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Ten Reasons Why Sex Hurts

Posted: Friday, January 9, 2015 at 8:49:15 AM EST by Alyssa Tait

Ideally, sex is a loving connection between two people – so what does it mean when sex hurts?

You’re not in the mood.

Sometimes, you are too tired or just not up to it. You can choose to say no at these times, or alternatively, you can choose to get into the mood. Focus on emotional connection and lots of foreplay – or only foreplay.

Your body is telling you no.

Pain with sex can be your body’s way of telling you something’s not right. There are many reasons for this, including emotional. If you’ve had negative sexual experiences or a history of trauma to this area, pay attention to your body’s signals.

Your libido is shot.

Sexual pleasure and libido often go together. While it is possible to get yourself in the mood and enjoy it even if your sex drive is low at the outset, it makes more sense to take steps to increase your sex drive.

Medication is having an effect.

Lots of meds can reduce libido. Are you on the Pill? On antidepressants? Ask your pharmacist if this could be killing your sex drive.

It’s not the right time of month.

At certain times of month, you may be more in the mood than others. Vaginal dryness is also normal for many women at certain times of month. Aim to learn more about the effect of your hormones on the environment down there.

Blame your hormones.

A drop in oestrogen tends to lead to vaginal dryness. After a while, this can lead to deterioration in the tissue quality, sometimes called vaginal atrophy or atrophic vaginitis. This is common after menopause, and when breastfeeding.

Things aren’t right down there.

If you have thrush or a urinary tract infection, things definitely won’t feel good with sex. Get this checked out and treated.

Your IBS is playing up.

The bowel and the vagina ‘’speak’’ to each other, so a flare-up of your irritable bowel can have the effect of putting the vagina ‘’off limits’’.

You’ve got vaginismus.

When your vaginal muscles are in spasm or tense up and cause pain with sex, this needs professional treatment. A pelvic floor physiotherapist with specific experience with vaginismus can help you.

You’ve got ‘’provoked vestibulodynia’’.

Vestibulodynia, sometimes called vulvar vestibulitis, tends to overlap with the vaginismus described above and with a condition called vulvodynia. This is a highly complex condition that needs treatment by an experienced and qualified clinician. But to get an idea, try my quick Vulvodynia Self Test to see if it's likely that you have it.

Of course, this is not a complete list, but it may give you a starting point. Understanding the cause allows you to take action to help. Some causes are simple and easy to fix, while some are more complex.

 If your relationship is being affected by painful intercourse, we strongly recommend you seek professional help, including a medical assessment. In the meantime, it might help to explore the possibilities listed.

If you have already been medically checked out, it may be a good time to make an appointment with us to address the cause.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Causes of Bladder Pain Part 1

Posted: Thursday, December 19, 2013 at 8:07:48 AM EST by Alyssa Tait

Bladder pain: what could be behind it?

Pain in the bladder can be downright distressing. Like all ‘’organ’’ pain, it is compounded by the anxiety associated with ‘’something being wrong’’ with an important body system.

There is a range of experience of bladder pain. Some aspects include:

-Pain when passing urine

-Pain that feels like it’s coming from your bladder, which increases as your bladder gets fills up

-An ongoing discomfort with urge; a feeling of constantly needing to go to the toilet, which doesn’t really ease when you go

So what are some of the possibilities when your bladder hurts?

Urinary tract infection.

The good old UTI is probably the most common cause of pain in the bladder, and usually is accompanied by a ‘’triad’’ of symptoms: frequency (going to the toilet more often, often for only small amounts), urgency (a feeling that you can’t put off the urge and have to rush to the toilet) and dysuria (pain with passing urine, usually worse at the end of the stream). Sometimes the body can fight this off, especially if you alkalise the urine with Ural or bicarbonate of soda, but if symptoms persist, it’s important to get to a doctor who can do a dipstick to check for white blood cells and send it off for culture. You will most likely need antibiotics. It is critical that the infection does not reach the kidneys, as this can cause long-term damage. You should always act quickly, particularly if you have a fever.

Stones.

