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This chapter is devoted to the pelvic floor (PF). Maternity care has always considered the PF muscles an essential part of the birth and its disturbances. Gradually, the pelvic floor became a vital element for both sexual pleasure and sexual problems. This chapter will start by explaining its role in posture and movement, and sexuality and delineat...
Contexts in source publication
Context 1
... pelvic floor, literally the floor of the pelvis, is a layer of muscles and connective tissue that spans the bottom of the pelvis (see Fig. 10.1). They are striated, voluntary muscles that, although hidden from view, can be consciously contracted (squeezed) and relaxed. The PF consists of multiple muscles which stretch from the os coccygis (tailbone) to the pubic bone and from one tuber ischiadicum (sitting bone) to the other. In women, the PF muscles surround the hiatus ...
Context 2
... muscles inhibit the extra blood circulation needed for the vaginal wall and the erectile tissues of the clitoris. The vaginal surface stays thin, and lubrication is insufficient, causing dyspareunia. The hypertonic PF muscles close and nod the vagina causing the feeling of a narrow and short vagina, an extra reason for pain at penetration. See Fig. ...
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... intercourse can have an overwhelming impact on women, affecting selfesteem and self-confidence. This condition can need counselling and maybe Fig. 10.2 The difference between relaxed and contracted levator ani muscle. On the left, the PF is relaxed, with the vagina straight and accessible. On the right, the PF muscles are squeezed. The vagina is curved and less accessible coaching. If a woman does not understand why she feels pain during intercourse, she probably increasingly tenses ...
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... with PF function being optimal between age 15-25, depending on the age of the first pregnancy and birth [5]. After 20-25, the pelvic floor function decreases slowly. Women (and men) need a minimal function to maintain continence and other pelvic floor functions. That is why the elderly have many pelvic floor dysfunctions like incontinence (Fig. ...
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... obstetric damage can cause loss of continence early in life. Even if the woman was born with good continence factors. Fig. 10.3 How the female pelvic floor function can change over the ...
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... recommended such a massage at least 1-2× per week from week 34 (see Fig. 10.4 for explanation). One can also relax and stretch the pelvic floor with the Epi-No ® . That is an inflatable balloon coupled to a pressure display hand pump for gradual stretching of the vagina and perineum in late pregnancy [7]. Applied correctly, it might teach women to relax the PF. The Epi-No ® does not prevent intrapartum levator ...
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Citations
... (26) Como consequência de experiências sexuais dolorosas, nota-se uma diminuição do desejo sexual, a antecipação da dor pode também reduzir a excitação, a lubrificação e a probabilidade de experienciar orgasmos. (32) Essa ação pode se tornar um ciclo, justificando a relação encontrada entre a presença de dor e o aumento de tônus, e como tal alteração tônica resulta em prejuízos nos domínios de desejo e estímulo subjetivo e excitação. ...
Objetivo: avaliar o tônus do corpo perineal em mulheres jovens nulíparas e correlacionar com as funções sexuais e a presença de disfunção sexual. Método: foi realizado um estudo descritivo, observacional, transversal utilizando uma amostra de conveniência incluindo mulheres adultas jovens nulíparas. A avaliação das participantes consistiu na aplicação dos questionários socioclínico, Pelvic Organ Prolaps / Urinary Incontinence Sexual Questionnaire (PISQ-12), Female Sexual Function Index (FSFI) e exame físico do tônus do corpo perineal. Os dados foram analisados pelo programa Statistical Package for the Social Sciences (SPSS®), versão 23, adotando um nível de significância de 5%.Resultados: participaram 77 mulheres jovens nulíparas (21,68 ± 2,94 anos), destas 77, 92% apresentavam vida sexual ativa e 66,03% tônus normal do corpo perineal. Dentre as alterações tônicas, o aumento do tônus predominou (33,76%). Houve alta prevalência de disfunção sexual (87,01%) pelo FSFI (23,38 ± 7,21) com maior queixa de dispareunia. Mulheres com tônus aumentado apresentaram maior disfunção sexual em relação a desejo e estímulo subjetivo (p=0,04), à excitação (p=0,01), satisfação (p=0,04) e dor ou a desconforto (p=0,03). Houve correlação inversa entre a presença de aumento do tônus e os domínios FSFI desejo e estímulo subjetivo (R= - 0,56) e excitação (R= - 0,34) e correlação direta para dor ou desconforto (R= 0,30). Conclusão: o aumento do tônus do corpo perineal piora a função sexual de mulheres jovens nulíparas.
... Then insert both thumbs deep in the vagina 3 4 cm and press down toward the anus and to both sides and maintain for 12 minutes. After that massage the fourchette in a Ushaped manner stretching the vaginal wall dorsally and laterally for 23 minutes [17]. ...
... Patient position during massaging anterior pelvic floor muscles[14] Perineal massage[17] ...
Background. Myofascial pelvic pain (MFPP) is characterized by the presence of tender myofascial trigger points (MTrPs) in the muscles and fascia of the pelvic floor. Pelvic floor manual therapy is frequently suggested as the first line of treatment for MFPP. Main body of the abstract. The existing literature affirms the beneficial outcomes of manual therapy in the treatment of MFPP and offers a concise summary of how these techniques are applied to patients with MFPP. Literature includes ten techniques; (1) myofascial trigger point release, (2) Thiele massage, (3) internal self-massage, (4) perineal massage, (5) combined manual techniques, (6) pelvic myofascial mobilization, (7) manual visceral therapy, (8) connective tissue manipulation, (9) scar release, and (10) internal coccyx manipulation. Methods. A narrative review was carried out to summarize the available evidence on pelvic floor manual therapy techniques for MFPP. Key content and findings. Upon review of the current research landscape, twenty-five studies met the inclusion criteria. Available evidence suggests that pelvic floor manual therapy is effective in the treatment of MFPP. Conclusion. Although current available studies are limited in number with limitations in study design, manual therapy is considered a promising, effective, and safe option for the treatment of MFPP.
