Feel Good

13 of the most common pelvic floor problems women encounter – and how pelvic floor physiotherapy can treat them

As women, a lot of us will experience pregnancy and childbirth. Even more of us will go through the menopause. And whenever our hormone levels change, some pelvic floor dysfunction is likely to follow… luckily, pelvic floor physiotherapy can significantly help.

Written by Becky Hardy

Published 04.05.2022

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1 in 3 women in the UK will have some level of incontinence in their lifetimes.

50% of women will experience prolapse of some kind.

78% of mothers, following a vaginal delivery, with have some degree of pelvic organ prolapse.

1 in 3 mums will have urinary incontinence, and 10% will have bowel urgency or faecal incontinence.

Yep, being a woman comes with its challenges, doesn’t it?

And what’s tricky is, some of these biological challenges – like the symptoms of pelvic floor dysfunction, for example – aren’t always recognisable when they first happen. We push them to one side as we deal with the mountain of responsibilities that are our inheritance as women and forget when they started, how they started or how long they’ve lasted. What’s worse is, we all actually accept that they’re ‘normal’.

This is a myth.

Pelvic floor dysfunction of any kind is not normal. We don’t say this to make any of you lovely readers embarrassed or uncomfortable. Pelvic floor problems are certainly common – as the statistics above can confirm. But they’re not normal, and we should stop assuming they are.

Because in doing so, we’re delaying or completely avoiding treatment. And this, for symptoms that can have a real impact on our quality of life – such as incontinence, pain during sex or irritation. Why?

Traditionally, because we’re women. And women have had a darned difficult time of it, medically speaking, throughout history. But no more. Not on our watch.

That’s why we’ve enlisted the help of pelvic floor physiotherapist – and every woman’s biggest cheerleader – Rosie Conway from Roseanna Grace Physiotherapy for a little advice.

Because here’s the statistic that really matters: more than 85% of women can resolve their symptoms justwith pelvic floor physiotherapy.

So, from how pregnancy weakens our pelvic floor muscles to how the withdrawal of oestrogen during menopause can cause recurrent thrush, Rosie takes us through the most common – not normal – pelvic floor problems women are most likely to encounter at some point in their lives, how we can prevent or treat these problems ourselves and when to seek medical help…

PRE-NATAL

‘Before a pregnancy, the pelvic floor can still show symptoms of dysfunction,’ Rosie explains. ‘These can be from bladder urge and frequency, recurrent thrush or urine infection, to pain with sex or urinary leakage (either on a day-to-day basis or just stress-specific, such as exercise, coughing or laughing).

‘Bed wetting, giggle leakage, fecal incontinence, orgasm dysfunction and constipation are also signs of pelvic floor dysfunction, but all can be massively improved and even resolved with specialist pelvic floor physiotherapy.’

Symptoms to watch out for:

Needing to wee more frequently
Needing to wee more urgently
Recurrent thrush
Urine infections
Pain during sex
Urinary leakages (either day-to-day or stress-specific)
Faecal incontinence
Orgasm dusfunction
Constipation

What to do:

Discuss any UTI or thrush symptoms with a GP
See a pelvic floor physiotherapist! It’s amazing how many of these symtpoms can be improved and even fully treated with targeted physiotherapy

POST-NATAL

‘Regardless of your method of delivery – whether it was a caesarean section, forceps, ventouse, normal delivery or water birth – pelvic floor symptoms can arise,’ says Rosie.

‘In my opinion, one of the biggest risk factors is a pregnancy itself, regardless of mode of delivery – because the pelvic floor muscles stretch and thin out so much as the baby grows.

‘So, either during your pregnancy to optimise your pelvic floor, or from six weeks after the birth, seeking out an experienced and knowledgeable pelvic floor physiotherapist is essential in reducing any risk of symptom reoccurrence later in life, as well as helping your symptoms right here, right now.’

Symptoms to watch out for:

Bladder pain
Urinary incontinence (day-to-day or stress-specific)
Frequent UTIs
A vaginal heaviness or a dragging sensation
A small, visible bulge
Tampons become difficult to use
Scar pain (episiotomy, tear or cesarean section)

What to do:

Discuss any UTI or thrush symptoms with a GP
See a pelvic floor physiotherapist! This will be beneficial not only for the here and now, but to avoid symptoms coming back, or developing, in future

PRE- AND POST-MENOPAUSAL

‘As oestrogen levels start to vary during menopause, some women will have no symptoms at all, while others will experience symptoms that are not usual for them,’ explains Rosie. ‘For example, a new onset of thrush, bladder pain or a urine infection. If these start to be recurrent, then I’d recommend you discuss these with your GP or pelvic health physiotherapist.

‘It’s also so important to start making a note of your menstrual cycle – these symptoms usually will coincide with your periods changing (getting further apart, closer together, lighter or heavier flow or more painful than usual). Making a note of this can help your healthcare professional decide on the best way forward to help you.’

Symptoms to watch out for:

New onset of thrush
Bladder pain
Urine infection
New onset of vaginal heaviness
New onset of bladder urgency, bladder frequency or incontinence

What to do:

Make a note of your menstrual cycle and how these symptoms are linked, if at all
If symptoms start to become recurrent, discuss them with a GP or pelvic health physiotherapist

ROSIE’S SELF-CARE TIPS

While pelvic floor problems are by no means completely unavoidable for most women (sadly enough), there are ways in which we can reduce our risk of encountering some of these issues – and there are certainly some healthy habits we can get ourselves into and use to our advantage to get on top of these symptoms, fast.

Here, Rosie shares her top self-care secrets…

If you are someone who is struggling with cystitis or thrush…

‘The first-line advice I’d give to you would be to ask to give your GP a urine sample, (or I can dip this for you in clinic so that we can see if there are any traces of blood or infection in your urine). Early detection and treatment is so important here.

‘There are some good self-help sticks from chemists where you can swab to determine if your symptoms are thrush or bacterial vaginosis too. Again, treating this quickly and effectively is so important.’

Drink water!

‘Drinking lots of water (two litres and over) is also important if you have cystitis or a urine infection to help ease your symptoms.

‘I know this may seem like the last thing you want to do if you also experience urinary urgency. It’s tempting to want to restrict your fluids to cope. But this can actually cause urine infections – as the condensed acidic urine can irritate the urethra and make the pelvic floor muscles tense up, causing pelvic floor dysfunction.

‘So, let us (pelvic floor physios) teach you how to retrain your bladder and get more control instead – enabiling you to drink more and look after yourself better!’

Check what lubricants you’re using during sex…

‘Some lubricants can cause irritation, including thrush and UTIs, while others can actually help. So, keeping an eye on which ones you’re using and how they’re affecting your body is always wise.

‘If any of your symptoms are occurring specifically after sex, then please consult a specialist pelvic floor physiotherapist, as we should be able to help guide you in more detail here.’

If you have any urine leakage or sensations of vaginal heaviness…

Please don’t try and just ‘put up’ with your symptoms. These could be signs of pelvic organ prolapse – so please seek help from a specialist pelvic floor physiotherapist. It’s always good to nip those symptoms in the bud and we can help give you guidance and direction to resolve these unwanted symptoms.

For more information about how Rosie can help you reclaim your confidence and overcome your pelvic floor symptoms, visit the Roseanna Grace Physiotherapy website, or follow them on Facebook and Instagram.

Or pop into one of her two Jesmond clinics and say hello:

15a Clayton Road, Jesmond, Newcastle NE2 4RP

89 Holly Avenue, Jesmond, Newcastle NE2 2QB