Postpartum Pelvic Pain: What You Need to Know

Giving birth takes a huge toll on the body, especially the pelvis. This means that giving birth has the potential to cause postpartum pelvic pain. The pelvis is the ring of bones at the bottom of your spine, which functions to stabilize muscles and protect organs.

When you have your hands full with a newborn, pain is the last thing you want to be dealing with, but it is a relatively common part of the postpartum healing process. The first six weeks postpartum are considered your “recovery period,” but everyone’s body heals at a different pace. It is normal for your body to need time to heal but you can proactively address pelvic pain instead of trying to wait it out. In this article, we will explore tips for preventing postpartum pelvic pain, potential causes, and how to manage pain when it emerges.

Symptoms of Postpartum Pelvic Pain

Some of the symptoms related to pelvic pain after childbirth are persistent pain in the pelvic area, hips, lower back, or pubic bone; difficulty walking or standing; and urinary or bowel issues. Factors such as type of delivery, the presence of complications, and the strength of the pelvis before childbirth will all influence which symptoms you experience. There are multiple possibilities for causes of pelvic pain, so a medical professional can help determine which one is contributing to your symptoms. The following section describes a few of the potential causes. 

Causes of Postpartum Pelvic Pain

Changes in the Pelvic Floor

Pregnancy and childbirth stretch and weaken pelvic floor muscles, which are connective tissues supporting pelvic organs like the bladder, rectum, and uterus. They serve to stabilize the spine and assist with continence. 

Pelvic Girdle Pain/Symphysis Pubis Dysfunction

Pelvic Girdle Pain (also known as Symphysis Pubis Dysfunction) happens when the ligaments that keep your pelvic bone aligned are too relaxed due to the hormone relaxin. While your body is supposed to produce relaxin before birth to allow for the baby to pass through, sometimes it produces too much, meaning your pelvic bones do not have the appropriate support and in turn, cause pain afterwards.  

Trauma from a vaginal delivery

There is, unfortunately, an association between vaginal delivery and ensuing urinary incontinence and pelvic organ prolapse. Pushing out a baby puts strain on the pelvic floor and weakens those muscles, leading to postpartum pelvic pain.

How to Prevent Postpartum Pelvic Pain

If you have yet to give birth, there are steps you can take to prevent or mitigate pelvic pain both during pregnancy and postpartum. These tips are not guaranteed to help you avoid pelvic pain altogether, but they may decrease the odds of experiencing it, or at least decrease the intensity of the pain you experience.   

Exercise your pelvic floor

Since pelvic pain is in part due to a weakened pelvic floor, working on strength building both before and after giving birth helps with postpartum recovery. Everyone’s body and postpartum challenges are unique to them, so it is best to do these under the guidance of a professional pelvic floor physical therapist. If that is not accessible to you, there are plenty of resources online that demonstrate some of these exercises. It is important to be aware of your body’s limitations and to stop if you experience an inordinate amount of discomfort or pain.      

Maintaining good posture

Though good posture is challenging to maintain when you have the weight of a pregnant belly pulling down, it will alleviate strain on the pelvic area. Good posture is also important postpartum, especially since early parenthood involves lots of lifting and bending.  

Move gently interspersed with rest

Staying active during pregnancy is vital to prepare your body for the strenuous nature of labor. Gentle forms of exercise like walking and stretching promote flexibility and blood flow without putting too much strain on the body. Equally important as exercise is to rest and avoid overexertion.

Wear comfortable footwear

Everything in the body is connected and affects other parts of the body. Even though your feet are not close to your pelvis, supportive shoes support spinal alignment and in doing so, reduces strain on the pelvis.

Use supportive devices

Maternity belly bands provide support for your belly and back can alleviate strain on your spine and pelvis.   

Treatments for Pelvic Pain

If you have already given birth and are experiencing postpartum pelvic pain, you have options for addressing it. The tips can still support your recovery if it is too late to prevent the pain. Additionally, you can take NSAIDs like acetaminophen, use a heating pad, get rest, and work with a pelvic floor physical therapist. Note that you should speak to your doctor as soon as possible about your concerns; they can give you specific guidance for the treatment options best suited to you    

The bottom line 

Understanding the potential causes, incorporating prevention strategies, and seeking appropriate treatment are the best ways to approach postpartum pelvic pain. Every person’s experience and body is unique, and healing timelines and trajectories will vary, which is why it is important to consult a qualified pelvic floor physical therapist and/or a sex therapist. Finally, though easier said than done, try to be patient with your body. It has just been through significant trauma and challenges, so health complications as a result are to be expected. By educating yourself and using available resources, you may feel more supported on the journey of postpartum recovery.     

