Spirit of Women magazine is a national publication presented to women by hospitals and their physicians. The magazine provides up-to-date, evidence-based healthcare information and promotes our hospitals as leaders in women's health excellence.
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17 SHUTTERSTOCK WHERE DOES IT HURT? Because the pelvis has so many components, it can be difficult to isolate the cause of pelvic pain. But most likely it's not the result of an injury but rather an indication that some portion of the pelvic area isn't working properly. "Pain is a signal," says Dr. Mary Ellen Wechter, an OB/GYN at Baptist Medical Center in Jacksonville, Fla. "It's not supposed to be there all the time. It's supposed to tell us something important." The pelvic floor, the muscle that supports the pelvis, can fatigue and cramp just like muscles in your arms and legs, causing discomfort. And a weakened pelvic floor can escalate bowel irregularities and urinary incontinence or leakage. Pelvic pain also can be skeletal, resulting from aches in the hip bones and joints, or gynecological, resulting from excessive bleeding or cramping. Past trauma or emotional strain is another possible source of pelvic pain, Dr. Scordalakes says. A woman suffering from psychological stress may tense during intercourse, for example, causing unnecessary yet severe agitation in the pelvic region. LISTEN TO YOUR BODY Discovering the cause of pelvic pain can be like solving a mystery. There are many clues—is the pain sudden, or does it come on gradually? Is the discomfort related to menstruation? "Be proactive," Dr. Wechter says. "Listen to your body and have awareness." It's also important to make your OB/GYN or family doctor aware of your pelvic pain—don't assume it's something you just have to live with. Before you go in for an office visit, track your pelvic symptoms so you can relay as much information as possible to your doctor. After collecting a full oral history and conducting an appropriate exam, your physician should be able to localize the cause of the pain or bring in an appropriate specialist if needed, and suggest treatment. GETTING HELP Dr. Svetlana Naymark, an OB/GYN at Parkview Medical Center in Pueblo, Colo., recommends pelvic physical therapy as an effective way to learn how to relax or strengthen certain muscles and gain control of your pelvis and its functions. Too many patients delay seeking help, she says, but most pelvic issues should be addressed and can be resolved. "I've had patients go into depression because of their symptoms," Dr. Naymark says. "And the minute we fix Pelvic pain symptoms the problem, their life has significantly improved— their confidence is better, and they are no longer affected on a daily basis." • A how-to guide to KEGELS Pelvic pain can come in many forms, some more obvious than others. Contact your OB/GYN or family doctor if you experience any of the following: • Chronic pain. Pain during ovulation is common, but persistent pelvic pain that doesn't ease when you take over-the-counter medicine could be a sign that something is wrong. • A change in your periods. This could mean going from relatively pain-free to painful bleeding between periods or postmenopausal bleeding. • Painful urination or bowel movements. Or, you notice the presence of blood or an inability to control urine flow. • Uncomfortable sex. • Vaginal dryness or abnormal vaginal discharge. Sometimes pelvic pain or discomfort has a simple solution: Kegel exercises that strengthen the pelvic floor. Dr. Svetlana Naymark, an OB/GYN at Parkview Medical Center in Pueblo, Colo., says these easy exercises can be useful for alleviating incontinence problems, especially after giving birth, and can also help increase sexual satisfaction for both partners. Here are her suggestions for mastering the Kegel: 1. Target the correct muscles. "Imagine you're sitting on a toilet and you're urinating, and someone asks you to hold your urine and you stop—it's those muscles," Dr. Naymark says. "You try to hold it as long as you can." 2. Be consistent. Try to perform three sets of 10 Kegels a day. "You have to stick to it, just like when you go to the gym," she says. "You aren't going to see results right away, but it will help." 3. Set a schedule. Working out your pelvis is the same thing as going to the gym three to four times a week, says Dr. Naymark. "Use the timer on your phone as a reminder." 4. Don't be self-conscious. "No one has to see you're Kegeling," says Dr. Naymark. "You can Kegel on your way to work."