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The Femina Physical Therapy Blog

Featuring original articles by our staff about current events and trends

Explore our insightful blog articles on pelvic health, where we delve into essential topics that empower and educate. From understanding pelvic floor disorders to strategies for conquering infertility, our content is designed for those seeking knowledge and support. We discuss the latest research, expert advice, and practical tips to enhance your well-being and foster a deeper connection to your body.

Featured From the Blog:

Hormonal Birth Control and Vulvodynia - Part 1: Combined Hormonal Methods

We Take a Look at Combined Methods of Hormonal Birth Control and Vulvodynia

In this three part series, we will explore the effects of hormonal contraceptive methods and their relationship with vulvodynia.

What is Hormonal Birth Control?

Hormonal birth control methods, such as birth control pills, patches, injections, rings and hormonal intrauterine devices (IUDs), work by altering hormone levels in the body to prevent pregnancy. Hormonal contraceptives fall into two categories: combined, meaning they contain both estrogen and progestin (think the pill, patch, or ring), or contain progestin only (think progestin only pill or “POP”, arm implant, IUDs, or injections). While the primary intent of these drugs are for contraception, they are also widely prescribed for other common issues such as: mood imbalance related to periods, skin issues, irregular periods, and painful periods.

Hormonal Birth Control and Vulvodynia Part 2: Hormonal Intrauterine Devices (IUD)

Hormonal Birth Control and Vulvodynia - Part 2: Hormonal Intrauterine Devices (IUD)

This article takes a looks at intrauterine devices (IUDs) and it’s potential effect on vulvodynia, or vulvar pain.

Intrauterine devices, also called long-acting reversible contraceptives (LARC), have become more and more popular as a birth control method in the United States due to high efficacy, less side effects and higher continuation compared to other hormonal contraceptive methods1,2,6. They are offered in two forms; hormonal (common brand names are Mirena, Kyleena, Skyla, Liletta) and copper IUDs. For this blog, we will be exploring the effects of the hormonal IUD only. This type of IUD releases progestin into the body which suppresses endometrial cell growth (called proliferation) and thickens the cervical mucus to prevent pregnancy4.

Participate in a High Quality Study Using Shockwave Therapy for Painful Intercourse

Learn about low intensity shockwave therapy for painful intercourse (dyspareunia)

Our team at Femina Physical Therapy is committed to providing the highest level of evidence-based care. That is why we are conducting a research study to determine the effectiveness of low intensity shockwave therapy for painful intercourse, or dyspareunia as it is known clinically. We are searching for volunteers to participate in this high quality study. Those who qualify to participate will receive a reduced rate on all visits related to the study!

We Take a Look at Combined Methods of Hormonal Birth Control and Vulvodynia

In this three part series, we will explore the effects of hormonal contraceptive methods and their relationship with vulvodynia.

What is Hormonal Birth Control?

Details: Written by: Anna Larson, PT, DPT; Published: 08 August 2024; Last Updated: 31 August 2024; 236 Views

Hormonal Birth Control and Vulvodynia - Part 2: Hormonal Intrauterine Devices (IUD)

This article takes a looks at intrauterine devices (IUDs) and it’s potential effect on vulvodynia, or vulvar pain.

Details: Written by: Anna Larson, PT, DPT; Published: 07 August 2024; Last Updated: 20 August 2024; 114 Views

Hormonal Birth Control and Vulvodynia: Part 3: The Mini Pill — Image courtesy of Towfiqu barbhuiya on Unsplash https://unsplash.com/photos/orange-and-white-medication-pill-w8p9cQDLX7I

Is the hormonal birth control mini pill better than the regular pill?

If you have been following along, this is the third part of our hormonal birth control and vulvodynia series. First, we covered how combination methods of birth control (containing synthetic forms of both estrogen and progesterone) could lead to vulvodynia. We then explored if there is a risk of developing vulvodynia after the insertion of a hormonal intrauterine device IUD). In this post, we will delve into the relationship between the progesterone only birth control pill, also called “the mini pill,” and vulvodynia. As a quick refresher, vulvodynia is pain on the vulva, or external genital tissue. For more information about vulvodynia, check out this post on our website.

