Lisa's Story*
Step 1
Lisa discovered what mattered
Lisa (she/her) is a 30-year-old primary school teacher who was referred by her GP with a 10-year history of sexual pain that had commenced with her first sexual experience. She was also experiencing poor bladder emptying, and chronic constipation. She bravely shared her experience of early childhood trauma and the devastating impact her symptoms were having on her life.
Lisa wasn’t ready for a pelvic floor and perineal examination until she felt safe and could trust the physiotherapist supporting her. A bowel diary and psychosocial questionnaires helped Lisa gain an understanding of how trauma had affected her nervous system and pelvic floor muscles. She learned that her muscles were chronically tight, protecting her but also creating pain. After 3 months, Lisa felt comfortable enough to consent to a transperineal ultrasound where she could see her pelvic floor muscles were not fully relaxing.
Lisa's Pelvic Health Goals:
- To have a better understanding of what is going on and what I can do about it - this would help me feel empowered.
- Improve my sense of control in my body, not be so reactionary - I'd feel calmer.
- Learn how to relax my pelvis and pelvic floor muscles – hopefully this will help empty my bladder and bowel better.
- Increase my body and self-confidence - I'd be more likely to go on dating apps and put myself out there.
- To one day have penetrative sex without anxiety - I'd feel more confident.
Step 2
Lisa restored what mattered
Lisa embraced breathing exercises and was amazed at how powerful regulating her breath could be. Calming her nervous system became a daily practice. She was diligent with her pelvic floor muscle awareness and relaxation program, finding it calming to practice before falling asleep. Transperineal ultrasound was used to provide biofeedback which helped Lisa connect with her pelvic floor. We helped Lisa apply this to improve her bladder and bowel emptying. Desensitisation techniques were introduced when she felt ready. Education about anatomy, libido, and pleasure were empowering. As her confidence grew, she engaged with self-pleasure practices that helped her feel safe in her body. The program surfaced unresolved memories and Lisa decided to see a psychologist she had seen many years ago.
Step 3
Lisa enjoyed what mattered
Understanding and feeling safer in her body gave Lisa the confidence to check out dating sites. After a few months, she met someone who she was able to trust. Taking her time, and with the support of her psychologist and physio, she felt comfortable to progress the relationship to include physical intimacy and was able to achieve all 5 goals. Lisa transformed from someone who felt disconnected and afraid of her own body to a confident woman who was dating, experiencing pleasure and living fully.