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For Women

Introduction:

Welcome to the Women's Pelvic Health Empowerment page at the Africa Pelvic Pain Advocacy Network. Women's pelvic health is a crucial aspect of overall well-being. Whether you're looking for information on reproductive health, pregnancy, or general pelvic health, you've come to the right place.

Understanding Women's Pelvic Health:

In this section, we'll delve into the various aspects of women's pelvic health. We'll discuss menstrual health, pregnancy, menopause, and common pelvic conditions. Knowledge is empowerment, and we aim to provide you with comprehensive information.

Pregnancy and Postpartum Health:

For women navigating the beautiful journey of motherhood, we'll provide guidance on maintaining pelvic health during pregnancy and postpartum recovery.

Pelvic Pain and Gynecological Conditions:

Many women experience pelvic pain or gynecological conditions at some point in their lives. We'll explore these issues, their causes, symptoms, and available treatments.

Resources for Women:

Discover a wealth of resources tailored to women's pelvic health needs. From articles and expert advice to community forums, you'll find the support you need to make informed decisions about your health.

Resources

One Woman's Story of Pelvic Pain

“Before you read my story, please note that it reflects my experience alone. It is my hope that my story will assist in raising understanding and awareness of pelvic pain in our community and is written for no other purpose. Some of the treatments I have tried may or may not work for you, though it is important that you always follow the advice of qualified health professionals. The important thing is that you give consideration to both cure orientated and management orientated approaches to pelvic pain. This process is individual and can take some time and is not always easy, so if this is you, hang in there! I decline to mention the names and locations of services and health professionals I have discussed in my story in the interests of remaining unbiased.

My name is Tiffany Brooks and I have experienced pelvic pain for over 15 years. My experience with pelvic pain began with particularly bad pain before, during and after my periods from the age of 16 while in high school. This quickly escalated to experiencing pain in my pelvic region almost daily and particularly severely just prior to and during my period. My high pain levels meant that I often had time off of school and the grades I had worked so hard for began to suffer. I often felt fatigue and flat and spent a lot of time in bed and sleeping. My pain meant that I had to give up many of the interests I had enjoyed outside of school, including long distance running. After experiencing pain for around a year, I began to seek professional help with the assistance of my supportive family…

How can I manage my Chronic Pelvic Pain?

There are many things you can do to manage your pain self-help techniques you can use to manage your pain.

1. Manage the original cause of your pain if this can be determined

This is usually a problem with one of the pelvic organs, although sometimes, no cause is obvious. See your doctor to exclude serious diseases or simple treatable things like vaginal thrush or infections. If you are getting period pain, start with simple medications. Period pain medications work best when they are taken before the pain gets bad, and then taken regularly during periods. Commonly used medications include ibuprofen, naproxen or diclofenac. Minimising periods by skipping periods using hormonal therapies, such as the contraceptive pill and long acting reversible contraception ( LARC) including the Mirena, is effective at managing cyclical pelvic pain.

If you are getting pain around your vulva due to irritation, avoid using soap/perfumed body washes. Replace this with soap-free washes , try using water based lubricants, or try the SiliSaddle to reduce friction.

If you experience painful bladder syndrome, a condition that resembles symptoms of a urinary tract infection with no evidence of infection, avoid certain foods that can trigger these symptoms, including acidic foods/ drinks( citrus, fruits, fizzy drinks, caffeine, cranberries, artificial sweeteners and tomatoes).

Furthermore, you have irritable bowel syndrome. IBS is a condition where the body cannot absorb certain sugars, resulting in fermentation and excess gas formation in bowels. The gas stretches the bowel, causing cramping, abdominal pain and bloating. Some people get diarrhoea and/or constipation. Try to identify foods that trigger these symptoms, or try a FODMAP diet with the help of a dietitian.

