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Anatomical drawing of pelvis depicting sexual dysfunction after pelvic fracture

Sexual Dysfunction After Pelvic Fracture Can be Traumatic

A 2014 study by Harvey-Kelly et al. points to the fact that the long term consequences of this injury can include sexual dysfunction and pelvic pain for both males and females.

Pelvic fractures occur most commonly with a high-energy trauma. The most common ways people fracture their pelvis include motor vehicle (57%), pedestrians hit by car (18%), motorcycle crushes (9%), falls from a height (9%), and crush injuries (5%) (Harvey-Kelly, 2014).

Chronic Issues After Pelvic Fracture

Thanks to advancements in critical care medicine and acute trauma care, the mortality rate for those who have had a pelvic fracture has been reduced over the years. However, pelvic fracture survivors often report chronic issues including chronic pain, chronic pelvic pain, changes in gait, issues with bowel and bladder, and sexual dysfunction. This is because the muscles, bones, nerves, and blood vessels, are often all implicated in these injuries, and the pelvis contains the organs of the urinary, bowel, and sexual function systems. Therefore, the subsequent rehabilitation of all these systems is more complicated than, say, a fracture of your ulna or radius in your forearm.

Prevalence of Sexual Dysfunction After Pelvic Fracture

In the 2014 study, survivors of pelvic fracture were assessed at a median period of 36 months after their injury. Patients were given questionnaires that asked questions about issues like orgasmic function, sexual desire, intercourse satisfaction, lubrication, erection quality, and pain with sex.

73.8% of the study participants showed a decrease in overall sexual function after pelvic fracture. Sexual dysfunction was identified in 43.8% of the female and 52.1% of the male patients, using the female sexual function index and the international index of erectile function. Quality of life scores were also significantly decreased for 77.5% of all the participants in the study.

The results of this study show that sexual dysfunction is an issue that many people who survive pelvic fractures may suffer from, but not all of them may be seeking treatment. Treatments such as pelvic floor therapy may help.

How Pelvic Floor Therapy Can Help

The therapists at Femina are experts at rehabilitation of pelvic injuries and the issues with the pelvic floor that may result. Some of the modalities used at Femina Physical Therapy to address sexual dysfunction after pelvic fracture can include (but are not limited to):

  • Manual therapy including soft tissue massage, connective tissue manipulation, muscle energy techniques, and myofascial release to treat connective tissue dysfunction and myofascial trigger points
  • Internal pelvic floor manual therapy to treat sensitive tissues, muscle spasms, trigger points, and muscle guarding that can cause issues like pain with sex, frequency and urgency of urination, and pain with bowel movements
  • Therapeutic exercises to strengthen muscles stabilizing the pelvic region, release entrapped nerves or strengthen the pelvic floor
  • Biofeedback technology to help you focus on relaxing the pelvic floor
  • Photobiomodulation Therapy for pain relief and encouraging cellular healing and desensitization of scar tissue adhesions, tender trigger points, and muscle spasm pain.
  • Visceral mobilization (gentle massage techniques that loosen internal adhesions and restore movement to the organs including the intestine, bladder, uterus, and ovaries) to improve motility and GI organ function
  • Training in self treatment techniques so you can start to manage your symptoms at home. These techniques can include self pelvic floor massage using medical dilators
  • Neuromuscular re-education and autogenic relaxation to reduce chronic muscle over-activity and improve parasympathetic nervous system function, including pain management and digestion
  • Patient Education and Empowerment

  • Lifestyle modifications like sexual positioning, stress reduction, bladder and bowel habits, hygiene, and optimal fluid intake and dietary fiber intake to control other factors that may be contributing to pelvic floor dysfunction.

If you are experiencing sexual dysfunction after pelvic fracture:

  • Schedule an appointment with your doctor.
    Tell your doctor your symptoms to get the appropriate referrals to specialists such as pelvic floor physical therapists, GI doctors, and psychologists to help you build a robust healthcare team.
  • Schedule an appointment with a pelvic floor physical therapist.
    Get a comprehensive evaluation with a pelvic floor physical therapist to establish a treatment plan and goals for your road to sexual health and recovery.

Are you dealing with sexual dysfunction after pelvic fracture? To learn more about our total body approach to chronic pelvic pain, contact us here.

 

Resources

Harvey-Kelly, K. F., Kanakaris, N. K., Obakponovwe, O., West, R. M., & Giannoudis, P. V. (2014). Quality of Life and Sexual Function After Traumatic Pelvic Fracture. Journal of Orthopaedic Trauma, 28(1), 28–35. doi:10.1097/bot.0b013e31828fc063

Copeland CE, Bosse MJ, McCarthy ML, et al. Effect of trauma and pelvic fracture on female genitourinary, sexual, and reproductive function. J Orthop Trauma. 1997;11:73–81.

Meyhoff CS, Thomsen CH, Rasmussen LS, et al. High incidence of chronic pain following surgery for pelvic fracture. Clin J Pain. 2006;22:167–172.

Metze M, Tiemann AH, Josten C. Male sexual dysfunction after pelvic fracture. J Trauma. 2007;63:394–401.

What Our Patients Have to Say

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Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

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