Pelvic floors and continence are feminist issues?

(53 Posts)
gussiegrips Tue 06-Nov-12 12:19:32

So, I'm a physio with an interest in women's health - specifically why physios are so bad at getting the message across to women that they need to look after their pelvic floor. I know we are rubbish at communicating that because 1:3 women age 35-55 wet themselves when they cough/laugh/sneeze...over 55's it's half. And, those are the official stats, the reality's much worse.

I'd quite like to get MN to run continence as a campaign - given that most of their readership will either have ishoos or know someone who does, and that MN is a powerful voice...we could change the UK's pelvic floors.

There's a link to a brilliant blog dealing with these topics on the front page just now... which led me to post this thread

So, why do women put up with this dreadful intrusion on their lives?

What happens is this:
pregnancy leak...post-childbirth worse...gets a bit better...more kids...gets a bit worse...knows she should be doing something in the way of exercises, but is too busy dealing with life, so solves problem with occasional absorbant pad...sex life disappears as sensation is reduced and she's worried she smells of pee...starts to wee more often to reduce frequency of leaks...can hold less...leaks more...more pads....feels embarrassed....low self esteem...worsening problem, mortified incase she's goign to become a smelly old lady...eventually, reaches breaking point and sees GP...surgery.

Add in the joy of vaginal prolapse and you have a debilitating condition that disempowers women, destroys relationships, interferes with every single thing she wants to achieve, is associated with pain and depression...and 70% of cases (of simple stress incontinence) would be resolved by doing the blardy exercises.

Are we effectively de-sexing ourselves by not educating girls in school about their pelvic floor, reminding them when they are pregnant, again after they have a baby, again when baby starts nursery, again when menopausal symptoms start...etc, etc, etc.

Would be very interested in your thoughts, the more I read, the more I think it's a political disgrace.

TerrariaMum Tue 06-Nov-12 13:41:00

I posted on the other thread, but will post here too. I really think it has to do wuth society's whole attitude to women's bodies and to women as well. I also wanted to say thanks for bringing this to my attention.

NanaNina Tue 06-Nov-12 14:00:33

GG I am a 68 year old woman and reading your post sounds like my life. I only had 2 children who are of course now adults. My stress incontinence has been getting worse and worse and now need a "normal" absorbent pad which is qute thick if I am doing any walking (not long walks ) but just 15 mins into town. I am afraid of all the things you mention. Here on MN there is an advert for the Pelvic Floor Toner (think that's what it's called) and the add says it's the only one that GPs will prescribe. It's £24 99 and I could easily get one but don't know if it will work. I also have a very itchy vagina from time to time so I was thinking of going to see my GP about the 2 things. Trouble is you can never gt an appt to see her,but suppose any female GP would be OK.

Any advice would be greatly appreciated.

Totally agree, the fight that some women have to get help and it's viewed as a side effect of having babies do shut up. Have suggested a campaign on another thread, don't know if they considered it. Doesn't have to be labelled as a feminist issue as such.

gussiegrips Tue 06-Nov-12 14:32:59

No, Severed, it's not a feminist campaign. We need to raise awareness for women, most women in Nana's age group know little or nothing about it - but, live with it every day.

Interesting you've suggested a campaign on another thread...which one? I'm hoping to present a job lot of messages to MNHQ.

Nana, symptoms get worse after menopause. The collagen in our ligaments change after menopause, so everything sags down on the pelvic floor a bit more than earlier in life.

There is good evidence to show that women of any age can improve, or solve, their continence issues by doing pelvic floor exercises. Really good evidence. The only trouble is, you've got to actually do the sodding exercises.

Things that complicate that are prolapses, or, ironically, pelvic floor spasm.

Itchiness can be a symptom of vaginal dryness, or infection - best chat to your GP about that.

Whilst there, hand them this form clever form from incostress
and take it from there!

Am just heading out to the school run, didn't want to not answer Have a look at my profile, there's a link to my website there, (am mindful of not falling foul of advertising rules!)

I'll pop back on mn once I've shouted the kids into submission later on.

Huffpot Tue 06-Nov-12 14:47:54

Absolutely think a campaign would be fantastic.

I have 2 DC and am 34 and after stupidly thinking leaking was just something to put up with after having children have just been diagnosed with a prolapse and am having monthly physio and have been told that I will need surgery.

So now I am forever curtailed from doing any high impact exercise and even told to try not to lift my toddlers anymore than absolutely necessary.

I know from speaking to friends (surprising the amount of people have symtoms) that we all just accept these issues rather than seek help

AbigailAdams Tue 06-Nov-12 15:37:04

I posted on your other thread. Also agree a campaign would be great. I think it is a feminist issue in the sense that women are silenced about the problems associated with childbirth. Their concerns, fears and real health issues surrounding childbirth are minimised by society in general, in a deliberate way.

