NOW CLOSED: Post-natal pelvic floor and bladder problems - the last great taboo? Talk and you could win £100 voucher

[AnnMumsnet]

There is a Pelvic Floor Toner that is on GP prescription but it is not being offered to new mothers as a matter of course - how would you sell it? How would you get it 'out there'? Share your ideas and you could win a £100 High Street voucher.

We've been asked by the team behind the PelvicToner to find out what Mums think about their product and to ask how they would market it if they were in charge of the product.

The team say "The PelvicToner is the only clinically-proven pelvic floor exercise device that is available on GP prescription and therefore free of charge to any women holding a Maternity Exemption Certificate. The incidence of Urinary Stress Incontinence (USI) in women outweighs practically all other health conditions (put together) yet the reaction of women at large, lobby groups and many in the medical profession, is just to accept it as a tribulation to bear - something to get used to or one that can't be resolved. This is just not true, and over 80% of cases can be quickly and simply cured with an effective exercise programme."

"The scale of the problem is enormous. There are approximately 15,000 births each week and clinical estimates are that 5,000 of these mothers each week will go on to develop USI. The problem typically starts with childbirth but just gets worst after the menopause. Since January 2011 GPs have been able to prescribe the PelvicToner which in clinical trials proved to be at least as effective as supervised pelvic floor training with a physiotherapist, but to offer significant advantages in that it 'enabled the confident identification of the correct muscles and provided effective exercise using a mild resistance'. It was also recognised that the PelvicToner improved compliance with the exercise programme not least because the patient noted significant improvements within a matter of days, unlike the physiotherapy programme where improvement was not expected within three months."

So - the team behind the product know it's good (they have sold over 100,000) and have loads of evidence to prove it can help with this widespread condition, but face issues from GP's not prescribing it and women not knowing it is either available or effective.

As a way of getting folks talking about this topic we wanted to ask Mumsnetters - if you were in charge of marketing this product what would you do?

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
~ Where else do you think it can be advertised?
~ What kind of message would be most persuasive to you?
~ How much do you think it would cost to buy?
~ What information would you like to know about the product?
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
~ How do you think they could persuade more GPs to prescribe the PelvicToner?

Any other comments on this issue welcome - PelvicToner very much want to get folks talking about this issue.

Everyone who adds their thoughts to this thread will be entered into a prize draw where one winner will get £100 in High Street vouchers.

thanks
MNHQ

[MerryMarigold]

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
I think that would 'demean' to some extent. I think it needs the support of the medical profession rather than appear gimmicky.

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
I would if I knew I had a problem, but I think sometimes the problems can come out later. I would think it needs to be pushed by midwives/ health visitors especially if you have had a tear or twins, or any other medical complications which may have weakened pelvic floor.

~ Where else do you think it can be advertised?
Bounty mags. Antenatal places. It's also good to have strong pelvic muscles before birth, so it would be good to market it as something you do before and after. It's a lot easier to get into a habit of using something before than after you have a baby when the world becomes a lot more complicated.

~ What kind of message would be most persuasive to you?
That it tones pelvic floor muscles and is better than kegels be whatever percent. That you know you're 'doing it right' (sometimes hard to know if you are doing kegels 'right'). That it can prevent incontinence later in life.

~ How much do you think it would cost to buy?
I have no idea how it works. Would have to see it. If it's 2 bits of plastic and a bit of rubber then maybe 15-20. If it has machinery attached and is very complex then maybe closer to 50.

~ What information would you like to know about the product?
Safety of use in pregnancy. How effective it is compared to .... How often you need to use it for it to be effective. How to clean it!

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
General pelvic floor but not bladder issues unless v close friend, not a general toddler group discussion!

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
No. GP is the least embarrassing of those options!

~ How do you think they could persuade more GPs to prescribe the PelvicToner?
To ask the question at 6 week check about incontinence (can't remember if they do ask it or not).

