Pelvic pain affects 25% of women and 11% of men. Often, those who are experiencing pain feel more alone than the statistics reveal because pelvic pain is not as readily spoken about as other parts of the body, like the back or hip.

Pelvic pain can disrupt bowel, bladder, digestive, and sexual function. Men and women who experience pelvic pain often have at least one other systemic concern (called co-morbidities).

For example, a woman with interstitial cystitis might feel her pain getting worse if she is constipated or flaring during certain times in her menstrual cycle. (Co-morbidities of pelvic floor dysfunction are not always painful.)

Let’s categorize what you or your loved one might be experiencing.

Urinary

Gastrointestinal

  • Constipation
  • Irritable Bowel Syndrome
  • Fecal (or gas) incontinence
  • Abdominal pain

Musculoskeletal

  • Fibromyalgia
  • Pudendal neuralgia
  • Coccydynia
  • Back pain
  • Hip pain
  • Sacroiliac joint pain
  • Pelvic floor muscle spasm aka overactivity aka levator ani syndrome

Cis women

Cis men

  • Chronic non-bacterial prostatitis

How is it treated?

Appropriate diagnosis

If you are looking for a second opinion from a provider who has a specialization in pelvic pain, the International Pelvic Pain Society is an excellent resource.

Your provider will be able to create a treatment plan that might include pelvic health physical therapy, medication, acupuncture, nerve blocks, therapeutic exercise, dietary tips, yoga, and mindfulness.

Avoid constipation

If you and your provider suspect diet might play a role in your symptoms, being properly hydrated, increasing fiber intake and avoiding irritants may provide relief.

You might also have pelvic floor muscle tightness or incoordination that might be making bowel movements sluggish, incomplete, or painful.

Some techniques to try while defecating include:

  • elevating your feet on a Squatty Potty (or stool),
  • working with the pelvic floor muscles (lengthen or strengthen), and
  • abdominal massage.

Stool consistency is a self-assessment tool you can communicate to your provider.

Mobilize

Movement that feels safe in your body is critical to feeling like your best self. This is why so many people love using yoga as an adjunct treatment modality to decrease pain and increase function.

Yoga offers the opportunity for slow, mindful movements with breath work and inner reflection. Relaxing, developing awareness, and integrating breath into your movement increases flexibility of the body and the mind.

Yoga helps control the release of compounds in your body: serotonin (the feel-good neurotransmitter) and cortisol (the stress hormone). The majority of serotonin, the feel-good neurotransmitter, is produced in the gut. Strengthening the parasympathetic nervous system response via pranayama, meditation, and gentle movement can be helpful in the balance of cortisol and serotonin.

Breathe

Conscious breathwork, or pranayama is another non-invasive tool to decrease pain and increase confidence that you have control over the pain by targeting the nervous system. See the pranayama section below for a continued discussion.

Aspects of a yoga practice

Eight limbs

The Indian sage Patanjali outlined “eight limbs of yoga” in the Yoga Sutras.

You may be familiar with asanas (physical postures) and pranayama (breathwork), but these are only two of the “eight limbs of yoga” as outlined by the Indian sage Patanjali in the Yoga Sutras.

Meditation, compassion, and other concepts and practices of yoga can be applied in the holistic model of healing the pelvis and general wellness.

Pranayama

Iyengar describes pranayama as “extension of breath and its control.” Pranayama can be practiced alone or in coordination with asana. Mindful pranayama encourages the student to explore diaphragmatic breathing without gripping and holding tension in the chest and ribcage.

To learn more about the relationship of the breath and the pelvic floor, check out this video of pelvic floor movement with the breath. If you wish to gain knowledge about different types of pranayama, read my blogs about dirga, ujjayi and letting go breath.

Asana

Asanas are the most widely known aspect of yoga. Prior to asanas, warm-ups are an ideal way to introduce movement. Gentle and slow movements combined with conscious breathing, act to warm up muscles, lubricate joints, and direct the focus of the student inward to the mind-body-spirit connection.