But a campaign most certainly does not need to be led by feminists or from a feminist perspective. Led by women for women I'd say! smile

EmmelineGoulden Tue 06-Nov-12 18:08:21

An awareness campaign sounds good, I'm all fro people being armed with facts. But really, is it realistic a realistic solution to the problem?

Is there any other condition that is likely to affect a quarter of the population before retirement age addressed simply with the message that you need to do x, y and z? It just doesn't seem like a message that is effective in our culture.

Are there other interventions that would help - elective c-sections? routine physio after child birth? Drugs that shore up collagen? I'm guessing wildly at these. I have no idea about what's effective, I'm just concerned that something that is so prevalent should be tackled through a solution that I suspect won't work well no matter how good the campaign...

To be honest I can't remember and no doubt nc since then. Have you visited the fallen fanjo thread ( otherwise know as any old prolapse) loads of ladies at the start and all the way through to the other side. Might have been an old prolapse thread actually......

jammic Tue 06-Nov-12 19:35:09

Another one who posted on the other thread. Definitely all for anything that will help.

gussiegrips Tue 06-Nov-12 22:22:00

Emmaline - the science is good. 70% of simple stress incontinence cases can be cured by doing pelvic floor exercises.

It's a free cure.

With no side effects.

Truly, they do just need to do x, y and z.

Which is why I'm so cross - it's an easy fix, except it takes time to develop a habit for health. You know, like brushing teeth.

I'd love it if pelvic health was taught alongside sex ed in schools.

That'd fix it.

Drop a sprog in France and you get 6 weeks of 1:1 physio paid for by the government.

french women are gorgeous, confident and wear white trousers sweeping statement I need no other evidence to prove that their system works better than ours.

EmmelineGoulden Tue 06-Nov-12 22:34:36

I'm not saying the science about the effectiveness of doing the exercises is bad.

I'm saying that it doesn't matter how much you campaign most people won't do exercises on their own.

The French physio thing sounds more likely to be effective. I'd be more convinced by statistics on the number of French women who suffer from incontinence than the fact they are stylish though!

NanaNina Tue 06-Nov-12 23:12:42

GG - I'm never sure I'm doing the exercise in the right way and mostly if I'm honest I don't do them - not sure why. As soon as someone mentions them I start doing them, or what I think I need to do. Was hoping you could advise whether this pelvic floor toner is worth buying. I also have urge incontinence sometimes which is really embarrassing. Can you advise what I should do - visit to GP?

ConsiderCasey Tue 06-Nov-12 23:40:48

I think it's a feminist issue for sure, in the way that the media presents the female body in a sexy, idealised way but is silent about the reality of women's bodies. It silences and embarrasses women because no one wants to admit that reality. . Which is why mumsnet is such a great forum for women.

I think in general women's sex lives suffer because of all the demands on how we present ourselves, and that's a feminist issue too.

Sod it, everything is a feminist issue! grin

Bue Wed 07-Nov-12 00:43:34

I think Emmeline's right - most women just don't do them, no matter how much you talk /campaign / educate etc. I'm a student MW - our Trust gives every new mum an excellent leaflet and I harp on and on about the damn exercises at postnatal visits (my mentor loves to remind people that pelvic floor exercises are for life), but I know most women will not actually be doing them. It is the last thing new mothers have on their minds. There is probably something in the French approach of structured physio - I'd like to see some hard evidence on that.

<does kegels>

extremepie Wed 07-Nov-12 00:49:21

I wish it was something that was talked about in society more widely and then hopefully people wouldn't feel so ashamed to admit they have a problem!

It took me at least 15 years to realise that what I had wasn't normal, wetting myself in public was the last straw that made me seek help.

I agree with your general message but unfortunately pelvic floor exercises don't help me - I have a different kind of incontinence which requires prescription medication and, funnily enough, also affects a close male friend!

HalloweenNameChange Wed 07-Nov-12 04:46:08

TBH, when I was pregnant I heard this loads but it felt like they were trying to remind me to work my vagina so it stayed "honeymoon" fresh. Found it quite offensive actually. Same with "sexy" maternity and nursing bras. Too much pressure to have yor body stay perfect

Dell28 Wed 07-Nov-12 11:18:35

I read something recently (this morning in fact!) About how men take it for granted that their penis can enlarge and then revert back to normal size without it even crossing anyone's mind that this might damage it somehow. (Ie, during arousal) The same can be true of vaginas. They are designed to enlarge and allow a baby to pass through. They enlarge during arousal etc to a lesser degree. It did say that if women do exercises which strengthen their pelvic muscles - kegels, but also hip-swirly dances etc, then it actually makes a lot of sense to see our vaginas in the way that men see their penises. Rather than continue thinking childbirth leads to 'sagginess' or whatever, see the enlargement they go through during labour as natural and normal and part of female life and have faith they will 'go back to normal'. But it did seem to identify pelvic exercises as the key to this being reality.

