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Over the years, I have counseled patients on a variety of pelvic health topics, however there are definitely three subjects that my patients seem most hesitant to discuss. While these topics are often thought of as “taboo,” they shouldn’t remain in the shadows! Openly sharing any medical issues that you may be experiencing with your provider is the first step toward getting the help you need. And remember, whatever issue you may be facing, your provider has likely seen other patients experiencing the same conditions – you are not alone!
I help my patients start the conversation by having them fill out a health history form that includes questions about their pelvic health. Chief complaints often reveal other areas we need to address, so the forms are an easy way to help identify exactly what my patients are experiencing and how pelvic health physical therapy can help.
Postpartum urinary incontinence is very common and occurs in 1 out of every 3 women. In fact, research shows that if a woman experiences bladder leaks 3 months postpartum, she has a 92% chance of continuing to have leaks at 5 years postpartum.
The good news is, pelvic health physical therapy can be very effective in treating postpartum issues like Bladder leaks, which typically don’t resolve on their own. I also recommend my patients use a dual-use pad like One by Poise® to help manage both period flow and bladder leaks while undergoing treatment.
For patients who come to me about urinary incontinence, I explore whether they have any sexual or bowel dysfunction. This conversation is key in helping ensure patients receive the proper treatment. For example, chronic constipation often directly impacts urinary leakage, so we can’t address one without resolving the other.
When I work with patients experiencing Pelvic floor dysfunction, I often look at their symptoms in an orthopedic context, because the root of many pelvic floor issues can be linked to issues like:
Pregnancy itself can also be a risk factor for developing pelvic floor dysfunction, no matter how you deliver (having a c-section does not automatically protect the pelvic floor). If you experience any pelvic floor dysfunction or other orthopedic issues postpartum such as hip or lower back pain, speak with your OB/GYN or a pelvic health physical therapist.
24% of postpartum women will experience ongoing painful intercourse, sometimes up to 18 months after delivery, which can greatly impact their relationship with their partner. In fact, once I start talking with my patients, I sometimes discover painful intercourse has led them to cease sexual activity altogether. Women who experienced one of the following are also more likely to have painful intercourse at 18 months postpartum:
Patients are usually surprised (and relieved) to learn that bladder pain and painful intercourse are closely linked, and can usually be successfully treated simultaneously. So, don’t be afraid to speak up about your conditions – you’re not the only one experiencing them!
Reducing pain and resuming a healthy, active sex life is life-changing for patients – and I’ve received flowers from their partners on more than one occasion.
While you may be hesitant to discuss issues like bladder leaks, sexual or pelvic health with family and friends or even your doctor, many women experience these issues, so I encourage everyone to shatter the stigmas.
Women’s pelvic health issues are not covered in high school health class, and very little education is offered to pregnant women during birthing or postpartum classes, so most women are taken by surprise when problems arise.
As a healthcare provider, talking openly with my patients is the best thing I can do for women everywhere. It’s the best thing you can do for yourself, too – if something isn’t working as it was before, feel empowered to talk openly with your doctor. And this goes for any pelvic health or general health issues you may be experiencing.
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Author Summary: Dr. Heather Jeffcoat, DPT, Pelvic Health Physical Therapist is the founder of Fusion Wellness & Femina Physical Therapy (FeminaPT.com). Her work focuses on pelvic and sexual health education for all, and she lectures internationally on Female Sexual Dysfunction and chronic pelvic pain. She is also the author of Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve.
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