Get your Amazon cart ready! In 2022, more women are being introduced to pelvic therapy during and after their pregnancy. Let’s be honest. Pelvic therapy has been around for years, but with the effects of social media, influencers and this 20-30s something generation, we are not sitting back and “waiting it out” like our mamas. We are familiar with the wedding and baby registry that provides our fellow family members and friends with our wish list of what is “needed” right now. Or what we think is needed right now. Many expecting couples purchase TONS of stuff for baby and wedding prep, including strollers, onesies, matching bourbon glasses and a Vitamix. Its all for the moment and not really addressing what you actually need!
But what happens, when the season changes or you are a DINK (double income, no kids) couple and YOU actually need something for your body to keep you feeling active, confident and comfortable. There is no registry or swanky gathering to celebrate this. Most times we are left to the devices of googling and scrolling on whatever platform you enjoy. So this is my celebration of you and the self-gifting registry you need right now!
Prenatal
Honestly, women suffer with pelvic pain, like symphysis pubis, but not likely to be properly evaluated for vulvar varicosities. Yes, spider veins in your vulva. Vulvar varicosities arise when the veins in your vulva struggle to circulate the blood from your lower body and pelvis back up to your heart. Some of the changes that your body goes through during pregnancy increase your chances of getting vulvar varicosities.
Increased blood volume and blood flow to your pelvis. During pregnancy, both hormonal changes and your total blood volume increases by about 30-50% and blood flow increases to the pelvis. Therefore, your veins have to do more work to carry that extra blood back to the heart. When there’s more blood to move than these veins can handle, the blood can start to pool and swell in your veins causing varicose veins.
Although there is no way to prevent vulvar varicosities completely during pregnancy, there are strategies that you can use to reduce the discomfort they cause and prevent them from worsening. Wearing a supportive compression garment such as the V2 supporter, V-Sling, or a belly band prenatal cradle to decrease discomfort. Wear it with gravity challenging positions like walking and standing. You will find the pressure of the pelvis decreases and the varicosities are less swollen.
Post Partum
Before I stand on my soap box, c-section care in the USA is terrible. Any other orthopedic surgery like a knee replacement is seen within 48 hours of surgery to assess muscle strength, range of motion and scar healing. This is not the way with c-section rehab. The easiest way you can support your healing, once the scar is healed and no more glue remains is to start basic scar massage. During some 6-8 week post partum visits, scar massage is mentioned, but how to perform, what to use and how to safely support your healing is not addressed. There is minimal instruction other than go ahead and rub your scar with some vitamin E, coconut oil or Bio-Oil.
It's one thing to start mobilizing the scar, but it's another to know how to do it safely. A pelvic therapist can help you and we have a great blog on how to start the massage. First do yourself a favor and get a big bottle of Bio-Oil and use it when you are “cleared”. Then call a pelvic therapist and learn how to safely massage your healing scar.
Pelvic Pain
There are different types of pelvic pain people experience, but for now I am sharing products specific to intimacy and sex. Pelvic pain may not occur only during intercourse, but also with the use of a speculum during a gynecological exam, using tampons or cups, foreplay with fingers, toys or oral stimulation. The medical term many women hear related to pelvic pain with penetration is dyspareunia or vaginismus. Vaginismus is the medical term for spasms or a quick tightening of the pelvic muscles limiting vaginal insertion of a tampon, penis or speculum. Dyspareunia is the term for pelvic pain with intercourse.
Thank goodness there are brave women who are creating products to support your nocturnal adventures and create confidence in your pelvic muscles. One of my favorite products, The Ohnut (not available on Amazon, but I could not resist sharing), is like a bumper for the penetrating partner to wear and minimize the depth of penetration, thus eliminating the pain and stretching on the muscles.
Another great product is dilators. Dilators or trainers from Intimate Rose or Soul Source are beautifully crafted to help you take control and gain confidence of placing or inserting something both vaginally or rectally.
