What’s going to happen to my pelvic floor next time I give birth?

This article’s in reply to a reader who developed prolapse after her first baby and now has “many concerns about how my already damaged pelvic floor would cope with another pregnancy and labour”.

Guidelines from expert committees advise health professionals to prescribe pelvic floor muscle training (PFMT) as a first line treatment option for bladder and bowel dysfunction and pelvic organ prolapse.

Do these recommendations apply to all women?

Mentioning the word ‘pessary’ as a treatment option for pelvic organ prolapse (POP) usually brings about the inevitable ‘what’s a pessary?’ query. The use of pessaries to treat female POP dates back to before Hippocrates when honey, hot oil and fumes were used along with various sizes of pomegranates to stem organ descent.

Last week I attended a long awaited workshop in Adelaide on fitting pessaries for pelvic organ prolapse. Under the combined efforts of the University of South Australia, the International Centre for Allied Health Excellence and the Australian Continence Foundation, this is the first Australian evidenced based workshop on pessaries.

When clients are asked what they hope to achieve with treatment, they invariably say, “I want to learn how to do pelvic floor exercises”. They understand that pelvic floor muscle (PFM) strengthening is an important strategy in resolving and preventing incontinence and vaginal prolapse.

Recently a 32-year-old mother asked me this question after her obstetrician mentioned the term during her six weeks post baby visit. I explained that damage to the perineal musculature from childbirth (or surgery) is a common cause of the relaxed vaginal outlet (not all women have symptoms).

With 50% of baby boomer women affected by varying degrees of pelvic organ prolapse (POP) and ultrasound studies showing unexpectedly high rates of mild to moderate prolapse in young and/or asymptomatic women, it’s important to address what can be done to change POP outcomes for younger as well as baby boomer women.

This Swedish study focused on 99 sexually active couples and aimed to assess the impact of female UI and urgency on women’s and their partner’s sexual life and to elucidate the concordance of answers within couples. Women aged 18 to 74 with urinary incontinence (UI) and or urgency were recruited from four outpatient clinics.

Many clients with pelvic floor dysfunction report irritable bowel (IBS) type symptoms causing an upset, bloated tummy. The resulting pain can ruin your day and distract from focusing on work or simply enjoying planned activities. If bloating affects your quality of life, maybe some of the following suggestions will help to relieve tiresome gut pain.

We don’t tend to think about children having pelvic floor dysfunction – it’s a condition that’s associated more with childbirth, obesity, ageing, heavy lifting and elite athletes. Pelvic floor dysfunction is not always recognized as the cause of ongoing bladder frequency, urgency, and pelvic and low back pain in adults let alone children.