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Pelvic Pain Disorders for Women...


Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside the uterus, but in areas outside of the uterus.  The exact cause is unknown and is most common to women in the childbearing years.  Most women with endometriosis have no symptoms; however, some do and they are typically pelvic and abdominal pain.  

Levator Ani Syndrome
Levator ani syndrome is also called levator spasm, puborectalis syndrome, chronic proctalgia, piriformis syndrome, and pelvic tension myalgia.

Levator ani syndrome is characterized by relatively constant and/or frequent dull anorectal pain, often associated with tenderness to palpation of the levator ani but not urinary symptoms or an organic disease which can explain pain.  This syndrome is often a result of trigger points and muscle shortening of the deep layers of the pelvic floor muscles.

Vaginismus is a condition where there is involuntary tightness of the vagina during attempted vaginal penetration.  The tightness is actually a result of involuntary contraction of the pelvic floor muscles and the woman does not “will” the tightness to occur.

Roughly 2 women in 1000 have vaginismus.

18% are under the age of 25 (probably high if the condition were better understood)
53% of women are between the ages of 26 to 35
26% are between 36 and 50 years old.  
It is highly treatable with Pelvic Floor Physical Therapy using a myriad of treatment approaches.

Vulvodynia is chronic pain in the area around the opening of your vagina (vulva) for which there is no identifiable cause.  Symptoms include burning, stinging, irritation or sharp pain that occurs in the vulva, including the labia and entrance to the vagina.  It maybe constant, intermittent or happen only when the vulva is touched, but Vulvodynia is usually defined as lasting for years.  It can occur during or after intercourse, when a tampon is inserted, or when prolonged pressure is applied to the vulva such as with cycling.  It is estimated 9-12% of women suffer with vulgarian  

It is not a psychological disorder and there are measurable inflammatory changes in the tissues.  There are a wide variety of possible causes including genetic predisposition to inflammation, allergy/sensitivities, an autoimmune disease similar to Lichen Sclerosus or Lupus, neuropathy, history of vaginal infections or injury to the affected area.  Pelvic floor dysfunction is often the underlying cause of some women's pain.

Vulvar Vestibulitis (Vestibulodynia)
Vulvar vestibulitis is localized to the vestibular region only.  It tends to be associated with a highly “burning” or “cutting” type of pain.  If it extends in to the clitoris this is referred to as clitorodynia.  

Vulvar vestibulitis Syndrome is the most common subtype of vestibulitis that affects premenopausal women and affects 10-15% of women seeking gynecological treatment.  



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