Pelvic Solutions
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Women

Women's health

Photo credit:  Ian Munro Photography

Photo credit: Ian Munro Photography

 

One is three women are known to suffer from incontinence.  As many as 50% of women also have vaginal prolapse and many suffer pain with sex or intimacy.  But incontinence is NOT a normal part of having a baby or aging. 

With specialist physiotherapy these conditions can be treated successfully.  Women that have had a baby are more likely to experience incontinence. Research has shown that Physiotherapy is effective in treating stress incontinence in up to 80% of cases.

Problems with the pelvic floor muscles can contribute to these conditions.  They may be weak, poorly controlled or too tight.  Pelvic floor exercises can help muscles that are too weak, but they can cause more trouble if done incorrectly or if muscles are already too tight. A comprehensive assessment with our pelvic health physiotherapist can help you discover your potential and start your recovery.  Two out of three women with bladder problems don’t seek help because they think it is something that the should put up with.  Don’t put up with it!  It can be treated effectively. 

 

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pregnancy

If you are pregnant and you hurt, then seek assistance. In pregnancy many women suffer unnecessarily with pain in the back, hips, pubic bone and groin (pelvic girdle pain).  Postural changes can occur due to the weight of the baby, and ligaments soften. This can put added strain on your body and lead to discomfort.  With the right education and advice on how to strengthen the pelvis and back with safe exercise, most women feel much better after Physiotherapy treatment in a short time. So don’t put up with being in pain during your pregnancy.

You can be given advice on childbirth preparation, the best birthing positions with pregnancy-related pelvic girdle pain, and how to speed up your recovery in the first six weeks after birth, until you can have a post-natal review with your therapist.


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post-nataL

It can be tempting to return to exercise quickly to get fit and toned after having a baby. But if the pelvic floor and abdominals are not ready for this it could lead to a host of problems such as incontinence and pain. We know how to help you restore your pelvic floor and core strength safely and effectively, and can help educate you with tips and habits to maintain life-long pelvic health, avoid pain and weakness. 

We recommend a 55 minute post-natal check six weeks following delivery. This is standard care in some countries such as France, but unfortunately not in NZ.  The check will include assessment of the tummy gap, posture, breath, pelvic floor function and any other problems due to pregnancy or childbirth.  Women will then be given advice and an individualised rehabilitation plan to meet fitness goals, and regain stability and function through safe exercise, good breathing, and alignment.  

incontinence

Stress incontinence may occur when you cough, sneeze, jump or lift.  With effort or certain activities, if the pressure on your bladder from above is more than your pelvic floor strength, then leaking of urine occurs. This is usually due to weak pelvic floor muscles.

Urge incontinence occurs when there is a sudden and strong urge to pass urine. The bladder contracts when you are not on the toilet, which can lead to loss of urine. Some women go to the toilet more frequently during the day and night due to this problem. Urgency may occur with certain triggers such as hearing a key in the door or running water. There are many contributing factors to this problem such as the drinking of bladder irritants such as coffee, tea, or fizzy; bladder habits; bowel problems; and muscle overactivity. This problem can be effectively treated with bladder retraining, education and optimising the pelvic floor muscles.


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prolapse

A prolapse is when one or more of the pelvic organs drops down from the original position and into the vagina.  As many as 50% of women have some degree of prolapse.  The bladder, bowel or uterus can all prolapse. 

Symptoms include incontinence, difficulty emptying the bladder or bowel, the feeling of not emptying completely, a vaginal heaviness, aching or bulge. 

Treatment options include specific muscle strengthening, education about lifestyle changes and modifications to exercise plans to improve pelvic health, stability and reduce downward pressure onto the pelvic organs.  A vaginal pessary may be necessary in some situations.

 


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sexual pain

Many women have pain around the vagina or pelvis with intercourse (dyspareunia) or sexual intimacy. Pain can occur at the entrance to the vagina or on deep penetration, and can be commonly caused by overactivity of the pelvic floor muscles meaning the muscles have trouble relaxing. This can create muscle tension and spasm with can lead to pain.

Other causes can be hormonal changes associated with menopause or breastfeeding, how you think and feel, relationship problems, vulval skin conditions, and some medications, which can reduce sexual desire and cause vaginal dryness. Vaginismus is a vaginal tightness which causes discomfort, burning, pain with intercourse or tampon use, penetration problems and sometimes almost complete closure of the vaginal opening, making intercourse impossible. 


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sexual dysfunction

Commonly women experience changes in their sexual wellbeing during stages of life.  Some women have weak orgasm or have never had an orgasm.  Vaginal dryness can cause problems with intercourse. 

There is a wide range of treatment options available to help fix these problems.  Our therapist understands that sexual problems can be challenging to discuss.  Your privacy and dignity will be fully respected during your appointments and support offered to reassure you and ease anxieties.   If you have pain with sex or the use of tampons, you should seek help from your Pelvic Floor Physiotherapist, especially if you are pregnant and experiencing these symptoms.


Pelvic Pain

Pelvic pain

Pain can be felt in the pelvis, lower abdominals or on the area between the vagina and the back passage. This can commonly be caused by pelvic floor muscles that are too tight (overactive).  Signs include:

  • Painful sex and/or problems achieving orgasm

  • Incomplete emptying of the bladder and/or slow urinary flow

  • Incomplete emptying of the bowel, thin stools, difficulty passing windPainful to use tampons

This condition can be treated by Pelvic Floor Physiotherapists


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bowels

Incontinence of bowel motions (poo) or wind can be embarrassing as can having to rush to the toilet due to a strong urge to pass a motion.

Bowel urgency can be caused by pelvic floor muscle weakness, loose bowel motions and a hypersensitive rectum.   

Defecation Dyssynergia (Anismus)

This is a condition where specific muscles contract rather than relax during a bowel movement.  Common symptoms are the sensation of incomplete rectum emptying after passing a stool, faecal impaction / loading / loss of liquid faeces.   


Seek assistance with your pelvic health expert for these conditions.

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