Disclaimer : I know mothing about this topic and was surrounded by toddlers whilst attempting to read, so I may be missing something. Makes sense to me though!

Himalaya Wed 07-Nov-12 11:37:24

Hands up if you started clenching as you read this thread grin

I do remember being taught about pelvic floor exercise at school in PSHE and again when I was pregnant. I don't remember to do them regularly though.

Is there an app to remind you do them smile?

grimbletart Wed 07-Nov-12 12:43:52

Hands up if you started clenching as you read this thread

<hand-raising emoticon>

Actually, it's just a question of acquiring a habit. For example, I acquired a habit of always washing my hands as soon as I came back from work, shopping etc. the minute I took my coat off...(years ago on the back of a flu outbreak in the 80s) and now it is so automatic I don't even think about it.

So I did the same with Kegels: not when I got indoors grin but every morning when I prepare breakfast and sit down with a cuppa. It's automatic. Even in the days when I was commuting miles and took breakfast pretty much on the run at 6.30am I did it because I had a horrid first birth with lots of fanjo damage decades ago and I was really scared of becoming a leaky person as I got older. I'm now 69 and so far (touching lots of wood here) it's worked. No problems.

So, just associate it with something you do regularly and it should become second nature.

Lifeisontheup Wed 07-Nov-12 13:12:50

When I had DD 20 years ago we were visited by a physio in hospital, she was seriously scary and told us to do 300 pelvic floor exercises per day for the rest of our lives hmm BUT it worked , she told us to do sets everytime we washed our hands, when we stopped at traffic lights, when we watched TV.
I can't say I did 300 but I did do loads and even now as I approach the menopause after 3 children, all reasonable size and delivered vaginally I rarely leak, very occasionally if I have a really bad cough/cold I have to remember to pull up my pelvic floor before I cough but can run/jump even with a full bladder.

gussiegrips Wed 07-Nov-12 13:28:06

Just checking in - I'll find the stats on incontinence in France. Great point.

The problems is that yep, vaginas should adapt to childbirth - but, sometimes, they don't.

And, honeymoon fresh isn't the point - not pooing yourself or having pelvic pain or giving up what remains of your sex life is.

I think it should be taught in schools, again at pregnancy, again when the kid goes to nursery, and at every single interaction you have with a GP.

The evidence shows that you need to do them every single day for it to work. ANd, yep, motivating women is difficult - show em an image of a G4 prolapse and the gadgetry they'll need to have a poo is fairly motivating.

It costs an average of £600 a year for absorbant pads. That's a whole lot of money which could be better spent on pinot grigio.

Am away to clinic - will trawl for French stats...though, even with effective teaching, you still gotta do the blardy exercises for it to work.

Thanks, this thread is very inspiring!

NanaNina Wed 07-Nov-12 14:55:32

PLEASE GG will you let me know whether you think the pelvic floor toner is worth buying?

gussiegrips Wed 07-Nov-12 19:31:32

Sorry, Nana, I forgot to reply to that! Clearly, time for me to get a PA.

Yep, it's a really good gadget - in fact, I've just had a box of them delivered for my ladeez. It works with springs, so it creates resistance. You bung it where you think it needs to go and do your exercises.

There's some good evidence behind it - have a look at www.pelvictoner.co.uk for the stats.

Also, might be worth asking your GP as it's available on prescription.

The only downside I see with it is that you've got to get your kecks off to use it - for optimum results you need to do your exercises x3 a day, which can be a challenge to fit in. But, not impossible, you've just got to make time to doyerblardyexercises.

The encouraging thing about the pelvic toner is that there's evidence it helps with minor grade prolapse.

So, all in all, yes, I like the gadget. But, buying it won't fix the fanjo - you've got to use it. Comes in sparkly red now too, naice.

apologies for the tardy reply!

NanaNina Wed 07-Nov-12 23:54:21

Thanks GG - you mention "minor grade prolapse" I suppose I need to get the GP to take a look, as a friend has a prolapse and it was really uncomfortable and I think they repaired it but it wasnt very successful as far as I can recall.

I will definitely send for the pelvic toner. x3 per day shouldn't be too difficult for me as I am retired.

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