Chronic pelvic floor dysfunction

Best Pract Res Clin Obstet Gynaecol. 2014 Oct;28(7):977-90. doi: 10.1016/j.bpobgyn.2014.07.008. Epub 2014 Jul 17.

Abstract

The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management.

Keywords: manual therapy; organ system dysfunction; pelvic floor muscle dysfunction; sexual dysfunction; vulvar pain; women's health physical therapy.

MeSH terms

  • Female
  • Humans
  • Pain Management / methods*
  • Pelvic Floor / physiopathology*
  • Physical Therapy Modalities
  • Quality of Life
  • Sexual Dysfunction, Physiological / physiopathology
  • Sexual Dysfunction, Physiological / therapy
  • Vulvodynia / physiopathology*
  • Vulvodynia / therapy