Pain With Intercourse with Amanda Fisher

Hi, welcome to the Pelby Biz Podcast. Are you a pelvic health PT or ot? Struggling to start your own practice? This podcast helps pelvic health PTs and OTs get out of debt, gain the income they desire, be able to treat patients without insurance restraints, and learn how to create time freedom for yourself and your family. I'm your host, Dr. Kelly Alhui, founder of Ortho Pelvic Physical Therapy, pelvic health business grower and pelvi biz. Over the last two years I went from a solo entrepreneur to a seven person team in counting. I'm here to help provide a clear path to grow your pelvic health business as fast as possible so that you can gain the time freedom, decrease debt, increase income and live the life that you desire. Before we get started today, make sure you click the link in our bio to grab your ticket for pelvi biz. Now let's get into today's episode.

Welcome guys. I'm your host Dr. Kelly Alhui with collaborative connections with orthopelvic physical therapy.

And I'm Dr. Amina Fisher with empower your pelvis.

Today we're going to do a collaborative podcast talking about how we both became a pelvic health physical therapist and what was our why you got it.

I'm Amina Fisher. Back in 20 2009, 2008, I was having sex. Premarital sex. Yes I was and with my husband to be but we I started experiencing pain with sex. So I was in grad school. I had just graduated from undergrad, moved to grad school, had a lot of stresses and back then that wasn't really thought of as something that could be causing pelvic pain. But I was experiencing pain with sexual going to grad school, planning a wedding. My parents were going through a divorce. Looking back on it now. Oh, and training for we were doing six half marathons a year. Who does that? A lot of us. But that's kind of what kind of pushed, you know, me over the edge and developing into my pelvic pain. And I realized I after going to my doctor, her telling me, you know what I mean? I just have a couple glasses of wine y'. All, have you ever had wine? And it makes you really tipsy and not really want to get in the mood like you just want to go to sleep. That was me. I didn't want to be intimate. I wanted to pass out to a rom com. So that didn't help the situation which.

Is I'm going to just interrupt for five seconds which is really interesting because what does a lot of OB GYNs tell you?

Recommend having a glass of wine.

I know. And it's not the solution, guys.

No. So figured out when I went to a CSM conference, a PT conference that year that you know what? I joined into a women's health talk called the Big O all about orgasms. While sitting there, realized, you know what? I believe this whole presentation is on me. And I don't know any of these professors, so I'm turning to people, looking at them, asking if they're feeling the same things that I had. I thought I was the only person who experienced fame with sex at this point. I was a sports med, PT thought I was going to only treat athletes. And this opened up a whole new realm for me to go down. So I dealt with my pelvic pain. Have been for probably the last decade. Came to understand like you can still have sex with pain, although it's not recommended. There are things that we can be doing and I had to learn to go to pelvic PT to help improve that because you don't want to continue to push on something that is uncomfortable because those muscles down there will tighten up and is eventually like resist anything coming in. They put up the walls, they block it. It truly is a cock blocker down there.

For real. The pain science is real, guys. What tends to happen is the your body knows when your husband or partner or whoever may be coming onto you goes, oh, warning, danger, something's going to happen and the body already senses it. So it already is going to tighten your pelvic floor without you actually even realizing that. And it creates the same loop and the same pattern when you repetitively have that same problem. And so our job is to help get you off of that loop, off the racetrack. I always say create a different pathway and be able to not have that pain anymore. And then also lengthen the pelvic floor, lengthen the muscular skeletal system. But it's a multi faceted and a multi dimensional approach that we have to have as pelvic health pts.

But back when I started experiencing it statistically, it was thought that one in eight women would have pain with sex at some point in their life. We now know that statistic is more like one in two. So it's more 50% we would even say again, this is across the lifespan. Almost anyone is going to experience that depending on hormonal shifts, postpartum sex, different things that happen in life. We see that all the time in the clinic, a lot of stress and anxiety can play into that because those muscles do tighten up down there to emotion. We've seen it. It's in the research. So you want to have a pelvic floor PT almost in your back pocket at any point during your life to really help get you through those moments of tightness, tension and pain.

