Pelvic Health Products We Love: Part Two

In Pelvic Floor Physical Therapy by Jandra Mueller3 Comments

By Jandra Mueller, DPT, MS, PHRC Encinitas

Here at PHRC we regularly discover all sorts of new and cool products that are available for people’s pelvic health needs. I am amazed at some of the products available and that are being developed and am so thankful there are people that are creating these products because they are SOOO helpful! 

Pelvic health physical therapists treat a multitude of conditions that can include, but are not limited to, urinary dysfunction, sexual dysfunction, bowel issues (aka pooping), as well as pelvic pain. Pelvic floor dysfunction is not a gender-specific disorder and can affect all people at different phases of their lives. 

In case you missed it, check out last week’s post with our first group of products we love. This week, we switch to things that can help people recover from pelvic pain and specifically painful sex.

Lets talk about sex baby… and all the products that can help with this fun activity!

Dilators aka known as “trainers” – Here at PHRC we have quite a few that we are a fan of! Dilators are used to decrease pain and increase tolerance of both vaginal and anal sex for all people, straight, bisexual, transexual, pansexual… literally everyone! There are differences in materials, colors, styles, and pricing so finding the right fit for you is important.

 

 

Milli vaginal trainerThis dilator is unique, it is the only expandable dilator yet. This means that you don’t have to insert a series of dilators each time which may eliminate irritation if you have pain with initial insertion. It expands inside of you and you can measure specifically the dilation. Recovering from painful sex can take time, we love that this device helps people objectively measure progress with the digitized face depicting the size it has expanded to. It is made of a soft silicone and it does have a vibrating feature. It comes in its own charging case so it is easier to travel with as well.

Soul Source Silicone DilatorsThese dilators come in a vast variety of sizes and have different sets to match your needs. They are also made locally in CA! They are a bit on the pricier side, but they are definitely a quality product!

GRS – Dilator set by Soul SourceSoul source has made these specifically for those undergoing gender reassignment surgery in conjunction with a surgeon that performs this surgery. These dilators are made of rigid polyurethane, and can be chilled in order to use for post-surgical swelling in addition to using them for general dilation post-surgery.

Intimate Rose Dilator Set

Inspire Dilators

BioMoi

Similar to soul source, these offer soft silicone (maybe even a little softer) and a variety of sizes and sets, and a bit cheaper as well! 

Silicone in general is nice because it often feels more like human skin instead of hard plastic. 

These dilators are silicone and offer a tapered end that can be useful for self-trigger point release as well as the standard use of dilators. There is a ring at the end to help with grip.  These are another silicone dilator set, but are infused with an antimicrobial agent throughout the silicone. 

Clone-A-WillyYes, you heard it correctly, a cloning kit that allows you to clone your partner! This is for patients working specifically towards a goal of pain-free intercourse with their partner who may have anxiety/have a hard time communicating their needs during intercourse with their partners. Also comes in a variety of colors, even glow in the dark!

 

 

 

Ohnut!  – This device was developed for those that have pain with deep penetration. They are very soft, stackable rings that go on the male partner to create essentially a buffer so that penetration does not go so deep, yet both partners still feel pleasurable.

 

Personal Lubricants

To begin, there are a ton of personal moisturizers aka lubricants out there that are better used for anal vs. vaginal use. These depend on both the pH of the product as well as the osmolality. And there are things to consider like water-based or oil-based. SO. MANY. OPTIONS! 

Here’s a little run-down that was presented by Melinda and then I’ll share with you PHRC’s top choices.

Lube + Sperm: 

  • The best conditions for sperm survival and motility is pH 7.2-8.5 and osmolality 270-360 mOsm/kg.
  • Brands: Pre-Seed, Yes Baby

Vaginal and Rectal pH

  • Vaginal: 3.8 – 4.5
  • Rectal: 7.0

Osmolality

  • The World Health Organization (WHO) recommends osmolalities of less than 380 mOsm/kg
  • Silicone-, Plant, and Oil-based lube are also less likely to irritate, but their osmolality cannot be measured. 