Bladder stones are made up of minerals and proteins in the urine. Sometimes bladder stones can remain in the bladder with no symptoms. However, passing stones is normally (but not always) extraordinarily painful. A dipstick test with the doctor will show up blood in the urine (which may not be visible to the naked eye). An X-ray can show up some types of stones (calcium oxalate, but not uric acid stones), or a cystoscopy (camera in the bladder) may be necessary to diagnose them. They normally occur in older people or people who have become dehydrated.

Vaginal infection.

Sometimes, an infection in the vagina (bacterial or yeast infection) can cause pain in what feels like the bladder; it is also possible to have pain when passing urine, as the urethra (bladder tube) can be inflamed (this is called urethritis). Especially if your symptoms are not the ‘’classic triad’’ and don’t show up as a urinary tract infection on a culture, it is important to have a vaginal swab to rule out vaginal infection. It is important to consider chlamydia, an extremely common sexually transmitted infection, which in some women causes no symptoms at first, but can cause pain with passing urine.

That's just the beginning - watch this space in the next few days for some more causes of bladder pain and arm yourself with information!

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Causes of Bladder Pain Part 2

Posted: Thursday, December 19, 2013 at 8:07:30 AM EST by Alyssa Tait

What Else Could Be Behind Your Bladder Pain?

This is Part Two - so make sure you scroll down to the post below to get the full story on possible causes of bladder pain!

Cancer.

Let’s get this one out of the way! While bladder cancer or a bladder tumour, is an uncommon cause of bladder pain, especially in younger people, it is important to be ruled out. It is always important to identify the cause of blood in the urine, either macroscopic (meaning visible to the naked eye) or microscopic (meaning it shows up on a dipstick test).

Obstruction.

If the urethra (bladder tube) gets blocked, the bladder can overfill and become distended like a balloon, and cause pain. Obstruction may occur for many reasons, including prostate enlargement in men, bladder stones, tumours, scar tissue, or bladder prolapse in women. It is uncommon in women, and would occur with the symptom of difficulty emptying the bladder or a change to the urine stream.

Incomplete bladder emptying.

If the bladder does not empty completely it is possible for the bladder to overfill and cause pain, as in obstruction. This could occur with damage to sensory nerves of the bladder, such as with gynaecological surgery or a traumatic childbirth. There is also a rare condition in young women known as Fowler’s Syndrome, where the urethra (bladder tube) does not relax properly when trying to pass urine, leading to urinary retention.

Interstitial cystitis or painful bladder syndrome.

Interstitial cystitis (IC) is also known as painful bladder syndrome (PBS) or bladder pain syndrome (BPS). It is a condition causing pain (or pressure or discomfort) associated with the bladder, usually worse as the bladder is filling, and relieved to some degree with passing urine. It is a chronic condition (present for at least 6 weeks) where a urinary tract infection has been clearly ruled out. A dipstick test may show blood in the urine. A cystoscopy will normally show bleeding wounds in the wall of the bladder called ‘’glomerulations’’ or petechial haemorrhages. However, it is possible to have PBS without this classic sign of IC. Antibiotics will not change the symptoms.

Endometriosis.

Endometriosis is a condition where the endometrium, or uterine lining, grows abnormally in places that it shouldn’t, such as the bowel, the bladder and the pelvic cavity. Endometriosis often causes pelvic pain, usually exacerbated during menstruation. Sometimes the pain can feel specific to the bladder. With bladder endometriosis, a dipstick test may show pyuria (pus or white blood cells) in the urine, but a culture for a urinary tract infection will be negative. Antibiotics will not change the symptoms.

A Final Message About Bladder Pain

Bladder can be acute and self-limiting (meaning that it is related to clear cause and resolves predictably) or it can be chronic, where the cause is more difficult to find. When it persists for a period of weeks or months, it takes on the characteristics common to chronic pain, such as neurogenic inflammation and central sensitisation. Recurrent urinary tract infections are another issue that need expert help to resolve. Here at Equilibria, we have the expertise to help you solve these problems once and for all.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

In Search of That Elusive Libido

Posted: Thursday, December 19, 2013 at 8:07:11 AM EST by Alyssa Tait

Ladies’ Libido…a slippery creature indeed!