Yeah, it's so true. I experienced pain with intercourse as well. And mine was more because I went off of hormonal birth control after 16 years of being on hormonal birth control. Because that's what they just taught us to do when we were growing up.

They did.

I went off of it and all of a sudden I had pain with intercourse. And I was like, what the heck is this? I've never experienced this in my life. And it sucked. It felt like sandpaper was burning around my lower, like the six o' clock area. We'd like to talk about like the lower back. Yeah, that part. It was so painful. And you know, my husband was like, what the heck's happening? I was like, I don't know. Like, I don't know what's happening.

I remember crying, like, I broke it. Sorry I broken.

Yeah.

These crazy feelings when you're having it.

Yeah.

It's not fair.

And it's not fair. And then you're like, well, great, I can't connect with my partner as much. What do I do about this? And so that's really when we can, you know, shine and really come into play of, hey, we really can help these problems. I was able to help solve my issue, which is great. And now I'm able to have pain free intercourse. And you know, so many women come to us saying, we need your help, not only to help solve the pain problem, but also, like I was saying, it feeds into a relationship issue. It feeds into confidence. It feeds into, hey, I want to do this thing and I can't do this thing. And because of that, it can bring down your self confidence of, hey, I'm not good enough or hey, I can't do this task that I would like to be intimate with my partner, but I can't do that. And it becomes, it can become an issue.

And it's a big issue too. If you and your partner are not communicating what you're feeling. We the communication is key. You've got to be upfront with your partner. Let them know, like, hey, this position's a little uncomfortable. Can we try this one? Let them know what you're feeling. Let's talk about ways that maybe we can improve it. Let's Talk about love languages. How do we feed into your love language to make you feel good, but into my love language because that can play into a lot of our accelerators and breaks too, with pelvic pain. Because if I'm not getting the right love language back from my partner and it can really start to, you know, not want me to connect with them and I can start to go inside and not be talking about the situation. We know statistically too, female pelvic floors, the arousal takes a lot longer. We're like crock pots compared to our male partners. If we're having male partners who are more like microwaves, you know, they can be aroused in a couple minutes or less. Us, we're more like 25 minutes plus 15 minutes plus it takes time to get blood flow and circulation down there to plump up that tissue to make it ready for something. And that's okay.

Yeah. And a lot of us like external stimulation, guys. I think people are shocked by that.

I think that's the biggest. I'm reading a book right now called the Becoming Clitorate and that was the biggest thing in the book. It's about 90% of women actually have orgasms.

Literally.

Yes. Compared to what we see in the movies.

Yes.

Hollywood is dumbed it up of that. We need internal penetration to make that happen.

Yeah.

No.

And that's not the case. I always say use a vibrator externally. If you've never experienced a vibrator and you're open to it, you can go on Amazon, order a vibrator and try it and just place it externally. So can we get into. Amanda, can we get into like what can help people with pain with intercourse?

Yes. Pelvic floor physical therapy for one would be huge.

Duh. Right?

We've got. We really work. We see chronic pelvic pain and pain with intercourse on a daily. It's 50% of our population in the clinic. So we've even got our membership sites and courses that we work with patients on this we're really big on. We want you to learn how to self pleasure, how to self stimulate yourself first. We want you to know where the pain and discomfort is first. Because if you are relying on, you know, you've got to be really comfortable with someone to let them inside your body. Like that's a big issue that I don't think people really realize. And there's so many different factors that play into it. Nutrition is another one. If we're eating a lot of processed foods or foods that are highly irritated to our system, your Body's going to be inflamed down there too. If there's certain lubes, you know, condoms gotta have lube.

Condoms can irritate.

Condoms can irritate. I had one patient who, they didn't have lube, so she used her partner's saliva. Well, granted, he just had a peanut butter and jelly sandwich. She's allergic to peanuts. What happened down there?

Oh, my gosh.

So you've got to be really smart about what you're doing. Look at the whole situation of not just positional but other factors that might be playing into it too.

Yeah, and like I said before, the pain science approach, if there's any pain, guys, in our eyes, you should not try to push past that. Like I have women come to us that are like, Kelly, I go and take Advil or actual pain med and then go try to arouse their husband by giving them a hug and, and then being like, okay, I'll just take it by you doing that pattern. Just FYI, for anyone that's out there, this is a pattern that will be ingrained into the.

