Asking for a friend: Is sex supposed to hurt? A Q+A with Lauren Campbell, a Pelvic Physiotherapist

We sat with Lauren Campbell, a pelvic physiotherapist to answer some burning questions that we had about pelvic health. We hope you enjoy getting to know her as much as we did.

DIEM: For someone that thinks physio only exists in the realm of a high school soccer injury, can you explain a little bit about what you do?

LAUREN: As a pelvic physiotherapist, I see a wide variety of patients of all ages, all who are experiencing pelvic floor dysfunction. Our pelvic floor muscles and associated soft tissues are structures that play an important role in bladder, bowel and sexual function. If these tissues are not functioning properly, one can experience incontinence (this is the loss of control of urine or stool), pain, and sexual dysfunction, among other issues. Our pelvic floor muscles are both external and internal and in order to truly evaluate and treat these structures, an internal evaluation (vaginal and/or rectal) is typically performed.

DIEM: How did you decide you wanted to do this?

LAUREN: I learned about this unique scope of physiotherapy while living in New York City 10 years ago. I began taking courses and mentoring and soon realized how rewarding it was to help patients overcome pain during sex, pelvic pain, as well as issues with urinary frequency and urgency, just to name a few. This is a hugely under-serviced group of patients who are SO APPRECIATIVE to be able to gain normal function again upon receiving treatment.

DIEM: Why is pelvic floor health so important?

LAUREN: In Maslow’s Hierarchy of Needs, peeing, pooping and having sex are at the bottom of the pyramid. These activities should not only be easy, but should be rewarding. When we either have trouble with these routine activities or have pain completing them, it becomes very difficult to engage and focus on other aspects of life. Our pelvic health is at the root of our general health and well-being.

DIEM: In terms of women in their reproductive years, what are the most common things women visit you for?

LAUREN: The most common complaint we treat is pain during sex. This can be as a result of childbirth (vaginal birth or C-section!), persistent pelvic pain conditions like endometriosis or sometimes these muscles are just plain tight! Of course stress and anxiety don’t help, but many times, we see women who have never been able to have comfortable penetrative sex and it becomes this vicious circle of pain and tension. We tighten up more in anticipation of sex hurting, it then hurts more, we want to relax but we can’t… and so the story goes.

We also see women during pregnancy for pelvic girdle pain, pubic symphysis pain and low back pain and also to help optimize labour and prepare for delivery. There is so much we can do to help prevent problems that routinely occur during delivery. ****

DIEM: What about women who are perimenopausal or menopausal?

LAUREN: This is another common age group for women to begin experiencing pain with sex! With the declining levels of estrogen, our tissues change and this can be a major contributor to pain during sex. Please know that at no time in life, is it normal for sex to hurt. Women may also start experiencing incontinence at this time of life as well. Again, these are just muscles and they too, need time and energy devoted to them, just like the rest of our body does, if we expect them to age well and function optimally.

DIEM: If you had to give advice to the women of the world about their pelvic health, what would you say?

LAUREN: Leaking urine is not normal! Sex should be enjoyable and pain-free! If you have any concerns about this area of your body, reach out to a pelvic physiotherapist (we would love to see you at Advanced Pelvic Physiotherapy Centre).

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