The topic of a future blog post, for the time being I would like to share some wonderful resources for women who are seeking that elusive creature.

You may find these resources useful if you:

  • Have noticed that your sex drive has dropped
  • Have never really felt much with sex
  • Are motivated to improve your libido and your sensation with sex

The V Book – A Doctor’s Guide to Complete Vulvovaginal Health by Elizabeth G Stewart

This is a must for any woman who is not sure what’s what ‘’downstairs’’. It very clearly takes you through the anatomy of the vulva and helps you become familiar with that part of your body that is often lacking in attention and awareness!

The following three on this list are more like ‘’workbooks’’. They are designed to be worked through, not just read!

Becoming Orgasmic by Julia Heiman

Despite its slightly cheesy title, this is an all-time ‘’classic’’ in women’s sexuality. It helps you explore the reasons that may be stopping you from experiencing ideal sexual pleasure.

The Elusive Orgasm by Vivienne Cass

In no way all about orgasm, this is a more modern book written by a psychologist and sex therapist doctor that is easy to read and very non-intimidating. A great one to start with.

Women’s Anatomy of Arousal by Sheri Winton

This was awarded Book of the Year in 2010 by the American Association of Sexuality Educators, Counselors and Therapists. It really is a tremendous book that brings many age-old ‘’secrets of sexuality’’ from Eastern traditions into the mainstream, in a way that is humourous, irreverent, and easy-to-read. Highly recommended to share with your partner.

Don’t forget to check your local library for these books. Otherwise, they are easily accessible on Amazon.com.

 

 

 

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

The Healthy and Balanced Vagina

Posted: Thursday, July 17, 2014 at 4:25:02 PM EST by Alyssa Tait

Concerned that your vagina may be ''out-of-whack''?

There is a lot of talk about the importance of health and balance these days – and the vagina is no exception!

What makes for a healthy vagina? When the vagina is comfortable and there are no symptoms of abnormal discharge, unpleasant odour, itching, dryness, irritation or discomfort, the vaginal environment is likely to be in balance. (By the way, there are six key areas to focus on to resolve vaginal dryness).

A normal, healthy vagina contains high populations of good bacteria – mainly lactobacilli. These are similar to the ‘’good bugs’’ present in a healthy digestive system, but may be slightly different species. Higher amounts of lactobacilli are associated with reduced dryness in menopausal women, and those with more diversity of species had more dryness. In women of menstruating age, there is a reduction of lactobacilli during the menstrual period.

The lactobacilli help maintain a protective acidic environment in the vagina. The higher the lactobacilli, the lower the other bacteria. Where there is more variety of bacteria, the pH is higher (that is, the vagina is less acidic). So, the vagina is a case where less variety is actually a good thing! Lower amounts of lactobacilli in the vagina increases the risk of both sexually-transmitted infections and bacterial vaginosis. This can be associated with miscarriage or premature rupture of membranes in pregnancy. An increase in the ‘’bad’’ bacteria is present in what has been recently called ‘’aerobic vaginitis’’, which is a state of inflammation in the vagina.

What helps promote these good bacteria? Firstly, good oestrogen levels. Oestrogen helps promote lactobacilli, which keep the vagina acidic and help to fend off harmful bacteria. Interesting though, oestrogen also promotes the growth of thrush, which is why it is common to increase during pregnancy and while on the Pill. The acidic environment does not therefore fully defend against thrush, but certain species of lactobacillus do help resist Candida albicans (thrush) colonisation.

Secondly, avoiding artificial hormones and implants helps promote normal healthy vaginal flora. The balance tends to shift with the use of not only the oral contraceptive Pill, but the IUD (intra-uterine device). Studies have shown an increase in the harmful bacteria in the vagina, which does not occur when using condoms for contraception.

Thirdly, the balance of gut flora has an influence on the vaginal flora. As the vagina and the anus are in such close proximity, the bowel flora tend to ‘’migrate’’ to the vagina. It is therefore important to have a good balance of gut flora by eating fermented foods and/or taking probiotic supplements, as well as avoiding unnecessary antibiotics. Stress depletes the good bugs within hours, so this is our fourth important factor – improving stress management!

