Uterine fibroids from a Gynecological standpoint are rarely in the category of "triggering” (or causing) significant pelvic pain. Fibroids are extremely common in the general population and statistically occur more in African Americans. They are one of the main "reasons" for hysterectomies in the US, but not because they are the cause of pain. Pain of various sorts can be associated with fibroids - usually it’s pressure type discomfort if they are big enough and pressing on various other structures. Rarely, if they grow too rapidly they outgrow their blood supply they can "degenerate" which is painful and serious but is easily remedied with surgery. The main problem with fibroids is that certain types of them can cause excessive uterine bleeding and if they continue to cause too much bleeding and anemia, then there are different types of surgical and other invasive procedures (embolization) to treat them.
We have observed that many women are told that their pain is due to fibroids just because they have fibroids and they have pain. But actually most fibroids are completely asymptomatic and do not require anything to be done about them and they shrink down after menopause. Uterine fibroids should not be considered a significant cause of chronic pelvic or sexual pain because to do so would be extremely misleading. If you are one of millions of women suffering from chronic pain conditions in the pelvic region and have been diagnosed with uterine fibroids as the primary cause of your pain but you are not noticing any improvement despite being treated for them, please insist on further testing or evaluation for bladder, bowel, musculoskeletal, or nerve related causes of your pain. Or insist on finding a practitioner that is familiar with these conditions. Start with our resource page and The Echenberg Institute for Pelvic & Sexual Pain atinstituteforwomeninpain.org
Paindownthere.com and the educational/instructional videos Healing the Pain ‘Down There’ intend to explain, as best as possible, that there are many reasons in the pelvis for pelvic floor dysfunction and for genital and pelvic pain. One of these reasons may be hypertonicity (as posted about last time). Virtually everyone with pain, caused by all sorts of injuries to the body, has reactive hypertonicity in and around that injured area. The muscles around a knee injury or shoulder injury, for instance, always tighten to guard that area and stabilize or “splint” that area. Same in the pelvis. The way that pain is processed in the brain along with fear and anxiety factors can also continue to cause hypertonicity even after the initial injury has healed. Mind/body aspects of care become so important in this instance.
Other reasons or “triggers" in the pelvis for pelvic floor dysfunction and for genital and pelvic pain besides the implications of hypertonicity include:
Somatic reasons: Current or previous injuries or stress on all of the surrounding structural entities. These structural entities include bone, muscle, fascia (connective tissue), ligaments, and nerves.
Visceral reasons: Organ dysfunction like IC (Interstitial Cystitis or Painful Bladder Syndrome), IBS (Irritable Bowel Syndrome), Endometriosis, Prostatitis and others.
We want to help “connect these dots” for all the potential and interconnected sources or “triggers” of chronic pain in the pelvic and genital area.
Hypertonic pelvic floor muscles (or hypertonicity) are too tight and tense which can lead to pain and can also create weakness which can actually lead to incontinence (loss of control) of the bladder. Hypotonic pelvic floor muscles (or hypotonicity) are too loose and can also lead to incontinence of both the bladder and the bowels. So both hypertonicity and hypotonicity can lead to loss of bladder control. However, loss of bowel control is more often associated with hypotonic related weakness. Pain would only be associated with hypertonicity. So to recap:
Hypertonic pelvic floor muscles (hypertonicity):
Hypotonic pelvic floor muscles (hypotonicity):
Stephanie Yeager: Passionate about spreading the word of hope and healing for those like her, influencing a paradigm shift in the medical community toward greater understanding of chronic pelvic pain disorders, and prevention initiatives that may protect young women before onset can occur.