Pelvic Congestion Syndrome: Causes, Symptoms, and Treatments

Chronic pelvic pain is a common occurrence among people assigned female at birth, affecting an estimated 15% of people of childbearing age in the United States. One of the causes of pelvic pain is pelvic congestion syndrome (PCS). PCS occurs when varicose veins develop around the ovaries. Varicose veins are twisted, enlarged veins that most often appear on the legs because standing and walking cause the blood to engorge the leg veins. Most of the time, varicose veins are completely benign and painless but when they appear on the ovaries, they can cause pain and discomfort. The exact cause is still unknown but pregnancy and estrogen can both play key roles in making the veins structurally unsound. Any type of chronic pain can be disruptive to your life so it is important to learn about the cause of your pain and what your treatment options are. This article will cover the symptoms of pelvic congestion syndrome, how it affects one’s sex life, and the treatment options that exist. 

What are the symptoms of pelvic congestion syndrome?

Dull and achy pelvic pain is the primary symptom of PCS, but it can manifest as a sharp pain as well. The pain can be exacerbated after standing or sitting for a long time, before and during menstruation or sexual activity. Additional symptoms include varicose veins in other places like the pelvis, buttocks, and vulva, an irritable bowel, stress incontinence, and pain with urination.   

How does pelvic congestion syndrome affect one’s sex life?

As mentioned above, pelvic congestion syndrome and the associated pain tends to be exacerbated by sexual intercourse. This not only poses physical obstacles to having sex, especially penetrative sex, but chronic pain can also cause a low libido. That does not mean that you can never achieve a fulfilling sex life though. In addition to the PCS treatment options below, there are ways to have great sex without penetration. You can engage in alternative forms of intimacy, like mutual masturbation, give and/or receive a sensual massage, or cuddle skin-to-skin. There are also ways to try to boost your libido, if you so desire. None of these options provide a permanent solution, but there are treatment options that can make it easier to live with PCS. 

   What are the treatment options for pelvic congestion syndrome?

Diagnosing pelvic congestion syndrome is not easy because the symptoms are easily conflated with other conditions and there is no test that will outright prove that PCS is the culprit. For this reason, doctors will typically run tests to rule out similar conditions, as well as use imaging like ultrasounds. Ultrasounds provide a view of the soft tissue; if more detailed imaging is required, a doctor may opt for an MRI or CT scan. The goal of diagnosis and treatment is to reduce or relieve pelvic pain, but there is unfortunately no known cure for PCS. The treatment you and your doctor pursue will depend on factors such as the severity of your symptoms and your medical history.

Treatment options for PCS may include: 

• Gonadotropin hormone drugs. Gonadotropins are hormones that regulate ovarian function; they are essential for growth, development, and reproduction functions. These drugs can block ovarian function and therefore relieve some pain.  

• Progestin hormone drugs. Similarly to gonadotropins, progestin drugs are hormonal drugs that serve to relieve pain by assisting the regulatory function of your reproductive system. 

• Sclerotherapy or embolization. A sclerotherapy is a typical treatment option for any varicose veins, including pelvic veins, such as is the case for PCS. It involves a needle that injects a solution which causes the damaged vein to scar and eventually fade as blood is rerouted to healthier veins. A similar concept but different execution is gonadal vein embolization is a minimally invasive treatment that involves a small incision for a tube that is used to dispatch a sclerosant that blocks the vein, therefore guiding the blood to healthier vessels, similar to how sclerotherapy works. 

• Oophorectomy or Hysterectomy (to remove your uterus and ovaries). An oophorectomy (removal of the ovaries) and hysterectomy (removal of the uterus) are reserved for the most severe cases of PCS after milder treatments have failed. However, these procedures have been shown to be a very effective treatment for PCS pain in treatment-resistant cases.

The Bottom Line

Pelvic congestion syndrome is a taxing condition that has the potential to significantly impact your quality of life, particularly your sex life. However, with a proper diagnosis and treatment plan, you can find relief. If you suspect you have PCS, you should consult with a healthcare professional to explore your options. Additionally, if you need extra support for your mental health and/or your libido and sex life due to the chronic pain, consider reaching out to a therapist.   