[MerryMarigold]

Oh, also in terms of message: that it can improve your sex life!

[antonchigurwouldliketomeetyou]

I agree with those who say there isn't enough physical follow up after giving birth. No-one examined me after I was discharged from midwifery, even though I had a difficult instrumental delivery.

When I noticed that "things" were different my first stop was my GP (checking in with the mumsnet support thread to prepare). I was referred on to a specialist physio who is great, she hasn't recommended any devices, just a variety of exercises. I do think something like the Pelvic Toner could be good, though. When you are just doing squeezes sometimes you don't know if you are doing them hard enough or whatever.

Mumsnet and other parenting sites are a good place to start promoting. Maybe leaflets in chemists, Bounty Packs, that sort of thing would be good. Discpounts are always welcome!

To me the persuasive message is anything about being easy to fit into your daily life, or being easy to do. Also improving continence, improving sexual function and preparing for any future labours.

The cost given on the website seems about right - probably at the maximum of what I would pay.

I don't find these issues taboo - certainly have talked about them to some extent with most friends.

I am happy to discuss with GP. I would sooner go to a GP about this than a toddler group contact!!!

I don't know how to persuade GPs to prescribe. I imagine through promotion of the findings of high quality research. Plus free pens.

[antonchigurwouldliketomeetyou]

merrymarigold have you spoken to your GP? Mine referred me to a specialist physio and I am noticing changes pretty quickly.

[LittlePicnic]

I agree- the medical community just expect women to 'get on' with these things. I have never heard of this. I would pay £20 for such a device. If mumsnet offered a discount, I would give a try. Any more expensive would be prohibitive- maternity pay doesn't go that far and mothers generally put others' needs before their own,

[twonker]

My kids area a bit older now, but I found pelvic floor exercises highly effective and have no ongoing continence issues. I'm sure my health visitor brought the subject up. I would think it would be agood idea to ask the coordinator of health visiting services in NHs trusts to include an information leaflet about stress incontinence to be disseminated as part of one of the developmental checks. I realise not everyone gets along with their health visitor, but there is a programme of developmental checks... Which has changed since I had my kids. Babies used to be given a 9month check which included hearing, but now they test hearing at birth so have scrapped that developmental check. I would say 9 months would be an ideal time as if pelvic floor exercises were going to work they would have done so by then. But whenever they do the check would be good.

[marchpoppy]

When I was discharged after giving birth a fortnight ago, the midwife doing the discharge told me I should do my pelvic floor exercises and she warned me that if I didn't I could end up with a prolapse (she also quoted some other horrible medical difficulties that I forget the name of!) I know this is more of a 'stick' than 'carrot' approach but it worked for me - before now, I thought pelvic floor exercises were an optional extra to labour and delivery but this particular midwife made it quite clear they really need to be done to avoid possible serious complications later in life. I think to market a product in this market, a similar information-giving approach would be needed, pointing out what can go wrong.

[ShotgunNotDoingThePans]

Re. the squeezing against something (or not) that someone mentioned earlier; you can actually get a similar effect by scissoring your fingers and using them instead of this thing - if you cba.
Just saying.

[MalmoMum]

Nickelb that sounds a bit rough. Have you been checked out? And checked out again a bit later to see a specialist.

I eventually had an endoceal after DS3 which is a vaginal repair. The fascia in the back wall of my vagina had fallen down after DS1, saw a doc after DS2 and said if I wanted another to wait. It does effect how you can deal with a poo, an another bit deals with how you wee. I saw a consultant when DS3 was a baby but was too knackered to follow through. Probably like most with pelvic floor and wee.

When a super fit'n'slim mum at the gym mentioned she had just had a fantastic procedure for her pelvic floor and had seen the same guy, my ears pricked up. DS3 was 3 by then. Saw doc week later and got it done on husband's private scheme. Doc put the bit back in place and tidied bits up which included some stitches I had probably needed after DS1 but better to get them after all 3 so they never ripped again.

