What do you know about your pelvic floor?
During the month of June we’re talking about pelvic floor issues.
We looked at postpartum recovery, what to expect from a pelvic floor physiotherapist appointment, and the main causes of vaginismus.
Today, Bethany Peterson, a pelvic floor physiotherapist, joins us to talk about why it’s so important to get to know your pelvic floor!
Historically, female anatomy has been a hushed topic.
Science and medical fields were centuries into studying and dissecting men’s bodies before anyone turned their attention to women. The generational delay in understanding female anatomy negatively affected our advancements in women’s health and pleasure!
To slow our progress even further, the Evangelical Church’s approach to women’s bodies and sexuality has been one of fear. Don’t look at it, don’t talk about it, and definitely don’t touch it.
The man-made walls society and religion build around female genitalia are dangerous.
Those walls cause women to disassociate from their own pelvises to the point we are afraid to talk to our physicians, unable to communicate with our partners, and live unnecessarily detached from a part of our God-given body.
It’s time to take those walls down.
Getting to know your pelvic floor
Before we get too deep and personal on this topic, let me introduce myself! I am Dr. Bethany Peterson, a Pelvic Floor Physical Therapist based in Kansas City.
When a new patient walks into my office, I make education my first priority. I pull out my handy dandy pelvis model and use it to help women understand where their muscles and organs are, how those body parts function, and what can cause them to malfunction.
(This isn’t a picture of the model, but it is a diagram of the pelvic floor!)
You see, girls don’t naturally interact with their private parts during childhood like boys do. A boy’s anatomy is very external. They see their penis and touch it when they go to the bathroom. Erections are normalized at a young age. And, while masturbation tends to be a taboo topic especially in the church, it’s much less taboo for young men than for young women.
Girls interact with their private parts primarily during toileting. They don’t spend time looking at or touching their body. And, sexual arousal is rarely addressed, often making girls feel weird, guilty, or even dirty about the natural sensations they feel in their pelvic area.
The idea that any part of your body is inherently dirty is simply unbiblical. Every piece of your body is miraculously made and no one has the right to make you feel any differently! In fact, the systems that shame you or make you disassociate with your pelvic region are in themselves, abusive.
Dissociation with your pelvic floor is dangerous.
The majority of women who come to my office for the first time are dissociated from their pelvis. Their body is sitting right in front of me, but that pelvis of theirs might as well be on Mars.
They are likely suffering from very common conditions like incontinence, abnormal periods, discomfort with sex, or a variety of other painful and wildly disruptive symptoms. But, they’ve been trained to believe that these problems are just a fact of life.
When I ask women exactly where they feel pain, what those sensations are like, or what their “normal” is, I often get that deer-in-the-headlights look. They are so conditioned to feel shame and embarrassment about their pelvic floor, that they struggle to advocate for themselves to a doctor!
Let me tell you, nothing makes me more excited than to assure these women that they can relax. The physical pain they are in is not because of anything they have done wrong. And, freedom from that pain is possible.
Once they take a deep breath, the stories start flowing. I listen carefully to stories about sexual trauma, abuse, shame, and traumatic pregnancies and births. Then, I get questions. Questions about sexual consent, duty sex, sexual addiction, spousal rape, vaginismus, and much more.
One of the big glaring problems is, terms like “consent,” “duty sex,” and “vaginismus” are not terms in most of my patients’ vocabulary.
I arrive at these terms with my clients after long, deep conversations about their own personal experiences.
I find out that they have never experienced an orgasm, yet they continue to have penetrative sex with their husbands because after all, “he needs it.” Or, I discover that they’re postpartum and their organs feel like they’re going to fall out when they have sex, yet they continue to do it anyway.
Sometimes, these stories clearly point to trauma and abuse, but the woman is so unaware of her rights to pleasure and autonomy over her own body, that she doesn’t even realize she’s had traumatic or abusive experiences.
Perpetuating women’s ignorance about their own anatomy makes them more vulnerable to abuse and less equipped to advocate for their own health and wellness.
None of this is the woman’s fault! It is the failure of generations of societal and religious wall-builders who keep them from knowing themselves.
Knowing your own body is crucial for communication and pleasure
Inability to orgasm, low sex drives, and pain with sex are all very common symptoms. In my professional experience, these are all far more prevalent in the Christian women I treat than they are with women who don’t subscribe to a particular faith.
There’s data to back up that experience, too. In a 2011 study published in the Journal of Sexual Medicine, vaginismus was found in more women who adhered to strong conservative morals over liberal morals. And, those experiencing vaginismus were “more restricted in their readiness to perform particular sex-related behaviors than the control group.”
