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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.

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A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

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I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

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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 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.

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Heather is the best! I saw her today for terrible hip/groin pain. I was so impressed with the safety measures in place and felt completely safe . Thanks for the healing hands.

S.S., age 54

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

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