One of the best things I have ever, ever done. I class it as a designer vage. Better still, I could work out more effectively and ended up prepreg weight.

So overall, after birth we are too tired to some extras and money always a worry. Great idea to tie in with buggy fit and yoga classes. Visiting play groups and getting people to giggle about it great way to break down barriers and know you are not alone. If there had been more talk about doing stuff about your post birth fall out down below, I would have done something earlier. On the other hand, I only had to deal with stitches and not a newborn, BF, milk coming in blues etc and got 3 days in a private room.

Yes, still a taboo IMO. Good luck

[MalmoMum]

Idith sounds like you should get checked for an endoceal (sp?). Life changing

[Kleptronic]

Ok people the website is dire. It looks massively unprofessional and I wouldn't buy anything off there, it looks like an amateur did it. I would think I would be spammed for years if I put any details into it, that's if my bank account details didn't turn up on the Dark Net.

Not to put too fine a point on it, if this was my product to sell, I would vajazzle it, or at least make it less implement-y. Style it. Possibly this would clash with the being on prescription certification, I don't know. But if it works, would it matter if it was beautiful? Or at least slightly less PCV white double glazing. Would the certification be taken away?

I would big up the improved sex life. I would sell it in Ann Summers and through Avon. Hell, I would sell it at Pampered Chef parties. Anywhere women buy clatter, sell them there. Claire's Accessories. Home Bargains. All over the place. You want to take away the screaming 'medical device' vibe from this and make it a 'me time for we/e time' thing. You could have different designs for different age groups. Be slightly cheeky with it. You want a product designer to get going on this. Think training shoes or those rabbit things (don't have one, never seen one) but you get my drift - trainers come in all shapes, sizes, guises and some are serious and some are not, but they are all styled.

That's if you want to sell them. If you want them to be issued free on the National Health, well that's a different post altogether.

I would be selling this to ALL women, and especially going for the younger ones in terms of marketing - they'll be mothers soon enough, unless they choose not to be, obviously. Get them embedded in the (false) conciousness before a problem happens, we'll use them afterwards.

This sort of thing should be part of a self-care 'beauty' regime - not a 'shit my fanjo's falling out' last resort. We ALL deserve to have urinary control and we ALL deserve a good sex life, assuming penetration is our thang.

I am deliberately saying this in a hard-nosed beeyatch marketing type way. You want to sell more of these things. Presumably they work. That is good. Get them to be normal women's gear BEFORE women give birth, then none of us will have any bother over it.

I'd buy it if it was a tenner. Otherwise it starts eating into Other Things money.

Disclaimer: before anyone flames the fanjo hairs off me for being a whatever, I had a ventouse delivery and was ripped back and forth, I know whereof I speak. De-medicine it and more people will use it, which can only be a good thang.

[twonker]

Go kleptronik!

[hazchem]

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
Sure.

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
I didn't realise I could talk to my GP about it. I'm going to book an appointment tomorrow. 15 months post birth and I've taken up jogging and the PF exersizes aren't helping.
~ Where else do you think it can be advertised?
Bounty?
~ What kind of message would be most persuasive to you?
That it's normal but fixable
~ How much do you think it would cost to buy?
When I see ads for PF systems they never have a price so I assume they are in the £100s

~ What information would you like to know about the product?
HOw you fit it into daily life.
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
No never talked about it for more then afleeting joke
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
If I'm too embarrased to get from a GP I'd rather get it off the internet
~ How do you think they could persuade more GPs to prescribe the PelvicToner?
Well the issue is that at 6 weeks they say oh just do the PF and then there is no follow up so maybe when they do the 8-12 month baby check the HV or someone could talk to mums about it then.