So what do you do when your vaginal flora is ‘’out-of-whack’’? It’s important to have a swab test with the GP if you have any symptoms of itching, irritation, change in discharge or pain with passing urine. There are also naturopathic treatment approaches for unbalanced vaginal flora, many of which have research studies to support them.

It is sometimes hard to know if your vaginal discharge is normal. This depends both on the general characteristics of the discharge, as well as how it might vary from what you've experienced previously. A few guidelines can help you work out if it is part of a healthy pattern of variation or not.

If you are concerned that you are out of balance from the vaginal perspective, make an appointment at Equilibria for tips on how to get this tested as well as possible treatment options.

If you would like to know more about achieving a healthy, balanced vaginal environment, go to our homepage and subscribe to our newsletter via the button below, ticking the box for ‘’Vaginal Health, Thrush and BV’’ for a series of free e-newsletters on the topic.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Coccydynia: The Can't Sit Down Syndrome

Posted: Saturday, August 16, 2014 at 6:13:20 PM EST by Alyssa Tait

Tailbone Pain and What Can Be Done About It

Can’t sit down without pain? You don’t realise how disabling this is until it happens to you.

Tailbone pain, or coccydynia (also called coccygodynia) refers to pain felt in the area of the tailbone – that is, right where you sit! It is almost always due to a trauma: a fall on the bottom while ice skating, rollerblading or skiing, and childbirth being some of the most common traumatic incidents I see.

Coccydynia after childbirth is terribly difficult to deal with – not least because you are trying to focus on getting the feeding right, and if you can’t sit because of pain, this is almost impossible.  Tailbone pain is more likely to occur with difficult deliveries, use of forceps, and use of the vacuum. Subluxation of the coccyx (i.e. the tailbone being moved out of position) is the most common cause of pain, but fracture is possible (albeit rare).

coccydynia

So what can you do about it?

Well, the obvious thing (that you have figured out already!) is to get off it – to reduce the pressure as much as possible.  Lying on your stomach is ideal. Sitting backwards on a chair (i.e. straddling the chair) and leaning forward into a pillow resting on the back of the chair can be a lifesaver. Doughnut cushions are controversial; I rarely recommend them, as in the postpartum period, they can increase the pooling of swelling at the perineum and make the whole area even more sore.

So how do you fix it?

I hate to be the bearer of bad tidings, but to fix coccydynia – that is, to really get rid of the coccyx pain and not let it linger on long-term – the best form of treatment is manual therapy. Unfortunately, the best way of accessing the coccyx is via a rectal examination. This sounds awful, but most people I see with tailbone pain get over the potential embarrassment quickly because they are so keen to get rid of the pain. It is easy to gently mobilise the coccyx during a gentle rectal examination, and to treat the tailbone muscles, which are usually in spasm.

Most sufferers of this debilitating condition are very glad they go ahead and have this form of treatment. It often only takes one to two sessions to dramatically improve things. It can be effective surprisingly quickly with people who have suffered from tailbone pain for a long time as well. I frequently see women who have had the pain for ten years, who are so glad to know that something can be done.

sittingcomfortably

Of course, it is important that you see a practitioner who is licensed to perform these examinations, and also skilled and experienced in the area. This is a service we provide at Equilibria.

As a postscript, I must add that a former patient of mine swears by a supplement I gave her for her tailbone pain! I will leave the last word to her:

''I have nearly run out of the supplement you have given me, and they have been an absolute treasure for me, when I get the pain in my Coccyx,

which I might add is not very often these days, but I would not like to be without them.'' (Mrs G, age 59).

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Tampon troubles...why they hurt or won't go in

Posted: Thursday, December 19, 2013 at 8:01:03 AM EST by Alyssa Tait

Problems with using tampons?

This is more common than you might think! Many women choose not to use them. They may find tampons difficult to use at the outset, when they first start using them, or problems may develop even when they used to find tampons fine to use before.

To work out likely causes of the problem – and therefore the solutions – we need to look at the main symptoms.

Problem: I can’t get the tampon to go in!

