perineo

Woman

Due to a woman’s anatomy, perineal dysfunctions occur more in women than in men and as a result of the lifestyle that we lead, it is common to see younger and younger women with some symptoms of these conditions.

Urinary incontinence (loss of urine) is the most common complaint among these women but they can also show signs of urinary retention (difficulty to urine), fecal incontinence (loss of control over gases or feces), intestinal constipation (difficulty evacuating), pelvic organ prolapse (“fallen bladder”), pelvic pain (pain in the pelvic region) and sexual dysfunction (pain during intercourse, reduced pleasure, difficulty in having an orgasm, etc).

Urogynecological physiotherapy, through perineal rehabilitation, is indicated for both the treatment and prevention of these pathologies. Ideally, as soon as they begin their adult life, women should carry out an assessment of the PERINEUM to be aware of these muscles and, if necessary, start perineal rehabilitation, improving their quality of life, well-being and sexuality.

Perineal dysfunctions are embarrassing and cause women to have a decrease in their personal, social and professional quality of life. Leading, in some cases, to social isolation.

The Sooner You Start The Treatment Better Results You Will Get

Urinary incontinence

Usually, women start losing just a few drops of pee when they cough and sneeze; or when they make some effort like picking up a weight, jumping, running. This is stress urinary incontinence.

In some cases, women lose urine for no apparent reason, they feel a urinary urgency, a sudden need to urinate; generally, when they are arriving home, near the bathroom, or hearing the sound of water. This is urge urinary incontinence.

It is also common to complain about the loss of pee in female athletes. The effort made during physical activities leads to a great increase in intra-abdominal pressure, overloading the PERINEUM muscles, causing these women to lose pee when they are practicing more intense physical activities. Although they are physically fit women, they are not oriented towards working the PERINEUM muscles.

Urinary incontinence affects more than half of women in adulthood and, due to lifestyle, is increasing among younger women.

Unfortunately, because they find it embarrassing or because they think it is a normal evolution of age, few women seek treatment. These losses tend to get worse by forcing the constant use of pads or diapers.

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My patients stop losing urine with just a few sessions, start your treatment now.

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Urinary retention

Urinary retention is the difficulty of totally eliminating urine (peeing), giving the feeling of always having a full bladder, increasing urinary frequency.

Among its causes are anatomical changes, neurological dysfunctions, surgical complications of the correction of urinary incontinence, or other pelvic surgeries.

Fecal incontinence

Fecal incontinence is the difficulty or inability, to hold flatus (gas) or feces in a liquid, paste, or solid-state.

The main causes of this pathology are the weakness of the muscles of the PERINEUM, aging, pregnancy, injuries caused by vaginal delivery, some neurological disorders, and surgeries that can lead to damage to the anal sphincter or pudendal nerve.

Constipation

Intestinal constipation is the difficulty in eliminating the feces, being considered pathological when one spends 3 days or more without being able to evacuate.

The great effort to evacuate can lead to other perineal dysfunctions such as urinary incontinence and pelvic organ prolapse.

Pelvic pain

Pelvic pain is characterized by persistent and recurrent pain in the pelvis region causing a very negative impact on the quality of life and sexuality of these women.

The difficulty in identifying the cause of this pain is one of the great challenges in the treatment of this pathology, sometimes it can be frustrating for patients not to have their complaints taken seriously. With my assessment, I can help you identify the cause of this pain and choose the best treatment.

Among its main causes are alterations of gynecological, gastrointestinal, urological, or musculoskeletal origin.

Pelvic organ prolapse

The pelvic organs (urethra, bladder, uterus, and rectum) can move towards the vagina causing genital prolapses: cystocele (bladder prolapse), urethrocele (urethra prolapse), rectocele (prolapsed rectum), and prolapse of the uterus.

Usually, the symptoms start with a complaint of weight in the vagina as if they had a “ball”, with the progression of the pathology the patients feel the organ leave and it is possible to see it in the vaginal introitus (vaginal entrance).

Its causes are the weakness of the PERINEUM, aging, pregnancy, childbirth, obesity, high-impact exercise.

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Sexuality

Women are increasingly looking for greater satisfaction in their sexuality, worrying about having more pleasure, intense orgasm, and not feeling pain.

Perineal rehabilitation can improve female sexuality. The first benefit is a better knowledge of your body, increasing body, and perineal awareness. For some women, there is still a taboo that does not allow them to get to know their bodies better.

The metabolism increase causes a more blood supply in this region, also increasing sensitivity and vaginal lubrication. Muscle hypertrophy makes the vaginal introitus tighter, making penetration more pleasurable.

During orgasm there is a contraction of these muscles, so the women who can contract them correctly can reach orgasm more easily and have more intense orgasms, being able to have multiple orgasms.

The lack of relaxation of these muscles can make penetration painful, teaching perineal relaxation is recommended in these cases, being indicated for vaginismus and postpartum.

Sometimes myofascial techniques are needed to treat scars and pain and trigger points.

I have success rates in managing sexual dysfunction.

Sexual dysfunctions

  • Disorders of desire: decreased or absent sexual desire, sexual fantasy, or sexual thoughts
    • Aversion: anxiety or repudiation of the sexual act
  • Disorders of arousal: reduction or absence of psychological or physiological responses that prepare the body for sexual intercourse
    • Persistent Excitation: unwanted genital response in the absence of desire
  • Orgasm dysfunction: diminution or absence of orgasm, decreased the intensity of orgasms, difficulty reaching orgasm
  • Dyspareunia: recurrent or persistent pain or discomfort during vaginal penetration or
    • Vaginismus: persistent or permanent difficulty in allowing the introduction of the penis or any other object in the vagina, although there is a desire to do so
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