What is pelvic rest?
Pelvic rest refers to limiting activity to allow tissues in the pelvic area to heal after injury, surgery, or childbirth. It typically involves avoiding sexual intercourse, using tampons, and doing strenuous exercise that involves the pelvic muscles. Pelvic rest allows inflammation to subside and small tears or incisions to heal. It is commonly prescribed after procedures like hysterectomy, pelvic surgery, dilation and curettage, and childbirth. The length of pelvic rest depends on the reason it was prescribed.
Why is pelvic rest prescribed?
There are several reasons a doctor may recommend pelvic rest:
- After surgery: Pelvic rest is typically recommended for 4-6 weeks after surgical procedures like hysterectomy, myomectomy, cyst removal, and more. It allows incisions and internal tissues to fully heal.
- To treat pelvic floor dysfunction: Conditions like pelvic floor muscle spasms and pain often benefit from a period of pelvic rest. Resting the muscles allows inflammation to decrease.
- Following dilation and curettage (D&C): Pelvic rest is advised for 1-2 weeks after a D&C, which is a procedure to remove tissue from the uterus.
- During pregnancy: Pelvic rest may be prescribed to pregnant women with concerns like vaginal bleeding, premature labor, placenta previa, incompetent cervix, or hydronephrosis.
- After childbirth: Doctors typically recommend pelvic rest for 4-6 weeks after giving birth vaginally and 6-8 weeks after a cesarean section. This allows the uterus, vagina, perineum, and any incisions to heal.
The duration of pelvic rest varies based on the individual’s condition and procedure. Your doctor will provide guidance on how long you should maintain pelvic rest.
Restrictions during pelvic rest
Pelvic rest typically involves avoiding the following activities:
Sexual intercourse
Doctors recommend avoiding vaginal intercourse during pelvic rest. That includes penetration of any kind. Some doctors may allow other sexual activity like oral sex or manual stimulation. Discuss your specific restrictions with your provider.
Orgasm
Orgasms cause contractions in the pelvic floor muscles, so achieving orgasm is also usually off-limits during pelvic rest. That applies to both intercourse and masturbation. Leaking urine during arousal or orgasm is also a sign that pelvic rest is needed.
Using tampons or menstrual cups
Tampon and menstrual cup use is prohibited during pelvic rest because insertion can disrupt healing tissues. Pads should be used for menstrual bleeding instead.
Strenuous exercise
Vigorous exercise that activates the pelvic floor muscles should be avoided during pelvic rest. This includes activities like weightlifting, jogging, jumping, dancing, aerobics, and kickboxing.
Low-impact exercise like walking, swimming, or stationary cycling is generally okay. Check with your healthcare provider about appropriate activities.
Heavy lifting
Lifting anything over 15-20 pounds may also be prohibited during pelvic rest. Heavy lifting puts pressure on the pelvic floor.
Appropriate activities during pelvic rest
While certain activities are restricted, pelvic rest does not mean complete inactivity. Here are some appropriate activities generally allowed during pelvic rest:
- Light walking
- Gentle stretching or yoga
- Low-impact cardiovascular exercise like stationary cycling or swimming
- Light household activities like cooking, laundry, and washing dishes
- Desk work
- Driving
- Social activities
Check with your healthcare provider about any exercise or activity you are unsure about. As a general rule, choose lower impact options that do not cause pain or discomfort in the pelvic region.
Tips for following pelvic rest guidelines
Here are some tips to help successfully follow pelvic rest restrictions:
- Communicate with your partner so they understand why intercourse and orgasms should be avoided.
- Find other ways to remain intimate during pelvic rest like cuddling, massage, or oral sex if permitted by your provider.
- Try relaxation techniques like deep breathing, meditation, or yoga to manage sexual frustration.
- Distract yourself with hobbies like reading, crafts, or catching up with friends.
- Focus on low-impact exercise you enjoy like walking, swimming, or stretching.
- Get extra rest since your activity is limited. Nap when tired.
- Stick to pelvic rest until your doctor gives the all-clear to resume normal activity.
Pelvic rest requires patience but is an important part of the healing process. Be sure to follow your provider’s instructions closely.
Signs pelvic rest should be extended
In some cases, a longer duration of pelvic rest may be needed if healing progresses slowly. Signs that you may need an extended pelvic rest include:
- Bleeding longer than expected after surgery or childbirth
- Persistent pain in the pelvic area that worsens with activity
- Ongoing pelvic floor muscle spasms
- Prolapse of pelvic organs like the bladder
- Weakened vaginal cuff after hysterectomy
- Slow wound healing of incisions
- Continued uterine cramping after dilation and curettage
Discuss any of these warning signs with your healthcare provider. They will examine you and determine if a longer duration of pelvic rest is recommended.
When can pelvic rest be discontinued?
Your doctor will advise when it is safe to resume normal sexual activity and exercise after pelvic rest. This usually occurs:
- 4-6 weeks after uncomplicated vaginal delivery
- 6-8 weeks after cesarean delivery
- 4-6 weeks after most pelvic surgeries like hysterectomy or cyst removal
- 1-2 weeks after dilation and curettage
- After pelvic floor symptoms resolve and muscles regain strength if pelvic rest was prescribed for musculoskeletal issues
Always get the green light from your healthcare provider before discontinuing pelvic rest. Do not attempt penetration or intense activity until your doctor confirms everything has healed properly. Prematurely ending pelvic rest can disrupt the healing process.
Does pelvic rest guarantee healing?
While pelvic rest facilitates healing for many women, it does not guarantee resolution of all pelvic floor disorders or postoperative problems. Some conditions may require additional interventions like:
- Physical therapy to strengthen pelvic floor muscles
- Estrogen cream to improve vaginal tissue integrity
- Pessary to support prolapsed organs
- Surgery to correct any complications or fix underlying disorders
Pelvic rest removes aggravating factors that can delay healing like sex, orgasms, and high-impact exercise. But some problems need extra help. Stay in close contact with your medical team if symptoms do not resolve as expected after pelvic rest. Additional treatment may be warranted.
Seeking help for pelvic health
If you have been prescribed pelvic rest, follow activity restrictions closely and report any concerning symptoms to your healthcare provider. With their guidance, pelvic rest can facilitate healing after pregnancy, surgery, and procedures. But supporting recovery may involve more than just avoiding sex and exercise. A team approach, additional treatments, and close follow-up are sometimes needed to manage complex pelvic disorders. Work collaboratively with your medical providers to ensure you receive the best possible care and fully recover pelvic floor strength and function.
Conclusion
Pelvic rest requires refraining from sexual intercourse, orgasms, tampon use, and high-impact activity for a prescribed duration. The length of pelvic rest depends on why it was recommended, usually 4-8 weeks. While challenging, following pelvic rest guidelines allows surgical incisions, strained muscles, and sensitive tissues to properly heal after childbirth, dilation and curettage, hysterectomy, or other pelvic procedures. However, pelvic rest alone does not guarantee complete resolution of all pelvic floor disorders. Additional treatments like physical therapy, pessaries, or surgery may be needed based on your specific symptoms and diagnosis. Work closely with your healthcare providers throughout management and recovery. With their guidance, pelvic rest combined with any other necessary interventions can help you successfully regain pelvic floor strength and function.