Disclosing an STI: Tips on How to Tell Partners

Written by Seth Taylor, ALMFT

Beginning a new romantic relationship can be an exciting and nerve-racking experience. As you get to know someone on a deeper level, it's natural to consider when and how to disclose personal information, including your sexual health status. If you have a sexually transmitted infection (STI), the question of when to disclose can feel daunting. This blog will discuss some considerations for navigating disclosure and finding the right time to share your STI status with a partner. Here are some things to consider before disclosing:

Understand the Importance of Disclosure  

The first step in navigating disclosure is understanding the importance of being honest and transparent with your partner about your STI status. Some people may wonder, do I legally need to disclose my STI? In some jurisdictions, disclosing your STI status is an ethical responsibility and a legal requirement. It allows your partner to make informed decisions about their sexual health, such as choosing a partner, understanding potential health risks, and taking necessary precautions, like using condoms or other barrier methods and keeping an eye out for sores, redness, or other STI symptoms. Additionally, open and honest communication about sexual health fosters trust and intimacy in a relationship.

Educate Yourself about Your STI

Educating yourself about your STI before disclosing your status is important. Understand how it's transmitted, the potential symptoms, treatment options, and ways to reduce the risk of transmission. This will enable you to have an informed conversation with your potential partner and answer any questions they may have.

Consider the Timing

When it comes to disclosure, timing is crucial. There's no one-size-fits-all answer as to when is the "right" time to disclose, as it depends on the dynamics of each relationship. Oftentimes, it can be helpful to have the conversation outside of a sexually charged environment and when both partners appear to be in an amiable mood. It's generally recommended to have a chat before any sexual activity occurs. This allows you and your partner to make informed decisions about the level of risk you're comfortable with. In contrast, having the conversation right before sex or after sex may produce mistrust between partners.

Create a Safe Space for Conversation  

You may be asking yourself if it is okay to disclose via text. Texting may not be the best option unless you are questioning your safety due to revealing it. Creating a safe conversation space is important when you decide to tell your STI status. Choose a private and neutral setting where you and your partner can feel comfortable and relaxed. Be open, non-judgmental, and willing to listen to their concerns or questions. Remember that the conversation should be two-way, allowing both parties to express their feelings and concerns.

Be Honest and Transparent

Honesty and transparency are the values at the heart of this concept we are exploring. Provide accurate information about your STI, including how you acquired it, if you're currently on treatment, and what steps you take to manage it. Avoid any temptation to downplay or minimize your STI status, as this can erode trust in the relationship.

For example, your conversation may sound like, “I want to have an open and honest conversation with you because I value our relationship and believe in transparency. Recently, I was diagnosed with [specific STI]. I want you to know I am taking proactive steps to manage my health, including following the recommended treatment plan and practicing safe sex. I understand the importance of disclosing this information to you so that you can make informed decisions about your health. I am here to answer any questions you may have and respect whatever decision you make moving forward. Our health and well-being are both important, and I believe that open communication is crucial in maintaining trust and understanding in our relationship.”

Anticipate Reactions and Prepare for Possible Outcomes

You may wonder if disclosing your STI will be a dealbreaker for your relationship. It's important to be prepared for various reactions from your potential partner when disclosing your STI status. They may have questions, concerns, or emotional responses. They may need time to process the information, seek further information, or discuss it with their healthcare provider. Be patient and understanding, allowing them to process their feelings.

Respect Your Partner's Decision

After disclosing your STI status, you must respect your partner's decision, whatever it may be. They may choose to continue the relationship with appropriate precautions, or they may decide that they're not comfortable moving forward sexually. Respecting their boundaries and choices without pressuring or guilt-tripping them is important. Remember that everyone has the right to decide about their sexual health.

Take Necessary Precautions

You may wonder if it is safe to continue dating someone who has disclosed an STI. If you and your partner are sexually active, consider taking precautions to prevent the transmission of STIs. This may include using condoms or other barrier methods, getting regular STI screenings, and following recommended treatment plans, such as taking an antiviral, if applicable. It's important to communicate openly with your partner about sexual health and continuously assess and mitigate the risk of transmission.

Prioritize Self-Care

Living with an STI can be emotionally challenging, and disclosure can bring up a lot of emotions. It's essential to prioritize self-care and seek support when needed. This may include talking to a therapist, joining support groups, or confiding in trusted friends or family members. Taking care of your emotional well-being can help you navigate disclosure and build healthy relationships.

Remember That Your STI Does Not Define You 

So is having an STI a big deal? It's important to remember that your STI status does not define your worth and value. Having an STI does not make you any less deserving of love, respect, and fulfilling relationships. It's just one aspect of your life. Be kind to yourself and practice self-compassion as you navigate disclosure and relationships.

Takeaway

Disclosing your STI status to a sexual partner can be a challenging but necessary step in building healthy relationships. With open communication, mutual respect, and understanding, building meaningful and fulfilling relationships is possible while managing your sexual health. Remember that every situation is unique, and it's essential to consult with a healthcare professional or a qualified therapist for personalized guidance and support in navigating disclosure and managing your sexual health.