic pain—and everyone has a pelvis! People of all ages can experience this pain, too.
We most frequently hear about pelvic pain of people who have given birth. Pregnancy and childbirth causes strain on the pelvic floor and surrounding organs. But something as simple as a sports injury or constipation can trigger pelvic pain. Sexual and/or medical trauma are also common causes.
There are two different types of pelvic pain.
Hypotonic pelvic floor: frequently caused by pregnancy. It means the pelvic floor muscles are too weak to hold organs in place, which can lead to bladder leakage, incontinence, and/or prolapse (the organs start to sag into the pelvic floor). Thankfully, these muscles can be strengthened to restore the pelvic floor to former glory!
Hypertonic pelvic floor: the muscles are too tight and in spasm and are working even harder than usual. It’s like flexing your bicep but then your bicep stays flexed and doesn’t relax. If that happened, your muscle would hurt, and would also become weak. This is why it can be tricky to treat a hypertonic pelvic floor—because the muscles are usually too tight, but there is an underlying weakness to them. They first need to be relaxed and lengthened before they can be re-strengthened.*
We don’t hear as much about this type of pelvic pain, but it is the type that is most common in younger people and/or people who haven’t given birth.
What do I do if I have pain in my pelvic floor?
It’s best to see a professional. Depending on what body parts you have and where the pain is, the gynecologist can be a good place to start to rule out any vaginal infections. If you test negatively for yeast, BV or other common infections, your pain could be the result of some other condition, like interstitial cystitis (aka “painful bladder syndrome”) or pelvic floor dysfunction. If you’re having bladder/urinary tract symptoms, a urogynecologist (an OB-GYN who also specializes in urology) may be able to help you. If you aren’t able to start with a specialist, see your family doctor first.*
Should I do kegels?
A lot of us have heard of kegels! We’re told to clench the pelvic floor muscles to make them stronger, stop bladder leakage, and even experience stronger orgasms. But kegels are actually kind of complicated because you also need to know how to properly relax your pelvic floor after clenching it, and it can be difficult to learn how to independently control a muscle group as complex as the pelvic floor. Kegels can actually make a hypertonic pelvic floor even worse!
What does Early to Bed have that can help with my pelvic pain?
Dilators: they look like dildos and usually come in sets of three to five. They are meant to insert into the vaginal canal to reintroduce the feeling of something filling it. Our favorites: Wearable Dilator Set ◆ Blush Dilator Kit ◆ Intimate Basics Dilator Set ◆ Sinclair Select Dilator Set
Ohnut: a set of interlocking squishy rings that you put at the base of a penis, dilator, or dildo. It helps you customize the depth of vaginal penetration. It’s genius!
Bumper pads: silicone devices that can either be placed as a cushiony “bumper” between the body and strap-on dildos OR can also be used in the underpants for vulvar pain or even as a soft masturbation toy.
CBD lube: CBD is the part of cannabis that doesn’t get you high. It can act as an anti-inflammatory and promote relaxation in the vagina and pelvic floor. Our staff loves this stuff! We recommend applying/inserting it about 15-20 minutes before playtime to let it the effects kick in.
Kegal balls/ben wa balls: can help you train and strengthen your pelvic floor muscles. If you already experience pelvic pain, this may not be the best product choice for you (yet)!
Our favorite books: Healing Painful Sex ◆ When Sex Hurts ◆ Healing Sex: A Mind-Body Approach to Healing Sexual Trauma
Some of our favorite pelvic health professionals on Instagram: @youseelogic ◆ @femfusionfitness ◆ @thepelvicperspective ◆ @pelvicguru1
* Excerpted from Scarleteen articles by ETB staff member Nicole Guappone: “What’s Pelvic Pain and What Can I Do About It?” and “Getting to Know Your ‘New Normal’: Tips for Sex When You Have Pelvic Pain”