Details: Written by: Iris Xu; Published: 07 August 2024; Last Updated: 08 August 2024; 238 Views

Understanding Paradoxical Diarrhea — Photo by 99.films on Unsplash

Have you ever experienced a peculiar mix of constipation and diarrhea at the same time? This unusual phenomenon, known as paradoxical diarrhea or overflow diarrhea, can be both confusing and uncomfortable. Here’s what you need to know about this condition:

What is the pelvic floor?

The pelvic floor is a very important group of muscles that live in the bottom of the pelvis. Both men and women have a pelvic floor. These muscles sit in the bottom of the pelvic floor like a hammock, and can move up and down like a trampoline to support your internal organs inside your body. They also help to control the openings and closures in the bottom of the pelvis, which is why they are so essential to urinary, bowel and sexual function. Just like any muscle, when they are weak, they can start to cause issues with any of these functions. Common signs of a weak pelvic floor include urinary incontinence, fecal (or bowel) incontinence, feeling of pelvic heaviness or pelvic organ prolapse, as well as low back or hip pain.

Does my pelvic girdle pain have anything to do with my mood and sexuality?

Many of our patients experience sexual dysfunction and anxiety, depression and chronic pain. These conditions are known to coexist, and we unpack each component of pain, mood and one’s behaviors, desires and attitudes related to sex and physical intimacy.

Details: Written by: Anna Larson, PT, DPT; Published: 07 August 2024; Last Updated: 08 August 2024; 119 Views

Yoga for Chronic Pelvic Pain — Image courtesy of Jared Rice on Unsplash

Chronic pelvic pain is a common debilitating condition that greatly impacts a person’s health and quality of life. Often, the origin of the pain can have one or several causes including: endometriosis, vulvodynia, interstitial cystitis, irritable bowel syndrome, chronic pelvic inflammatory disease, adenomyosis, fibroids, celiac disease, fibromyalgia, degenerative disc disease, and chronic urinary tract infections, to name a few5. Sometimes, the exact origin of the pain is unknown, even stated as high as 61% of chronic pelvic pain cases5. To learn more about the interactions between these conditions and how they can cause chronic pain see this previous blog post here.

What is symphysis pubis dysfunction (Lightning Crotch)?

Symphysis pubis dysfunction (SPD), also known as pubic symphysis dysfunction, anterior pelvic girdle pain, or lightning crotch, is a common musculoskeletal condition that is experienced by pregnant women and can vary from minor discomfort to severely debilitating pain. It is typically characterized by discomfort in the front pelvic area that can radiate to the inner thighs and perineum (think where your pubic bone is).

More On How to Help Lipedema and Lymphedema

In our previous article, we went over the definitions of Lipedema and Lymphedema and just barely scratched the surface on treatment options. This article will go into more details on the different treatment options we offer at Femina Physical Therapy to help support our patients with these diagnoses.

Here are some treatments that are beneficial for both conditions.

Learn How To Help Lipedema

This article covers the differences between Lipedema and Lymphedema and what treatment looks like for them.

Few conditions are as prevalent and underdiagnosed as lipedema. Lipedema is the symmetrical buildup of painful subcutaneous adipose tissue (fat) and fluid in the limbs. Adipose tissue accumulates primarily in the thighs, buttocks, legs, and arms, typically without involvement in the face, hands, and feet. Lipedema is a chronic progressive condition that is frequently confused with obesity, even by healthcare providers. With obesity, adipose tissue accumulates in the entire body. Lipedema can also be present in the absence of obesity. Since lipedema is often confused with obesity, the exact prevalence is unknown. The most commonly cited prevalence in cisgender women is estimated at 11%.

What is Edema, and what causes swelling during pregnancy?

During pregnancy, extra water and salt retention is one of the most common complaints and symptoms that occur during pregnancy– this is called edema. Edema happens as a result of a few different changes that occur in pregnancy: the growth of the baby as they put greater pressure on one of the major blood vessels of the body called the vena cava which is located in the abdomen; hormonal changes that happen during pregnancy such as changes in progesterone, estrogen HCG (human chorionic gonadotropin), and prolactin which can cause increased swelling in the body; increased blood volume (by up to 50% more in pregnancy). Additionally, varicose veins may occur in up to 60% of females, with an increased risk depending on increased age and increased number of pregnancies.1 Edema can cause stiffness in joints, heaviness, and a sensation of warmth in the area that is swollen.