Leakage (of anykind)
Although you may feel like you are the only one who experiences leakage, many women around the world have faced the same obstacle. About one in three women will experience urinary incontinence at some point between the ages of 15 years old to 65. Every woman should feel comfortable talking to a doctor or physical therapist about this common problem. A simple short term support may be the use of Impressa.
It is like a non-menstruating tampon that supports the bladder and urethra to eliminate leakage. Some women wear during vigorous activity like running or CrossFit and all share that they do not need to wear black pants only to the gym! Yay for no leakage. When you purchase, make sure you buy the right size for you!
Another training tool to help you find the strength and coordination of your pelvic muscles to reduce leakage are vaginal weights! I love the graduated weight collection of weights from Intimate Rose.
Try it at home and let me know how it goes! It is eye opening to feel the variation of pelvic muscle strength! It is my favorite product to try in the office. If I could bottle up everyone’s facial expressions I would!
Prolapse
Pelvic organ prolapse happens when the muscles, fascia, and connective tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weakened or lax. This allows one or more of the pelvic organs to descend or press into or out of the vagina. With POP, the pelvic organs themselves are not actually damaged, it is simply the supporting structures like fascia and connective tissue that are stretched and/or injured. Compression shorts are an excellent way to create support for your perineum, especially postpartum or post surgically. We suggest a short that is more of a bicycle short instead of a "short" booty short. It will also provide compression to the vasculature and muscles of your legs.
Also the V2 Support, or Belly Bandit V-Sling can be worn over your undies and under yoga pants or leggings. While not the most sexy fashionable item, it is helpful for both prolapse and vascular pressure during and after pregnancy!
Stress Management
Chronic pelvic pain can be difficult to address―like other chronic pain syndromes like fibromyalgia, chronic regional pain syndrome and chronic low back pain―as many systems are involved. Meditation and deep breathing are prescribed to address pain and to minimize protective tensions in the pelvis or body. A fellow pelvic colleague and personally well respected instructor, Nari Clemons created a pelvic specific meditation audio you can purchase from Amazon Music. From meditating to have a pain-free poop to learning the signals of your body, this meditation is a must for soothing stress and pelvic pain.
Because the brain’s pain response involves multiple systems of the body, therefore addressing the nervous system can ultimately have a more positive effect. It’s important to understand that we need the nervous system’s “slow” system as much as we need the “go” system. One way to prime the nervous system’s brakes is to address the cranial nerves, a group of nerves closest to the brain which includes the vagus nerve and the nerves that coordinate sensory input from the eyes, the ears and taste.
The book by Stanley Rosenberg, "Accessing the Healing Power of the Vagus Nerve"
shares simple, but effective movements and stretches to sooth the Vagus nerve. A fantastic resource to nerd out on about healing, anxiety and our nervous system.
Other great adds to your cart
For muscle aches and pains is Biofreeze and Rocktape are essential.
Biofreeze is a menthol based pain relieving gel that is great for any body part! DO NOT directly on your genitalia! Best used on the glutes, lower back, knees, ankles, and shoulders!
Rocktape is a professional grade sports tape to provide stability and awareness to muscles, ligaments and joints. My favorite application for Rocktape is taping about the pubic bone for menstrual cramps or along the lower back for eliminate the pressure of sacroiliac (SI pain) joint.
Any/all of the links on www.breathelifept.com are affiliate links from with we may receive a small commission from sales of certain items. As an Amazon Associate, I earn from qualifying purchases. Thank you!
BTW: Your pelvic health will thank you with less leakage, more self empowerment and better poops! Learn More.
Dr. Amanda Heritage, PT, DPT is the owner of Breathe Life Physical Therapy & Wellness, LLC located in Collingswood, NJ. She has been practicing physical therapy for 10 years with a strong focus on pelvic health. She enjoys encouraging women and men about pelvic therapy as a treatment option for those suffering with pelvic pain, incontinence or constipation.
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