2. Learn more about your pain

If your doctor has fully assessed your pain and no serious disease has been found, you may understand that you aren’t in danger but still do not know how to manage your pain. Everyone is different, so it is vital to learn more about your individual condition – why you have pain, where it comes from, and what makes your pain better or worse. With an increased understanding of your condition and pain, the fear, stress and anxiety around your pain can be reduced. This knowledge empowers you to take control of your pain rather than allowing your pain to control of your life.

Maybe your pain is brought on by sitting or standing for more than thirty minutes, wearing tight jeans or when you had a stressful day. Maybe your pain improves when you stretch and have a nice relaxing bath after a long day at work. It is a good idea to make a list of your issues and record the activities that improve or worsen your pain and which treatments helped you most.

3. Pace your activites

Sometimes ongoing pain can cause us to alter activity levels, which can be helpful short term but not long term. Fear of pain flares can mean we avoid things, including the things that can help with our pain.

Others do too much when they feel good ( boom) and then cannot do much for a while (bust) due to the pain flare from the overexertion. Doing too much or too little can lead to more pain and less function. Finding the middle road by pacing can be helpful.

Activity pacing involves breaking activities into smaller manageable chunks with regular breaks gradually increasing intensity. This allows you to conserve energy to achieve more overall,  with less discomfort. Pacing empowers you to have more control of your life, allowing you to do the things important to you.

Try to accomplish activities with up to 80% effort, with a gradual increase of 10 % increase in activity each week,  with regular rest breaks in between. For example, if you know pain or fatigue sets in after 10 minutes of walking, limit your walking to 8 minutes at regular intervals. Increase the duration of walking by 1 minute each week. This allows you to walk every day, rather than walking for one day and then recovering for multiple days.

If you flare, try not to panic! Sensitive nervous systems may flare to protect you, but it does not necessarily mean you are injured. Go back to a level you can manage and start pacing up again. Remember to take one step at a time; consistency is more important than intensity.

4. Learn to relax the pelvic floor muscles and your mind using special stretches and whole body guided relaxation

No matter how the pain started, if you have pain on most days, it is likely that your pelvic floor muscles are constantly tensed without you realising it. When muscles stay tight, they get painful and can spasm. Reducing the tension in the pelvic floor muscles through relaxing and stretching exercises allows the muscles to work normally again, reducing your pain and potentially improving bladder, bowel, and sexual function. It is also important to have good bowel and bladder habits to take pressure off your pelvic muscles. Bowels should work easily without straining, and emptying should not be painful.

The pelvic floor muscles lie across the bottom of your pelvis like a trampoline. On top of the muscular trampoline lies the bladder and rectum. The pelvic floor muscles need to relax to pass urine, bowels or semen. The trampoline sags and moves down when it relaxes and tightens and moves up as it contracts.

Targeted stretches ( link to stretches page) will help reduce tension and pain in and around the pelvis. If you need help, you can seek help from a pelvic floor physiotherapist.

Whole body relaxation is good for identifying muscles you habitually and subconsciously hold tight and tense. Guided relaxation exercises and stretches help reduce the tension in other muscles, as well as your pelvic floor muscles and are good for managing your stress.

5. Calm your nervous system, to reduce the pain sensitisation

Stress, anxiety and depression can worsen your pain. Learn to manage your stress to improve your pain. Using the same techniques for pain, try to identify the things that worsen and improve your stress. Additionally, getting good sleep, having regular manageable physical activity, and a healthy diet will help with stress. There are several online self-paced courses you can access to help manage stress, anxiety and pain. Visit https://thiswayup.org.au/ for some courses.

Medications such as Amitriptyline, Duloxetine and Pregabalin/Gabapentin can help calm your nervous system and reduce pain sensitisation and hyperalgesia. It is important to avoid opiate medications such as oxycodone and panadeine forte. Although they help in the short term, opioids can make the pain worse in the long term and have many associated issues, including dependence, tolerance, and addiction. See your doctor for further advice.

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