To the fast pace of life, work obligations and tight daily routines, the COVID-19 pandemic has added anxiety, fear, uncertainty and a global traumatic situation that will undoubtedly raised stress levels in societyin some cases, to its maximum point.
And it is well known that when stress ceases to be a punctual reaction and becomes a chronic situation, it has multiple consequences in the physical and mental health.
According to the American Psychological Association, chronic stress, if left untreated, can lead to anxiety, insomnia, muscle pain, and a weakened immune system, and can even contribute to the development of certain pathologies, such as heart disease, depression, and obesity.
And although most people may not know it, stress can even affect the pelvic floor, that is, the group of muscles and other tissues that form a kind of sling or hammock across the pelvis. In women, this “floor” holds the uterus, bladder, intestines, and other pelvic organs in place so they can function properly.
Now, various investigations show that the pelvic floor muscles actively contract in response to physical or mental stress, generating consequences in people’s daily lives and even in their sexuality.
Rachel Gelman is a physiotherapist specialized in pelvic floor and assured that “it is common that when people feel tense or nervous they tend to tighten the gluteal muscles, and although it is a normal response, when it is caused by chronic stress, it can cause all kinds of pelvic floor disorders. In this way, according to the specialist, “diverse consequences can appear that range from pain during sexual intercourse, pelvic organ prolapse or lumbar pain to bladder dysfunction and constipation.”
And while stress may never have been linked to those consequences, according to Caroline Correiadirector of Fisiofit Mujer, a Spanish physiotherapy clinic dedicated to women’s health, “stress alters the postural and respiratory patternwhich leads to an alteration in the musculature of the diaphragm”.
Specifically, this usually remains more tense, favoring the increase in intra-abdominal pressure and the downward thrust of the abdominal viscera. In this way, the pelvic floor muscles are forced to contract to counteract the increased pressure and ensure urinary continence. All this process of pelvic floor contraction over time will lead to the formation of trigger points, which are basically pain points.
“Most of the time they are the cause of pain during sexual intercourse, back problems, pain that radiates to the leg or discomfort during the period,” Gelman pointed out. In addition to these problems, a constant contraction of the pelvic muscles can lead to muscle fatigue, favoring the appearance of the dreaded urinary incontinence”.
consulted by Infobaethe gynecologist Marisa Labovsky (MN 84376) explained that “the pelvic floor is made up of muscles and the muscles contract like any other in the bodyTherefore, when one is stressed, everything contracts”.
“On the other hand, when you are stressed you have less desire to have sex and sometimes you have sex just the same, so when the muscles are contracted, the area is not well lubricated and that causes discomfort and burning, and a vicious circle is generated in the one that when the person knows that they are going to have sex, they think that it will hurt and therefore they contract and when they contract it obviously hurts and so on”, the gynecologist deepened.
Along the same lines, according to a study by the University of Örebro, in Sweden, only among women under 30 years of age, around 20% report recurrent sexual pain. This pain, in addition, causes fear of sexual relations and, therefore, the avoidance of them. In this way, according to this work, “women with pain reported higher levels of fear avoidance and pain catastrophizing, as well as depression and anxiety.” A situation that does nothing but maintain the stress and the underlying cause of the pain itself.
In her turn, the gynecologist Gabriela Kosoy (MN 70409), said before the consultation of this medium that “obviously stress influences all spheres of life, including sexuality.” “It alters the microbiota, so it can cause constipation,” explained the specialist. The pelvic floor has a very precise innervationso everything that alters the nervous system can alter its structure”.
Regarding the variety of symptoms involved, Labovsky argued that “the pelvic floor is full of muscles, and if they contract, it makes intercourse difficult, going from body to body, etc. because the entire pelvic floor involves the anal, vaginal and urethral orifice.”
The first step, according to specialists, is to identify that the symptoms may be due to a situation of stress and not to any other problem.
“The key is precisely to rule out other possible causes,” said Correira, for whom “a very similar case is that of chronic constipation. There are many women who have a correct diet, adequate water intake and exercise regularly, but still suffer from constipation. The answer would be the level of stress.”
In the case of the pelvic floor, “we should rule out that the pain is due to a physical cause. For example, having gone through childbirth or having suffered some type of injury or infection in the area, added Gelman. If we do not find another apparent cause and we know that we are going through a long stage of stress, perhaps we should first try to work on it”.
In that sense, the physical therapist recommended “obvious things like spending time outdoors, doing gentle exercises like yoga and dancing, writing, spending time with friends, masturbating or, of course, going to therapy can be of great help.”
“Do relaxation exercises, yoga, breathing and pelvic floor exercises will surely help, as well as being able to see what is the cause of stress and be able to solve it,” added Labovsky, while Kosoy added: “Anything that is breathing exercises, mindfulness, yoga of course that by improving stress will improve the symptom.”
On the other hand, there are also specific exercises to relieve stress on a more physical level. Correia recommended breathing mindfully for at least a minute. “Something so simple helps stimulate the parasympathetic nervous system, which is responsible for lowering stress levels,” she pointed out.
It should be remembered that there is a relationship between respiratory and postural function with the pelvic floor. According to some studies, functional improvements in breathing patterns and pelvic stability could indirectly affect the changes produced in the pelvic floor, even in the case of symptoms such as urinary incontinence. In addition, some stretching could also be useful to favor the relationship of the diaphragmatic muscles. “Such as stretching that favors hip opening, psoas stretching and quadratus lumborum”, Correira adds.
At this point, in dialogue with Infobaethe national teacher of Physical Education Mariela Catania contributed a exercise to strengthen the pelvic floor muscles.
“Lying on your back, with your legs bent, and feet supported, we place our hands on our belly and contract the pelvic floor. We have to feel how the sphincters close, how we raise the pelvic organs and how the lower abdomen tightens, ”she described.
And he continued: “Now we are going to contract the deep abdominal plane -transversus abdominis- without losing the pelvic floor. The contraction should be smooth. We breathe inhaling in two beats inflating the belly with air and exhale slowly in four beats. We repeat six to ten times and relax. We contract the pelvic floor, contract the inner abdomen, hold and relax.”
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