Do you know what makes women more likely to orgasm and enjoy sex? Open communication with their partner. Do you know who often has a hard time communicating with their partner? Conservative Christian women who have been conditioned to believe that their pleasure is secondary to their husband’s.
The 20,000 women surveyed for The Great Sex Rescue solidifies this evidence further:
Figure taken from The Great Sex Rescue.
In order to communicate what makes you feel good, you have to know what makes you feel good!
That requires you to have felt pleasure before, be able to reproduce that pleasure, and teach your partner how to help you get there!
Some of my most productive appointments have been when a woman’s partner comes with her to physical therapy. In those sessions, I can help a couple discover what’s anatomically happening in a woman’s body.
For instance, I can test for things like decreased mobility in the clitoris. The clitoris can be our best friend! But if it’s not touched and stimulated with relative frequency, it’s possible to develop decreased mobility. This is just one example of a common yet abnormal condition that can be fixed with a little education for both the man and woman in the relationship.
Knowledge is power and communicating knowledge can lead to great sex!
How do we get to know ourselves?
1. Get a mirror.
I know it seems silly, but we need to start by looking at our own bodies.
If I had a dollar for every time I handed one of my patients a mirror just to have them apologize for not shaving well, gross out at their own discharge, or say something along the lines of “that’s disgusting,” I could retire. Your anatomy is BEAUTIFUL! Do not apologize or be ashamed. (Do you think men apologize to their physician about their penis? Nope.)
2. Feel yourself.
Self-exploration does not have to be associated with lust, porn, or any other unhealthy behavior. Remember, men touch their penises daily. It’s healthy to know and be able to communicate what feels pleasurable and what feels uncomfortable when you’re touched. This is normal!
Discover your own normal. Every woman’s body is different. Your vagina will look, smell, and feel different than the next woman’s. If you know what your normal is, you can catch signs of abnormality early and talk to a doctor about anything out of the ordinary.
Educating the next generation
Our daughters do not need to grow up with walls around their pelvises. We have a responsibility to empower them with education. From a young age, they can learn the proper names for their anatomy. Instead of being afraid to whisper the word vagina, they can learn to communicate clearly to a doctor when they notice something is awry.
They can also be confident in telling their future spouse exactly what feels good and what doesn’t. And, most importantly, they can protect and advocate for themselves because they haven’t been made to feel ashamed about their own body parts.
Let’s forcibly stop society, religion, and men from dictating how well we get to know our own divinely created bodies and start getting acquainted with those beautiful pelvises!
Thank you, Bethany, and her co-author Rachel Bradrick!
For Physical Therapists, Bethany and Rachel are also working on a Continuing Education Unit about the cultural and religious implications on vaginismus. Pre-register here!
Bethany Peterson, DPT, graduated from Creighton University with a Doctorate of Physical Therapy. Prior to giving birth to her daughter, Bethany was working extensively with acute, skilled nursing, and traumatic brain injury patients in Kansas City. Her C-section recovery journey led her to more understanding and greater appreciation for Pelvic Floor Physical Therapy, so she took the leap and started training to specialize. Today, she is the founder and owner of Well + Core Physical Therapy in Kansas City, and an advocate for re-writing the script about female wellness and sex education, especially within the Evangelical Church.
Rachel Bradrick is a Kansas City-based physical therapist and the creator and owner of PTLearningLab.com. She graduated with her Doctorate in Physical Therapy from the University of Kansas and has worked extensively in outpatient, acute, skilled nursing, and traumatic brain injury care. Rachel is extremely passionate about patient advocacy and raising the standard of care among physical therapists. She and Bethany are currently collaborating on a Continuing Education Course for physical therapists based on the intersection of religious and cultural effects on vaginismus.
Can you relate to what Bethany and Rachel are saying? Why do you think women feel so uncomfortable touching themselves or so embarrassed at doctor’s offices? Let’s talk in the comments!
Pelvic Floor Series
- Why the Pelvic Floor Matters
- What Can You Expect from a Visit with a Pelvic Floor Physiotherapist?
- PODCAST: What should you expect after childbirth?
- 3 Keys to Childbirth Recovery
- The 4 Main Causes of Vaginismus?
- Why Exploring Your Pelvic Floor is Crucial to Your Health (and Sex Life!)
- The Pelvic Floor Podcast
- How to Address and Treat Vaginismus -- 9 Healing Steps
- Secondary Vaginismus Recovery: A Newlywed's Story
- 6 Conditions that Can Cause Painful Sex that AREN'T Vaginismus
- Top 10 Tips to Make a Pap Smear More Comfortable (June 28)
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