Many young women, when they first start using tampons, find that getting them in is not as simple as it seems in the instructions in the tampon packet! You might find you try every position they recommend: sitting on the toilet seat, standing with one leg up on the toilet seat, or lying down, and nothing seems to make a difference. You start wondering whether you are trying to put it in the right place…if only there was a map of the territory!

Solutions:

Study a map of the area – that is, a lifelike picture or photograph of the vulva! These are available in wonderful educational books such as The V Book and A New View of A Woman’s Body. Even better, take a closer look at the actual territory in question: use a large hand mirror to have a look at your own vulva! (Alternatively, lying in front of the mirror door of your wardrobe works well.) This may sound very ''1970s women's liberation'', but believe it or not, the feminists started encouraging women to do this for a good reason! If you don’t know what your vulva looks like, how are you going to know what’s normal for you? Finally, you need to investigate the territory. Have a look and see where the vaginal opening is. Experiment with gently inserting your finger. If you can insert your finger, you know where you’re going when you start to use tampons.

Problem: I know where my vagina is, but it just plain hurts to put the tampon in!

This is incredibly common in the women I see. I see women of all ages who describe how, when they first started to use tampons, it was painful and difficult. Some of them never persisted because they were so put off by this. Don’t worry! You’re not alone. If you do find it hurts, you probably have what is known as ‘’high-tone pelvic floor muscles’’. This means your pelvic floor muscles are too tense at rest, in the same way as someone working on the computer too much has high-tone neck and shoulder muscles. This makes them sore, tight and tense. No wonder the tampon won’t go in!

Solution:

Sometimes pushing your tummy out gently when you try to push it in will help. But if it doesn’t, don’t push it! You would benefit from seeing a pelvic floor physiotherapist specialising in pelvic floor pain. (This is our forte here at Equilibria!) You may have what is known as vaginismus, which is spasm of the pelvic floor muscles. This has many causes and you need the help and guidance of an expert.

Watch this space for Part II: When tampons won’t stay in.

Difficulties using tampons is a very common symptom I encounter in women I see. Make an appointment with me at Equilibria if this is a problem for you.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Stinging After Sex

Posted: Friday, January 9, 2015 at 8:51:00 AM EST by Alyssa Tait

That smarting, chafing feeling…what does it mean?

It really has a way of putting a dampener on things when you get stinging and discomfort after sex. After it’s all over, the vaginal entrance feels tender and irritated. It’s often worse when you go to the toilet to do a pee after sex. What does it mean, and what can be done about it?

A 2008 study for the Journal of Sexual and Marital Therapy looked at this very issue. The authors described  conversations with 24 women about pain after sex. All the women experienced stinging after sex, which they described as a burning or smarting pain. 70% of them had pain with passing urine after sex. Sometimes this will be a spontaneous stinging feeling, and sometimes it will be stinging on the toilet when peeing after sex.

stingingontoilet

So who were these women? They were all women with either (or both) vaginismus and vulvodynia. With all of them, their symptoms had started off as pain after sex (usually for around 2 hours). As time went on, they started having pain during sex (which they described as a ripping or cutting pain). Many of them eventually stopped having sex because it was too painful.

Painful sex is incredibly common. Vaginismus and vulvodynia (or provoked vestibulodynia) are conditions that may be present if you have pain with sex. Most importantly, don’t ignore the early warning signs! It is not normal for there to be stinging or burning after sex, with or without doing a pee. It is also not normal to have painful intercourse (known as dyspareunia).

If you are wondering whether you might have vulvodynia, try my quick Vulvodynia Self-Test. It's a super-quick questionnaire you can do here.

While much can be done to help vaginismus and vulvodynia, getting in early is even better. Don’t sit around hoping it will get better on its own. Seek help from an expert in vaginismus and vulvodynia.

Here at Equilibria, helping women with vaginismus and vulvodynia is what we do – day in and day out! So if you suspect you might have a problem, simply give us a call or drop us an e-mail.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Ovulation Pain or Mittelschmerz

Posted: Thursday, December 19, 2013 at 8:00:22 AM EST by Alyssa Tait

 Can you feel when you're ovulating?

