Send us Fan Mail DISCLAIMER: This episode discusses sexual trauma, pelvic pain, pain during sex, sexual dysfunction, and difficulty tolerating medical examinations. Please listen with care. The effects of sexual trauma are not limited to thoughts, emotions, and memories. Trauma can also affect the nervous system, muscles, breathing patterns, and pelvic floor. For some survivors, that may look like pelvic pain, pain during sex, vaginismus, erectile dysfunction, bladder urgency, constipation, chronic tension, or an automatic pattern of clenching and bracing. In this episode, Heleen Woest, MA, LPC, speaks with Kara Schuft, DPT, a pelvic health physical therapist and the Director of Clinical Success at Mendwell Pelvic Health in Portland, Oregon. Kara has more than eight years of physical therapy experience and advanced training in pelvic rehabilitation, chronic pain management, and orthopedic care. Her approach welcomes all bodies and genders and places consent, communication, pacing, and patient choice at the center of treatment. Kara explains what pelvic floor physical therapy actually involves, how trauma and PTSD symptoms may contribute to pelvic floor overactivity, and why some clients continue to experience physical symptoms even after meaningful progress in talk therapy. Research involving more than 25,000 adult women found that at least 32 percent had a documented pelvic floor disorder. Other research has linked PTSD symptoms with increased pelvic floor activity and has found an association between childhood sexual abuse and pain during intercourse in midlife women. The conversation also explores what a first appointment may look like for someone who is afraid of touch or cannot tolerate a gynecological examination, why internal examination should never be assumed, and how pelvic health professionals can collaborate with mental health clinicians. Kara discusses care across the lifespan, including pregnancy, postpartum recovery, perimenopause, menopause, endometriosis, PCOS, chronic pelvic pain, bladder and bowel symptoms, men’s pelvic health, and gender-affirming care. A Cochrane review found that women with stress urinary incontinence who completed pelvic floor muscle training were eight times more likely to report a cure than women in inactive control groups. Pelvic health treatment is not one-size-fits-all, however. Some people need strengthening, while others need help relaxing an overactive pelvic floor, improving coordination, and teaching the nervous system that it no longer has to remain braced for danger. This episode is for survivors, partners, mental health clinicians, medical providers, and anyone who has been told that pelvic pain or dysfunction is something they simply have to live with. Healing often takes a wraparound team, and pelvic health physical therapy may be a missing piece. Connect with Kara Schuft, DPT: https://www.mendwellhealth.com/team/kara-schuft Mendwell Pelvic Health: https://www.mendwellhealth.com/ Visit Heleen's Blog to learn more about this topic and the research behind it: https://www.lifesolutions.io/blog/ Watch the video version of this episode on YouTube: https://www.youtube.com/@heleenwoest/videos Explore upcoming topics that are dropping soon on The Missing Piece: https://www.lifesolutions.io/podcast/
