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Girl Talk: Incontinence and Pelvic Pain

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Girl Talk: Incontinence and Pelvic Pain

Most topics are considered fair game for your closest friends—but less glamorous subjects, such as pelvic pain and incontinence, aren't necessarily what you bring up after book club. We asked UnityPoint Health physical therapist, Peggy Scott, A.T.C., P.T., to sit down for some "girl talk," discussing these women’s health issues and more.

The Scoop: Pelvic Floor Problems and Urinary Incontinence

The pelvic floor is made up of ligaments and muscles that provide support for organs, bathroom control and sexual experience. The pelvic floor is present in both men and women, but it is structured differently. Scott says recent statistics indicate almost half of all women experience some form of pelvic floor issues, most commonly, women older in age.

"Signs and symptoms of pelvic floor issues in women can be the most obvious with leakage of urine,” Scott says. “Other signs may be pelvic pain or pain with intercourse, which is sometimes explained by too much tone of the muscles. Constipation and/or leakage of feces, as well as the uncontrollable urge to go to the bathroom could be other symptoms of pelvic floor issues."

Types of urinary incontinence include:

  • Stress incontinence – pelvic floor usually is not trained to take on the stress of running, sneezing, jumping, coughing or even walking. This occurs gradually with possible weight gain and/or post-pregnancy, after vaginal deliveries.

  • Urge incontinence – unstable bladder. You may see on television advertisements, showing women (or men) needing to go "right now."

  • Mixed incontinence – a combination of both types.

Other issues that should not be ignored: pelvic organ prolapse (weak pelvic floor muscles not supporting organs, such as uterus, bladder and rectum) and painful sexual intercourse.

Advice: Seek Treatment

You might be embarrassed to bring up sensitive women’s health issues, but Scott says not to worry what your provider will think.

“No question is too embarrassing for us, and as practitioners, we are accustomed to these questions. We’re here to help. At your yearly physical, your primary care provider should also ask if you’ve experienced any leakage,” Scott says.

Treatment begins after a thorough evaluation for muscle tightness, weakness or pain, which usually includes a manual exam of the vaginal area. A complete exam of the back, hips, legs and walking pattern is also done before treatment. After the evaluation, an individualized program is developed for the patient. Scott says a large part of treatment is teaching patients about how their bodies work, so they can understand what helps with re-training their pelvic floor.

Having issues, like incontinence, after pregnancy can be a worry for some. But, Scott says it doesn’t happen to most women.

“If an expectant mother is referred before delivery with any type of back pain, I always include an emphasis on post-partum exercise, specifically doing Kegels (pelvic floor muscle) and easy ab work, with the reminder to avoid sit-ups at first. Certainly, if at her 6- or 8-week check, a new mother is having continued leakage, pain or unexplained symptoms, she should ask for a referral,” Scott says.

Regardless of your stage of life, Scott encourages you to be vocal about any women’s health issues you experience.

"As with any medical problem, the longer it has been going on, usually, the more difficult it is to alleviate or cure. Many of us after having children know our bodies well and if something does not feel right, read about it, talk to your friends and if you find out what you’re experiencing isn’t a temporary condition, like a urinary tract infection (UTI) or yeast infection, go see your UnityPoint Health provider," Scott says.