What “Only Murders in the Building” Can Teach Us About Our Pelvic Floors

In a recent episode of the wildly popular Hulu series “Only Murders in the Building,” the pelvic floor was an unexpected plot point. Charles-Haden Savage (Steve Martin) was visiting chiropractor Dr. Maggie (Veanne Cox). He wanted to find out more about Sazz Pataki (Jane Lynch), the (spoiler alert) murdered stunt double who was also a dear friend. After talking to Dr. Maggie, Charles realized that his relationship with Sazz might not have been as good as he thought it was, and he became depressed. Glenn (Paul Rudd), feeling sorry for him, asked, “What have you got for heartache, Mags?”

“Well,” she replied, “relationship worries are stored in the pelvic floor so….”

“Whoa ho ho! No. No,” Charles said nervously, while protectively putting his hands over his crotch.

It’s a typically funny Steve Martin moment but also a teachable one.

I think most of us understand that the mind affects the body. Anyone who has ever felt her heart race or stomach hurt during a stressful moment knows this all too well! Stress may also play a part in the health of your pelvic floor: It makes our muscles tighten, which can slow down circulation, both of which can potentially result in pelvic floor dysfunction.

Relationship worries are a factor that can give rise to dyspareunia, which frequently shows up in women who have hit menopause, though it can occur even if you are pre-menopausal. Up to one-half of postmenopausal women may be affected by dyspareunia. Put simply, it’s pain during sex, and that can be just a little bit up to extremely uncomfortable. Maybe you thought this was normal? Your cross to bear? You’ll be happy to learn that it’s not, and is definitely treatable. It can be helped by changing the soap you use to a milder one, using lube when you have sex, vaginal estrogen if atrophy is a concern, and counseling. Relationship problems aren’t the only possible emotional cause of dyspareunia. Being taught that sex is something to feel guilty about, past sexual abuse, or even a previous traumatic pelvic exam could be to blame.

Vaginismus is one cause of dyspareunia. We don’t know how many women suffer from it because we’re not encouraged to talk about it, even in this day and age, but we know physical and emotional trauma can be a factor. The muscle spasms and pain of it can make penetration impossible, which of course can be incredibly frustrating for both you and your partner. Talk and sex therapies can help. Getting treatment can greatly increase your quality of life, since a healthy sex life is so important for our happiness!

The pandemic may have given some of us a condition known as “pandemic pelvis.”  COVID was, in some ways, the perfect storm for pelvic floor dysfunction. Those strong emotions the pandemic unleashed – stress and fear – could have been the reason our pelvic floor muscles were tightening. (We were also likely in front of the computer more than usual, perhaps in a seat that wasn’t super ergonomic and were coughing a lot, which is not great for incontinence!)

The University of Miami recommends getting more active as a way to deal with stress. “Physical activity is a great way to clear your mind, spend time in nature, reduce stress on the body from prolonged sitting, and encourage blood circulation—all of which can help reduce symptoms of anxiety and depression,” the university notes.

One cause of pelvic floor dysfunction is straining to have a bowel movement, which is something many of us might do when we are rushed and stressed! Increasing fluids, having a healthy diet and exercise can help.

Think of the pelvic floor as a messenger, alerting you when you might be experiencing too much stress. It might be just the thing that forces you to take a hard look at the way stress shows up in your life and inspires you to take better care of yourself. Once you are less stressed, it can help not only your pelvic floor, but so many other aspects of your life. 

And unlike Steve Martin’s character in “Only Murders,” you don’t need to be stressed at the prospect of pelvic floor physical therapy to treat a pelvic floor condition that may be related to stress! If you are in the New York area, please contact us at Revitalize so we can help you live a less painful and stressful life!

 

When They Don’t Have Time for Your Pain

Doctors are supposed to treat all patients equally, but sadly, sometimes they don’t. In fact, if you are a woman, you may actually receive worse treatment for your pain than if you are a man. If being in pain isn’t hard enough— add a doctor who won’t listen, and you can end up depressed, frustrated, and distrustful of the entire medical profession. 

What kind of inconsistencies are happening exactly? Let’s take a closer look. 

  • In a study of almost 1000 patients published in the Academic Emergency Medicine journal, it took women with abdominal pain in an urban emergency department 16 minutes longer than men to be treated. Women were also not as likely to be prescribed opiates. The study concluded that “gender bias is a possible explanation for oligoanalgesia in women who present to the ED with acute abdominal pain.” (Oligoanalegesia is just a fancy term for when pain is undertreated.) 
  • A 2022 article in The Washington Post looked at studies that explored the inferior medical treatment received by women experiencing pain compared to men. This included enduring a longer wait time to be seen for a potential heart attack, or being told they have a mental illness when they had heart disease symptoms. “Among middle-aged women,” that study said, “31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts.” 

And then there are personal accounts of women struggling for years to receive a proper diagnosis.

Broad City actress Ilana Glazer spoke of her battle to be taken seriously by doctors for pelvic pain. She went undiagnosed for two decades! “I remember being 15 years old and my mom and I sitting there and this doctor telling me that my problem was too problematic for him, and just feeling laughed at and so angry,” she said.  

Essayist Carli Cutchin had to wait 11 years to be told she had a compressed pelvic nerve. The reason? Medical professionals simply didn’t believe that her pain existed.  

Cartoonist Aubrey Hirsch created a comic about being told her ear pain was not significant enough to be problematic. However, when the male doctor looked closer, he discovered it was a ruptured eardrum with an infection. “Why didn’t you say you were in this much pain?” the doctor asked her at the end of the session, even though she had!

A few years ago, when Hillary Koplinka was feeling tired and achy, she was told to participate in yoga by her male doctor for what turned out to be Hashimoto’s disease! 

Maybe you’ve heard stories like these from your female friends and family?

So what can you do? Although the onus shouldn’t be on the patient to get her doctor to listen, there are steps you can take to advocate for yourself.

Zocdoc suggests being thorough in keeping notes about “when, where and how” your pain occurs so you can describe it. Having another person validate your story is also important, be they a friend or relative. It can also help to parrot back the information the doctor shares during the visit. 

Finally, don’t stop until you find a doctor with whom you are comfortable. 

 And if you are having pelvic floor dysfunction pain and live in New York or nearby, consider Revitalize Physical Therapy. You will receive top notch medical care from providers who know what you are going through! We will never dismiss your pain because we recognize that having the right team who takes you and your pain seriously can make all the difference.