What we use in the clinic:

 

Slippery Stuff                           Surgilube                          Relevum                          Good Clean Love

Typically we use Slippery Stuff  or Good Clean Love in the clinic for our transvaginal physical therapy and surgilube for transrectal physical therapy. The chemistry shows that it has a pH and osmolality similar to vaginal tissues, which means it will not damage tissues or make us vulnerable to infection, like some harsher products.  It also has aloe vera, which is a great moisturizer.

Releveum is now classified as a moisturizer because it can be used for longer than 60 minutes, while lubes are short-term and do not last longer than 60 minutes. Releveum is an aloe vera based lube/moisturizer. It contains 4% lidocaine that can be used to help soothe or numb burning tissue, like for those that have pain with initial penetration and suffer from vestibulodynia, and can help in the short-term for improving that pain!

For a more in-depth review about why lube selection is important, stay tuned for next week’s blog by Melinda Fontaine, Lube 2.0!

Moisturizers and other care products for “down there”

There are some other moisturizers that can be helpful for irritated tissue, especially if you don’t want to, or cannot use hormones for any reason. There are two that we often recommend for women that have pain with initial penetration from irritated or inflamed tissue at the entrance of  the vagina and the vestibule. I often recommend them for my mama’s that are pregnant or postpartum and CANNOT use any hormones (even local ones) because it is contraindicated in pregnancy and postpartum. This is also true for those women who are concerned about, or would feel more comfortable not using hormones because they have had certain types of cancer.

Vital V                                                        V-Magic

These are both used to soothe the tissues, but have slightly different ingredients. Vital V is an infusion oil of wild yam, vitex which is often used to balance progesterone in the body, but naturally, comfrey as well as lavender oil and can be used as both a lubricant and moisturizer. V-Magic has some ingredients that are more antimicrobial. We use them both and it may just be a personal preference of which may work for you!

Now… this next one is specifically for the men out there!

Tame the beast – This product line is specifically for men. This line offers all sorts of products to make you smell good everywhere without creating irritation by using products with heavy chemicals.

 

 

Pelvic Floor and Technology

Even this area of the body is getting attention and there are a few apps that are pretty handy in helping with pelvic floor pain, dysfunction, fertility, etc. Here are a few of the top ones we use. 

One reason for tight pelvic floor is stress and our busy lifestyles! We often get so caught up in day to day life we aren’t even aware that our muscles are clenching to the max! Being mindful and aware of your pelvic floor is one of the first things we teach our patients at PHRC. This means maybe taking a break to breathe or doing some meditation. Both Insight timer and Calm are great apps for doing various timed guided meditations. Read Stephanie’s blog here to find out why and how meditation and mindfulness can help with chronic pain. 

Flo app is a period, ovulation, and pregnancy app where you can log all of your info! It’s very easy to use and has 1-touch buttons that can help you track any symptoms you may have. This is helpful when you can’t remember all the things that happened when you need to report back to your therapist each week! It also offers some daily fun facts and information about your health that you may not have ever known!

 

If you have ever been a patient here at PHRC or visited our office, you may recognize these products because we really do use them all the time! If you have feedback about these products we’d also love to hear so feel free to comment below and share some of your favorites!

FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

Comments

  1. I have used one of Theo products and wow, it really helps relaxing my pelvis. Now I can pee better.

  2. I use V Magic daily and have for several years now. And Love it! I had a reaction to the Vital V ointment. I have very sensitive skin. Also use slippery stuff and it works great. I don’t try new things once I find something that doesn’t flare me. I also used the soul source dilators and had good results with them. Soft enough, firm enough and easy to clean.

  3. Thank you for showing what is used in the clinic for lube. I look forward for the lube 2.0 story by Melanie. I will also be looking for these lubes for home use during this covid shut down.

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