Into your brain.

Yeah, into your brain. And repetitively, no matter if you had pain or not, whenever you see your husband coming on to you or even just trying to give you a hug, your response of that pelvic floor will be tense. And that's just so we don't want to reinforce that. And we really want to be able to breathe, relax, find a position that works best for you. We like using wedges, we like using pillows. I personally always teach, like having a vibrator externally because that is something we know typically feels good for a lot of people. And then after that, can your partner start warming up your vag by placing gently, maybe a finger in, maybe it's a pinky finger. Can they start lengthening the tissue and maybe even before that, can they even just pull in the laby as gently to help externally stretch the tissue? If you're still not comfortable with internal, that's okay. Once that happens, then if you, you know, after about two or three minutes of that and you're lubing up the penis or lubing up the finger, can then they enter and not have that pain as you breathe. So these are things that we can teach you guys on how to have pain free intercourse and be able to kind of be like us and be like, we had the pain and now we don't have the pain.

And it start paying attention to your menstrual cycle too. If you're not, that's really a report card for your body, maybe for your last month of like how stressful it was, maybe how your food relation was. But patients will come in too and they'll tell us when they're having their pain and we'll ask them if they're tracking it with their cycle. And you might find month to month it's happening at a similar, similar time. And during those times, if we can start to hone in on that and get you to do exercises or stretches or even practicing more stretches with your partner or communicating that, that can help us benefit and move past that bridge and help connect you into that pain free zone. We like to look at the pain too. I always give the analogy of like the stove is hot and you touch the hot stove the next time you go there, maybe it's a hot curling iron. You're a little bit more reserved, right. You kind of hover over it to see if it's uncomfortable because you don't want to touch it again and get another burn on your hand. You want to be easy like, is it hot, Is it not? Is it hot? Is it not? The nerves down here that work with the muscles are the same way. If we continue to touch on pain and discomfort and push through it, it's only going to tick off that nerve even more and create that pain response even higher. So you really want to think just gentle touch on that discomfort, back off, touch on it, be aware where it is. Get the heck out of dodge.

Yeah. And also guys, another point that we can make here is you can bring your partner into a session with you.

Please do pelvic pts. Love that.

Yes. Because we can educ both. Both you and your partner.

And so many light bulbs go off when that happens too. It helps your relationship. Exactly.

And they will start to see and maybe get more comfortable. Or maybe we can teach them techniques that we use to be able to say, hey, okay, I'm more comfortable because now the therapist showed me what to do. Because a lot of times we know your partner can be sometimes afraid because there's already pain. They don't want to hurt you. And. And so they're like, oh my God, I just don't want to touch anything because I just really don't want to hurt you. Well, if they come to a session or, you know, join us virtually online, then they can start to understand of, hey, I'm not going to hurt you and I'm going to be able to do these things to really help you out and progress both of us together and get through this together.

It's my favorite thing when the partners show up, because it is. You can tell that that is going to improve so much faster than if you're working at it alone. Yeah, no, it's great accountability, partner, to make sure you're doing your exercises because you guys both want to connect and have pain free intercourse together and, you know, make it rainbows and butterflies again.

And this will be on your membership site, right?

Absolutely.

Yeah. Yeah.

That's great.

That's that.

We also do our coaching with our clients and that's where we recommend definitely have your partner watch the videos, make them aware of what's going on. But then it also, we are really big on stirring up that communication.

Yeah, guys, I mean, hopefully you're inspired today by this. Hopefully you're inspired by two pelvic health pts. We both had pain with intercourse. Now we're able to have pain free intercourse, which is amazing. And now we're able to give back and be able to teach teach you guys how to be able to have pain free intercourse and start connecting with your partner more without being fearful.

All right, Kelly, where can they find you if they have any more questions on this?

You can find us at orthopelvicpt on Instagram and www.orthopelvicpt.com and I'm Dr. Amina Fisher.

And on Instagram, it's power your pelvis or empoweryourpelvis.com Bye, guys.

Hi.

Thank y'. All.

If you are ready to change your life, click the link in the show notes to get your ticket to Pelvibiz.

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