How Can Pelvic Floor Physical Therapy Connect to Sexual and Mental Health? Insights from the 27th Annual SMSNA Fall Scientific Meeting
On Thursday, October 8, at the 27th Annual SMSNA Fall Scientific Meeting, Drs. Kate Adams and Amy Hoover discussed how mental health practitioners and pelvic floor physical therapists (PTs) can work together to support sexual health. Drs. Adams and Hoover presented a case study of a woman who struggled with penetrative sex, tampon use, and pelvic exams. Using this case as an example, they explained how pelvic floor PTs can determine whether the pelvic floor muscles are tight or weak, which can affect sexual function. PTs primarily aim to address the patient's chief complaint, which may include sexual pain or incontinence. They can use several tools, such as dilators, vibrators, biofeedback, and electrical stimulation, to help improve blood flow, stretching, and muscle strength.
Beyond physical symptoms, a heightened nervous system may also contribute to pelvic floor dysfunction. The brain and pelvic floor are closely connected. If a person has experienced negative events resulting in hypervigilance, their pelvic floor muscles may become tighter and more rigid. Calming these responses may help relax the pelvic floor. In the case study, the patient struggled with anxiety, fear, avoidance, trauma, and sexual confidence. The PTs determined that she would struggle with stretching and muscle exercises but was able to connect with her breathing.
Drs. Adams and Hoover were able to treat the patient by addressing the full picture. Mental health professionals can help address nervous system-related elements of pelvic floor dysfunction that hinder sexual wellness. PTs can help address body confidence concerns and other pelvic floor-related issues that may affect mental health through negative feedback loops. Drs. Adams and Hoover emphasized the importance of time, patience, and education in helping the patient adapt to treatment and home exercises. Through gradual treatment and patient education, the woman was eventually able to tolerate dilators, use tampons, and complete a pelvic exam.
Drs. Adams and Hoover recommended shifting the focus to how a patient's brain and environment may be interfering with sexual function.
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