Women’s Pelvic Health

Pelvic health plays an important role in a women’s complete physical, mental, social, and sexual well-being.

Many women, throughout their life will experience pelvic health issues. Problems such as pain, incontinence, and pelvic organ prolapse often cause embarrassment and discomfort resulting in women failing to seek care due to:

• lack of education
• incorrect information such as believing it is normal part of aging
• a lack of access to resources and
• correct management programmes.

Just because these are common problems that women face does not mean they should be ignored or allowed to affect how you live your daily life.

What Causes Pelvic Health Disorders (PHD)?

There are many different factors that can increase your risk of developing a pelvic disorder. It can either be from an isolated incident or from a combination of factors that may lead to the development of pelvic floor disorders. Some of these factors include:

Lifestyle Factors

o Smoking and drinking
o Unhealthy diet
o Overweight and low levels of physical activity

Pregnancy and Childbirth

o Number of pregnancies and whether they were full term or not.
o Method of Childbirth – C-sections or Vaginal Delivery and if there was the use of forceps, suctioning or other devices.

Other Factors

o Lack of correct education around sexual practices and general health.
o Age – older women are more likely to develop PFD than younger women.

Disease and Disability

o Neurological or neuromuscular disorders such as post stroke patients, spinal cord injury and multiple sclerosis can lead to PFD.

The most common types of Pelvic Floor Dysfunctions

Bladder Control Problems (Urinary Incontinence)

This basically relates to the leaking of urine. Types of problems include:

• Stress Incontinence – this causes a leaking of urine during activities or movements that increase pressure in our abdominal area such as laughing, coughing, sneezing, heaving lifting, etc.
• Urge Incontinence – this causes a loss of urine after a sudden, strong urge to urinate (overactive bladder).
• Dysuria – pain when urinating.
• Frequency – increased need to urinate due to lack of ability to control or hold in urine or recurrent urinary tract infections.

Bowel Control Problems (Faecal Incontinence)

• Leaking of stool that is either liquid or solid – this can be caused by the bottom part of the intestines shifting from its correct place or weakness in the muscles that keep the anus closed.
• Constipation – having bowel movements less than 3-4 times a week and having to strain or push excessively hard to empty or only partially empty the bowel.

Pelvic Organ Prolapse

When an organ prolapses it simply moves or “slips” forward or down out of the correct position. Any of the organs that are associated with your pelvic floor may prolapse, specifically bladder, bowel and reproductive organs. This often happens when the muscles and ligaments, that keep the organs in the correct position, weaken or are damaged. There are many different types of prolapses, some include:

• Cystocele – the bladder drops into the vagina.
• Rectocele – the rectum (the last portion of the small intestine which connects or ends at the anus) bulges into the vagina.
• Uterine Prolapse – the uterus drops into the vagina.
• Vaginal Vault Prolapse – the top of the vagina drops down into the vaginal canal or drops outside the body.

If this topic interests you, please read our full article on Pelvic Floor Dysfunction.

How can Physiotherapy help?

• Control and manage pain;
• Strengthening, mobility and motor control exercises;
• Restore flexibility and function of pelvic floor muscles;
• Education on coping strategies and management plan including bladder and bowel health;
• Electrotherapy modalities and tools;
• Stretching exercise.