S.Often pathologies such as vulvodynia, endometriosis, vaginismus and lichen are linked to problems of the perineum and pelvic floor: many ailments typical of these diseases can be treated by reducing the contraction of the deep muscles. Therefore, they should not be trained to be more toned, but more relaxed
THEThe pelvic floor, together with the perineum, is a little known part of the body and sometimes accompanied by many taboos. But pain and problems often depend on this area, which can be solved instead.
Perineum and pelvic floor: two underestimated parts
We hardly know what they are the perineum and pelvic floor. The perineum is that region of the body that rests on the bicycle saddle. Precisely it is located between the pubic symphysis and the coccyx, where three channels end: the urethra, the vagina and the rectum. The pelvic floor represents the inner part of the perineum. “The perineum is a hidden area and as such we are not so used to taking care of it, but neither are we used to knowing exactly how it is done »explains Elena Bertozzi, a physiotherapist specializing in pelvic floor rehabilitation. «Yet that of the perineum is a very important area for a woman’s health and well-being. We often become aware of its existence and of the pelvic floor only when certain disorders appear ».
Vulvodynia, endometrosis, vaginismus and lichen are related to the perineum
Vulvodynia, endometriosis, but also vaginismus and lichen can be linked to problems in the perineum and that part of the non-external genitalia. We often think that the problems are due only to the passing of the years or that we have to resign ourselves to accepting the pain, but this is not the case: “You realize that something is wrong when you start to have signs of urinary incontinence, pain in intercourse or drynessand in most cases we resort to an emollient cream or a sorbent, without imagining that something can be done instead, to regain muscle tone and well-being “explains Elena Bertozzi, also author of a book entitled The secrets of the perineum (Red!), together with Cristina Pelagatti.
Here are the expert’s advice for the most frequent ailments, including lichen, which is less common.
Vulvodynia: how to recognize the symptoms
Recently, the taboo on vulvodynia seems to have fallen. More has begun to be talked about, also thanks to the contribution of Giulia Soleri (Damiano dei Maneskin’s girlfriend) who suffers from it: “Vulvodynia is a chronic inflammatory disease in the pelvic area, it can arise with very clear symptoms: generally it is intimate burning, itching, dryness, pain during intercourse or even discomfort in wearing certain clothes, or even in sitting, or it can manifest itself with urinary symptoms such as frequency in needing to go to the toilet or burning in urination. We must pay attention, however: precisely because we are dealing with different manifestations, we must understand the cause well. Often the first thing you think about is an infection, then you resort to antifungals or antibiotics, but the risk is that in addition to not working, they could worsen the condition »explains Elena Bertozzi. What to do then?
The sensitivity test for vulvodynia
«The first step is to give due importance to these pains, then investigate the health of the intimate area with a first simple test. It is called a sensitivity test, it is carried out with a cotton swab with which the area of the vulva is touched to understand if there are hypersensitivity points. If the woman reports pain or burning or a pins-and-needles sensation, this is an alarm bell that indicates that the pelvic floor muscles as a whole are very tense or contracted. To intervene it is also necessary to relax it with physiotherapy, in addition to being able to resort to specific supplements and vitamins, on the recommendation of the doctor, and possibly also drugs»Explains the expert.
Vaginismus: what it is and how it is distinguished
«Also in the case of vaginismus the anamnesis and a differential diagnosis are very important. In fact, this problem can be confused with others. Vaginismus is a phobia of penetration: the woman who suffers from it has no problems in everyday life, does not feel hypersensitivity and is negative on the test with the stick. She does not even have inflammation or itching, but she suffers at the time of sexual intercourse: this happens due to a form of closure and an important contraction of the pelvic muscles which, if forced, triggers pain. It is therefore a problem that must be treated both at a psychosexual and rehabilitative level, by relaxing these muscles with specific exercises, on the recommendation of the specialist »advises Elena Bertozzi.
Lichen: what is it and what are the symptoms
«Lichen is a less known and less frequent disorder than the previous ones. It is an autoimmune dermatological disease that affects the external genitalia. Lichen changes the anatomy of the genitals: for example, the labia minora change or narrow the vaginal entrance. In this regard, the first advice to women is to learn to observe themselves to notice any changes. Sometimes – explains the physiotherapist – these changes are accompanied by very intense itching. Because of this the pelvic floor can contract and therefore give pain during intercourse “.
Lichen: how to cure it
In addition to getting to know each other, however, it is also necessary not to be ashamed to turn to a specialist: “Lichen can be confused with candida, but the difference is that the swab will be negative and above all there will be a mutation in the anatomy, with symptoms similar to premature aging of the genitals. The topical therapy par excellence is the cortisone, which however does not serve to block the disease but only the symptom of itching. The contraindication is that it thins the skin, thus facilitating atrophy. With physiotherapy, radiofrequency or oxygen therapy, on the other hand, the collagen is replenished and increased, restoring tone to the atrophied genitals»Explains the physiotherapist.
Endometriosis: what it is
If this problem has not been talked about for years now endometriosis it is better known, even if an attitude of resignation in the acceptance of pain remains widespread. “Endometriosis affects when endometrial tissue, which should be in the uterus, for unknown reasons comes out creating adhesions or nodules that cause pain. The consequence is often greater tension in the pelvic floor, which it gives deep pain to the penetration ».
Endometriosis: how to cure it between the pill and physiotherapy
In addition to prescribing the birth control pill to put the ovaries at restlet’s not forget the importance of physiotherapy to relax, even manually, the walls of this organ. The same beneficial effect can be had at the vaginal level, making the structures supple and soft »concludes Elena Bertozzi.
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