Taming Period Pain with Pelvic Floor Therapy — Don't Suffer in Silence!
Periods shouldn't be torture. Dysmenorrhea – cramping menstrual pain – affects up to 90% of women in their reproductive years 1. The pain often radiates to the lower back, thighs, and pelvis, and can be accompanied by nausea, diarrhea, headaches, or backache 2. Yet the solution isn't always pills. The pelvic floor – a hammock of muscles in the pelvis– supports the uterus, bladder and bowels 3. When those muscles are tense or out of sync, menstrual cramps can worsen. In fact, a clinical study found that targeted pelvic floor manual therapy combined with exercises significantly reduced menstrual pain 4. Pelvic health therapists use hands-on techniques (trigger-point massage, myofascial release, visceral mobilization and gentle joint work) to release pelvic muscle tension and improve circulation 5.
At home, you can help the process. Slow diaphragmatic breathing and relaxation exercises can help calm down your pelvic floor. Research shows that various exercise interventions, particularly stretching exercises, can effectively reduce menstrual pain 6, while a meta-analysis of randomized controlled trials found yoga to be an effective intervention for alleviating menstrual pain in primary dysmenorrhea 7. Simple yoga poses (Child's Pose, Happy Baby, gentle hip stretches) help open the pelvis and may ease cramping. Even adding heat is backed by science: applying warmth (a heating pad, hot bath or warm pack) relaxes muscles and cuts menstrual pain intensity 1. (So yes, cozy heat packs or an Epsom-salt soak are fair game.) In short: pelvic therapy can reduce tight muscles, improves blood flow and nerve movement, and often makes periods far more bearable 4.
Red Flags in Menstrual Pain
Most period pain is common, but it is always a good idea to speak to a health care provider, but there are certain "red flags" to look out for. These include:
- Progressively worsening or late-onset pain: If pain has suddenly worsened over months or started after years of painless periods, investigate underlying causes (endometriosis, fibroids, pelvic adhesions, etc.) 1.
- Abnormal bleeding or discharge: Heavy, prolonged flow with or without clots larger than a quarter which can suggest a gynecological issue, such as uterine fibroids or adenomyosis 8. Foul-smelling discharge or fever may signal infection 9.
- Pain that disables daily life: Cramping so severe that it sidelines you from work, school or exercise is more than "normal". Over one-third of women with dysmenorrhea miss work or school during periods 10, so consult a specialist if cramps consistently knock you out.
- Systemic symptoms: Severe nausea, vomiting, fainting or chest pain with menstruation are not benign. Even though rare, fainting or collapse can occur in very severe cases 11. Unrelenting pain unresponsive to NSAIDs or other OTCs also warrants a full evaluation.
If any of these occur, a pelvic exam and a transvaginal ultrasound may be needed to rule out secondary dysmenorrhea causes.
Beyond the Uterus: Bladder, Bowel and More
Remember: the bladder, uterus and rectum all live on that same pelvic "house" Pelvic floor dysfunction can manifest as bladder or bowel trouble. Tense pelvic muscles can cause urinary urgency, frequency, pain or hesitation 12, even incontinence. Patients may even feel like they have a chronic UTI ("it hurts to pee!"), yet cultures return negative – because the real culprit is muscle spasm, not infection 13. Likewise, constipation and incomplete emptying are classic signs: people with chronic constipation often have undiagnosed pelvic floor dysfunction 12. In one study, patients with pelvic pain reported high rates of constipation, painful bowel movements, and bloating 13.
Pelvic therapy addresses all of this holistically. By teaching proper toileting posture, breathing techniques, exercises to learn how to properly push and myofascial release of the pelvic floor and surrounding muscles, therapy can restore bowel and bladder function. Patients with pelvic floor tension often report improved bowel movements after just a few sessions.
Another common complaint: pain with sex. According to the American College of OB/GYN, about 75% of women will experience painful intercourse at some point 14.While it is common it's definitely not something a person needs to accept. Pain during penetration or even non-penetrative sex is often caused by a guarded, spastic pelvic floor. An overactive pelvic floor can make any entry painful and thwarts arousal and orgasm 15. Likewise, tension can irritate nerves near the clitoris, causing pain with touch or climax.
Fortunately, dyspareunia (painful sex) is highly treatable. Pelvic PT can teach you to relax or down-train a tense pelvic floor through exercises, external and internal massage, and gradual stretching. Many patients feel much more comfortable after a few sessions. In short, whether your pain is menstrual or sexual, pelvic floor therapy offers solutions.
If you're experiencing menstrual cramps, chronic pelvic pain, bladder/bowel symptoms or pain with sex, don't suffer in silence. Pelvic floor therapy may help. Consider scheduling a 30 minute consultation to discuss what might be going on and determine the next best steps!
(As always, this post is for educational purposes only and not to be taken as medical advice and is not a medical diagnosis. Please speak with a healthcare provider near you to discuss specific concerns and questions.)