Are You Suffering From Chronic Overlapping Pelvic Pain Conditions? We Can Help!

Part 1: Endometriosis and Vulvodynia

Chronic pelvic pain, sometimes abbreviated to “CPP”, is defined as “pain in the abdomen or pelvis for at least 14 days per month and severe enough to cause functional limitations” by a recent literature review of chronic pelvic pain⁵. The cause of chronic pelvic pain is often multifactorial and can be the result of conditions such as:

endometriosis
Vulvodynia (or vestibulodynia)
interstitial cystitis/bladder pain syndrome
irritable bowel syndrome (IBS)

Details: Written by: Stephany Tritt, PT, DPT; Published: 11 December 2023; Last Updated: 06 March 2024; 2934 Views

Discover the Ways Urinary Incontinence and Weight Are Linked

Today, let's delve into the intricacies of bladder leakage, commonly known as urinary incontinence (UI)

Balancing health and weight involves various factors, both intrinsic and extrinsic, making it a complex aspect of well-being. As a pivotal metric for assessing health, weight is not only a symptom but can also act as a causative factor for various health conditions.

According to the Centers for Disease Control and Prevention (CDC), in 2023, a staggering 41.9% of adults in the U.S. are affected by obesity, accounting for $173 billion in annual healthcare costs. While the implications of being overweight on cardiovascular and mental health are widely known, we explore whether it can also impact pelvic floor health, especially in the context of urinary incontinence.

Did You Know That Proper Footwear Can Improve Your Running Mechanics and Pelvic Floor Health?

How Do My Feet Impact My Pelvic Floor When I Run?

If you are a runner, you tend to look for ways to improve your running. If you’re thinking about starting up or returning to running, it can feel intimidating particularly if you have any symptoms related to pelvic floor dysfunction. This only complicates an exercise that, on the surface, seems fairly straight forward. There are some studies that have looked at how your feet can play a part in your pelvic floor muscle function while you run. And if you are looking to return to running postpartum, read on and also check out this article by one of our pelvic floor physical therapists.

Details: Written by: Debbie Dy, PT, DPT; Published: 09 November 2023; Last Updated: 14 November 2023; 4563 Views

Safe Exercise During Pregnancy: ACOG Backed Guidelines — Safe Pregnancy Exercise | Image Courtesy of Lucas Favre via Unsplash

Dr. Debbie Dy, PT, DPT

Orthopedic Clinical Specialist/Pelvic Health Physical Therapist

Once the exciting news of a new pregnancy is shared, it is common to get flooded with misinformation and “advice” from concerned family members regarding the safety of exercise during their pregnancy. Historically, it is common for people to be told to “take it easy” during their pregnancy or spend more time in bed. What we know is that exercise during pregnancy is safe and beneficial for both birthing parent and baby.

ACOG Updated Guidelines on Exercise During Pregnancy

The American College of Obstetrics and Gynecology (ACOG) in 2020 released updated guidelines regarding exercise in pregnancy which states that “exercise is both safe and desirable for birthing people in the absence of obstetric or medical complications or contraindications.” Not only is regular exercise safe for most pregnancies, exercising has immense physical and mental health benefits for not only the birthing person, but for the growing fetus as well. Birthing people who engage in regular exercise during their pregnancies have been shown to have decreased rates of gestational diabetes, hypertension, cesarean births, operative vaginal births and postpartum recovery time. It can also be preventative for the development of depressive disorders in the postpartum period.

Let's Discuss Some Solutions for Chronic Constipation

"Chronic constipation can have detrimental effects to daily life..."

Constipation is an extremely common symptom that has been reported to affect 63 million people in North America.¹ Chronic constipation can have detrimental effects to daily life and is known to increase psychological distress and impair health related quality of life. Most commonly, individuals who are struggling with constipation often intervene with laxative use and dietary changes to increase fiber intake. These interventions fail to improve symptoms in about 50% of patients whom they are prescribed.² If you find that you continue to struggle with constipation, there are many lifestyle changes one can adopt that can have a profound effect on symptoms including decreased frequency, straining, and pain with bowel movements.

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