Pelvic floor hypertonicity: how to manage it on a daily basis?

Hypertonicity of the pelvic floor or hypertonia of the perineal muscles is a health problem that, although it is sometimes unrecognized, can have serious repercussions on the quality of life of those who suffer from it. More than just a temporary discomfort or inconvenience, it can also impact urinary and digestive function as well as sexuality and intimate comfort. Here are some tips to overcome this problem and improve your intimate comfort on a daily basis.

What is pelvic floor hypertonicity?

Pelvic hypertonicity, also called perineal hyperactivity, is an intimate problem that most often affects women and people with vaginas. It occurs when the perineum is too tense or when the muscles that compose it contract. This is the opposite phenomenon to hypotonia, which refers to the abnormal relaxation of the pelvic floor. Since the muscles located in this area play a crucial role in supporting the urinary and genital organs as well as in urinary and fecal continence, their excessive tension is the cause of various symptoms and discomfort.

What are the causes of this problem?

The causes of hypertonicity of the perineum vary from case to case. However, various situations can increase the risk of developing this problem. Some are purely physical, while others are more psychological. Factors that can promote the onset of this phenomenon include:

• Trauma and injuries affecting the pelvic region : impacts to the coccyx, accidents and surgical interventions in the genital area, pelvic area, hips, etc.
• Hormonal fluctuations during the menstrual cycle, during pregnancy, after childbirth or at the time of menopause which affect the tone of the pelvic muscles.
• Intense physical activities that put increased pressure on the pelvic floor, such as cycling or horse riding.
• A history of sexual abuse, the psychological repercussions of which may manifest themselves physically through muscular tension in the perineal area, particularly during sexual intercourse.
• Stress and anxiety which can lead to muscle tension in general, including in the pelvic muscles.

What are the symptoms of pelvic hypertonicity?

Apart from the tension of the perineal muscles that can be felt by touch, hypertonicity of the pelvic floor can manifest itself in various ways. Its most common symptoms are:

• Chronic pelvic discomfort and pain: feeling of heaviness, tightness, myalgia (muscle pain);
• Dyspareunia : pain at the entrance to the vagina and in the pelvis in general during penetrative sexual intercourse;
• Urinary problems: frequent urge to pee, burning when urinating, feeling that the bladder is never completely empty;
• Constipation due to difficulty in passing stools properly;
• back pain resulting from excessive tension in the pelvic muscles which affects the lower back.

What to do in case of hypertonic pelvic floor?

What to do

Consult a healthcare professional

First of all, know that suffering from pelvic hypertonicity is not inevitable. Although this problem can have a serious impact on your intimate comfort and your sex life, there are many solutions to correct it. Whatever your situation and symptoms, it is essential to consult a health professional such as a midwife, a gynecologist or a perineologist physiotherapist who will be able to offer you a targeted and adapted approach: perineal rehabilitation sessions with or without biofeedback, treatments, specific relaxation techniques, etc.

Help your muscles relax

At the same time, in your daily life, it is essential to do everything you can to promote the relaxation of the pelvic muscles. Practice abdominal breathing. Favor sports that provide muscle relaxation, such as swimming, for example, and avoid movements that create muscular tension in the perineum. Learn to better control your muscles, but also your breathing, thanks to forms of restorative yoga (rather than dynamic yoga) or mindfulness meditation. These disciplines also have the advantage of helping you manage stress, which will have an immediate (and natural!) effect on your perineum.

Act directly on the perineum muscles

There are devices specifically designed to relieve tension in the perineal muscles and soothe pelvic pain. The pelvic wand is an ergonomically shaped wand designed to adapt precisely to the intimate area and reach the most sensitive tension points. Provided you know how to use it correctly, it can help provide targeted and beneficial muscle relaxation. Vaginal dilators can also be an excellent way to gradually regain control of your pelvic muscles . Effective and recommended by physiotherapists, these devices must however be used in agreement and with precise instructions from the healthcare professional who is following you.

Adapt your food hygiene

Constipation is both a symptom and a contributing factor to hypertonicity and must be managed as a priority to avoid making the situation worse. It is therefore essential to eat foods rich in fibre and drink enough to prevent intestinal disorders and avoid additional and unnecessary trauma to the pelvic area.

What to avoid

To prevent muscle tension from increasing, it is also important to avoid a number of things:

• Using geisha balls or performing Kegel exercises without prior medical advice;
• Physical exercises that can aggravate this problem: lifting heavy loads, impact sports (jumping, jogging, etc.), cycling, horse riding, etc.;
• Pushing excessively when constipated or when urinating, but also holding back from going to the toilet;
• Sitting for a long time or in a slumped position which puts pressure on the stomach and therefore on the perineum;
• Situations that may cause excessive stress.

Reflexes that can save your sex life

Beyond its effects on general intimate comfort, hypertonicity of the perineum can have major repercussions on sexual life. The pain felt during penetration generally leads to a fear of sexual intercourse, which then increases stress and therefore tension in the perineal muscles. And this vicious circle can quickly become a source of conflict or at least discomfort within the couple. There are, however, a number of solutions for regaining a fulfilling intimate life:

• Practice abdominal breathing to promote relaxation of the deep muscles.
• Perform relaxation exercises to prepare the body (and mind) before penetration.
• Use devices designed to soften the perineal area in case of dyspareunia or hypertonicity, such as dilators or a pelvic wand. Remember to use a good water-based lubricant to facilitate insertion and therefore muscle relaxation.
• Adopt sexual positions that promote relaxation of these muscles and do not put excessive pressure on the pelvic area.
• If the pain is intense or you can't relax enough, remember that clitoral stimulation also brings a lot (if not more) pleasure. Favor (at least temporarily) non-penetrative intercourse to continue to fully enjoy your sex life and intimacy with your partner without accentuating the disorders.
• And above all, don't hesitate to talk about it openly with the person you share your life with so that things left unsaid don't spoil your relationship.

By adopting these tips and listening to your body, you will gradually manage to regain confidence in yourself and in your partner to find the path to pleasure and your intimate comfort.