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Myths and Misconceptions

The pain is all in my head.
While symptoms may fluctuate with stress levels and thought processes, they are very real. If you have ever watched a scary movie, or been on a very turbulent airplane ride, or ridden a roller coaster, you know the feeling of tension in your muscles that accompanies fear or stress. Your muscles naturally tighten up in a protective pattern during frightening or stressful times. Stress may range from day-to-day family routines or job-related duties, to fear of a disastrous diagnosis. Recognizing your body’s physical response to these stressors is the first step to changing that response.

There is no effective treatment: just live with it.
While pelvic pain is a chronic condition in many cases, one does not have to live with symptoms on a daily basis. By learning the techniques utilized in our treatment approach, it is within your hands to keep symptoms at bay in the long run. It will take ongoing effort, and the development of new habits and ways of moving, but this will help you to live without symptoms. Ongoing self-monitoring of your state of muscle tension will continue, and you may find yourself becoming mildly symptomatic if you discontinue your program, but this will be a reminder to get back on track. It will be your responsibility to nip it in the bud before it gets out of hand, or to schedule a “tune-up” visit on an as-needed basis in the future.

Only women can have pelvic pain.
We see about an equal number of men as we do women with pelvic pain conditions. As the problem is related to muscle tension, and both men and women can have muscular problems equally, this is not a gender-specific problem.

Most pelvic pain comes from being sexually abused.
There is not a higher incidence of sexual abuse history in the pelvic pain population than in the general population at large. There are many sources of muscle tension that can contribute to pelvic pain conditions, and regardless of the original source, learning a new way of holding oneself to reduce this tension is the best approach to alleviating symptoms.

I’m just small, that is why I cannot insert a tampon or tolerate a pelvic exam, or tolerate sexual penetration without pain.
Click here to learn more.
It is extremely rare for an individual to have a vagina that is too small for normal function. Vaginal tissues and muscle are designed to stretch a lot more than is required for sexual participation, even with a well-endowed partner. More likely, you are unconsciously contracting the pelvic floor muscles in anticipation of penetration. This can occur for a number of reasons, but regardless of the reason, our clients quickly learn to relax their muscles and stretch tight structures in order to participate in various forms of penetration, including tampon use, pelvic exams and sexual activity without discomfort.

Incontinence is just a normal part of aging in women (or… having children makes women incontinent)
Click here to learn more.
While muscle weakness can be related to aging, and while pregnancy and delivery may be hard on the pelvic floor, many women manage to remain continent for life despite advanced age or multiple pregnancies and deliveries. The most common types of incontinence (stress incontinence and urge incontinence) are extremely treatable, and most of our clients are fully continent following treatment. Muscles, regardless of whether they are on the surface of the body or deep inside the pelvis, respond to loading by increasing their ability to produce force (i.e. strengthen). Physical therapists are highly qualified experts in the movement system and muscle performance, and as such are the appropriate health care practitioners to address continence issues related to muscle performance. In addition, many behaviors or habits result in continence challenges, such as urinary urgency or decreased bladder capacity. We address these behaviors and work on developing new habits as part of our plan of care.

Menopausal Myths & Misconceptions

Click here for more information on menopause.

My symptoms cannot be related to menopause, because I still get my period/it hasn’t been a year since my last period (Click to expand)


Hormonal changes associated with menopause can begin well before a woman’s last menstrual period. Some women begin feeling these symptoms as young as in their early 40s. A woman’s last menstrual period and the “official” start of menopause (1 year after her last period) is an indication of drastic changes in her hormonal status. Even small changes in hormonal status, however, can impact the way a woman feels- just as she might be symptomatic during different stages of her cycle at other phases of her lifespan.


There is only one form of hormone replacement and I am not a candidate for hormone replacement therapy (Click to expand)


Hormone replacement therapy runs the gamut from oral hormones, to transdermal patches, to local (vaginal) application of hormones. There are natural bio-identical forms of hormone replacement as well as pharmaceutical forms. Estrogen is not the only form of hormone that may need “boosting” after menopause: forms of testosterone and progesterone may also need replacement, depending on one’s presentation/symptoms. It takes a bit of trial and error to find the correct replacement balance for any individual. While one form of hormone replacement may be contraindicated (e.g. systemic hormone replacement in the case of history of cancer), another may be perfectly safe (e.g. vaginal application of estrogen, which remains local). While one mechanism of hormone replacement may exacerbate a woman’s symptoms, or not work at all, another might alleviate her symptoms (e.g. Estring ® vs. estrogen cream).


All forms of hormone replacement cause cancer (Click to expand)


While systemic hormone replacement therapy (e.g. in the form of pills or a patch) might be contraindicated in individuals with a history of certain cancers or genetic predisposition to certain cancers, many of those women can utilize vaginally-applied forms of hormone replacement which remains local. This may be quite effective in alleviating certain vaginal symptoms such as dryness/discomfort and urinary symptoms such as frequency or incontinence.


Your body has changed forever and there is nothing you can do about it (Click to expand)


While some changes associated with menopause are permanent, i.e. your body no longer produces the same forms of estrogen in the same proportions as it used to, the effects of menopause are, in many ways, addressable. Muscle stretching and strengthening, as well as techniques to increase vaginal and vulvar blood flow may help to alleviate some of the discomfort and urinary symptoms associated with menopause.