That niggling pain is back again, low down in the left of your lower abdomen. It’d be nice to just sit down and put your legs up, but you’ve got to keep working.  That time of month again – no, you’re not due for your period for another two weeks! This is mid-cycle pain. Not only do you get period pain, but you’re hassled in the middle of the month by more pain! Why?

That cyclic stabbing pain in one side of the lower abdomen that some women experience is known as ‘’Mittelschmerz’’ (meaning middle pain) or ovulation pain. It is typically described as occurring at mid-cycle. However, this is dependent on the length of the cycle. It would be more accurate to say it occurs approximately 2 weeks before the menstrual period – that is, at the time of ovulation.

Ovulation pain tends to switch sides from month to month (depending on which ovary you are ovulating from, obviously). For most women it lasts a few hours or less – just enough to let them know they are ovulating. For some women, it lasts for more days. And for some very unlucky women, it is severe and can be accompanied by other symptoms such as nausea or even vomiting.

The precise cause of Mittelschmerz is uncertain. It may be due to the enlargement of the follicle before the egg bursts forth in ovulation, or the rupture of the follicle itself, with the spilling of its contents into the surrounding tissue. Whatever it is, if it is anything more than a minor nuisance, you may want to have it looked into.

Severe Mittelschmerz is often due to endometriosis, a condition where the inner lining of the uterus (the endometrium) ends up implanted in places it shouldn’t be. Endometriosis can only be definitively diagnosed with a laparoscopy – a relatively invasive procedure. Women with endometriosis usually have painful and heavy periods as well, and sometimes pelvic or abdominal pain at other times of the month. This can imitate irritable bowel syndrome.

In my experience, cyclical abdominal or pelvic pain is more likely to occur when there are ‘’tissue restrictions’’ around the organs involved (in this case, the ovary, fallopian tube and uterus). For example, endometriosis causes adhesions (scarring) within the tissue which causes it to tighten up and be less flexible. As your pelvic organs contain smooth muscle and are designed to be very mobile, these restrictions can result in you feeling things you shouldn’t (such as pain) – or feeling sensations more strongly than necessary. Tissue restrictions that can be palpated by an experienced physiotherapist are certainly present where there is endometriosis, but many women I see with these problems do not have a diagnosis of endometriosis (yet, anyway).  In my experience, ovulation pain, period pain and other pelvic or abdominal pains can be successfully treated by gently easing these tissue restrictions. This involves a form of tissue release known as visceral manipulation, or visceral-specific myofascial release. Visceral manipulation is very gentle and performed through the abdomen by a physiotherapist who has trained specifically in this technique. It can provide relief within just a few sessions.

Contact us for an assessment using this approach and possible visceral manipulation treatment, or just to make an enquiry.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

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Link Between Prolapse and Osteoporosis

Posted: Thursday, December 19, 2013 at 7:59:38 AM EST by Alyssa Tait

Hot off the press…

… from the recent International Urogynaecology Association meeting in Brisbane comes some important health information for women: having a vaginal prolapse puts you at increased risk of low bone density or osteoporosis.

Two separate studies were reported – one an Australian study by Professor Pauline Chiarelli, and one a Japanese study by Abe and colleagues. They both had similar findings – that women with prolapse were more likely to have osteoporosis as well. However, they had quite different theories about why this would be the case.

Abe and colleagues proposed the possibility it could be to do with a change in collagen type (one of the proteins that makes up connective tissue, which is involved in both bone and pelvic organ support). They also highlighted a possible role of declining oestrogen impacting on both bone and the pelvic floor.

Chiarelli put forward the idea that osteoporosis could be related to prolapse in the following way: the reduction in height caused by osteoporosis could potentially put pressure on the pelvic organs, promoting prolapse.

Whatever the mechanism, it seems clear that vaginal prolapse and osteoporosis are linked. What can we get out of this? Keep active – this helps keep your bones strong and keeps your muscles going, which is important for both these conditions. If you know you have prolapse, consider getting your bone density checked, especially if you are approaching menopause. If you have low bone density, or a family history of osteoporosis, have your pelvic floor assessed by a pelvic floor physiotherapist and get onto a program to keep it healthy!

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

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