Pain during a women's health physio exam

[LostAtSea]

First off, I should note that I have autism and a childhood trauma history. My doctor suggested I see a women's health physio because of painful periods that don't respond well to pain killers and period-like pain in the pelvis and legs when running. When the physio did the internal exam she was pressing in different places to see where hurt. There were some places that hurt internally, but also it felt like my vulva/vaginal opening was hurting when she was adjusting to a different spot. I couldn't talk about it with her because I have trouble discussing things like this, but also because I was crying and kind of running on 'automatic pilot'. She said that I have internal tension and also lower back issues but I didn't really understand what she was talking about. I guess I'm wondering if that more external pain is normal, what causes the internal tension and how this all relates to the period pain and running pains.

[Anya]

Hi LostAtSea,

Visiting a sexual health clinic is a great step in helping yourself identify where this pain is coming from. In looking through some of your past posts I can tell that this was huge for you in advocating for your health and i'm sure very diffucult, so congratulations! I'm sorry to hear that it wasn't as clarifying as you had hoped, and I can totally empathize with the anxiety of verbalizing these kinds of things to doctors or clinicians. For the best, most accurate information on this issue I do think that seeking someone who can physically observe how this presents in your body is ideal, as they can potentially pinpoint the root of the pain in your body, when we are more generally geared towards providing education and cannot diagnose.

That being said, I can give you a few places to look if you want to do some of your own research, with the caveat that to resolve this concern my recommendation is that you continue to communicate with your physician if possible. If you are interested in talking about communication skills for engaging with medical professionals we can absolutely include this in the conversation, so just let me know!

The "internal tension" she might have been referencing could be a pelvic floor thing, so for that, consider this article: Pelvic Problems: Non-Relaxing Pelvic Floor . And for more on pelvic pain: What's Pelvic Pain and What can I do About it?

External pain could be due to a few different things, but given you also are experiencing internal pain (potentially from some sort of tension) I would consider looking both into physical support, but also mental supprot around this. A lot of the time our mental anxieties, reservations, or fears can manifest in our physical body causing us pain to show us that it needs attention. I would recommend talking more to your therapist about this if you feel comfortable.

How does this feel? Would you like to talk more about how to address some of this with a medical professional if you choose to go back to the clinic?