[Hoopsadazy]

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
Yes please!
~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
I have looked at buying, but would like to go to GP to get as then could get advice on whether it might work - sometimes hard to know whether claims on a website are genuine. Need a way to authenticate the site
~ Where else do you think it can be advertised?
Women's glossy mags? Perhaps the more 'family' oriented women's mags?
~ What kind of message would be most persuasive to you?
Not sure......that it works, I think. That it's easy to use
~ How much do you think it would cost to buy?
I wouldn't to pay more than about £15
~ What information would you like to know about the product?
Hygiene, ease of use, ease of access to the product, discreet packaging - not just delivery, but also to keep in your house without your mil spying it or the cleaner! How to use it, what to do if it doesn't seem to be working. Some diagrams! Please, we have no real clue what's in our bodies
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
Ha ha, no! Do not discuss in person!
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
Nope, online
~ How do you think they could persuade more GPs to prescribe the PelvicToner?
I think they need to have a clue about it all. Not just how to help fix it, but to understand what has happened in the first place and not just dismiss the problems as they are bored/more interesting diseases/packed waiting room/embarrassed

I had been meaning to book a GP appt to ask for yet another referral to physio dept at hospital (who, btw, never mentioned that could get on prescription!) nor did relevant hospital consultant. I will book appt tomorrow and ask for a prescription.

[WitchOfEndor]

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
definitely, if an offer on this pops up on the next mumsnet recommends email I would buy it

~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
I was fobbed off by the nurse when I mentioned having issues so am reluctant to go back

~ Where else do you think it can be advertised?
pregnancy magazines, forewarned is forearmed!

~ What kind of message would be most persuasive to you?
enables mums to regain control of their pelvic floor quickly and easily

~ How much do you think it would cost to buy?
£25 - £40

~ What information would you like to know about the product?
how it works, how quickly improvements can be felt

~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
occasionally mentioned to fellow mums, not discussed with husband

~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
not sure I'd like to buy through a toddler group!

~ How do you think they could persuade more GPs to prescribe the PelvicToner?
education, a lot of gps seem ignorant of a lot of the side effects of pregnancy and labour

Looking forward to seeing a discount code soon!

[sillymummy11]

I've got one!!!! My GP prescribed it for me after I complained about peeing myself when running. It was really, really getting me down. I wouldn't have gone to her about my problem...but a friend at yoga told me about the pelvic toner when we were having a giggle about needing the loo all the time- she'd been prescribed one. I was the first person my GP had prescribed it for- she said that she would have to order one so that she could see what it looked like. Before prescribing it she did suggest that I was a bit daft to be running, and what did I expect after having 3 kids?!!! It has helped a fair bit to be honest- but I still have to wear a pad when running at the moment- but a smaller one rather than a huuuuuuuge one, which I was using previously. It is difficult finding the time to use it with small children though- there are no private places in my house at any time of the day or night. I feel that even though I don't use it every day it has helped me to recognise how hard and exactly where I need to pull the muscles in, so I can do my exercises more effectively without it too.

~ We know Mumsnet is a good place to start (hence this thread!) but would you like to see a discount on Mumsnet for this product?
YES
~ Do you think it's the sort of thing you would buy or got to the GP for (if you were to experience this issue)? If not, why not? If so, why?
I did go to the GP. Only cos I couldn't afford the £30 and I was going to see her anyway. I would normally be too embarrassed, but I was pretty desperate.
~ Where else do you think it can be advertised?
Baby magazines. Running magazines (this topic is always on forums) Weekend papers- women of all ages have these problems. Women's magazines generally.
~ What kind of message would be most persuasive to you?
That it can help strengthen the pelvic floor
~ How much do you think it would cost to buy?
£30
~ What information would you like to know about the product?
proper scientific trial info
~ Is this the sort of topic you talk about in real life with other mums or are pelvic floor and bladder issues taboo?
A bit- it has to be a close friend. Mainly in a jokey way, never serious.
~ If you are too embarrassed to talk to your GP would you rather buy from a friend or alternative practitioner or through a toddler group contact etc?
I'd be happier talking to my GP rather than any of the above. Or get it off the internet.
~ How do you think they could persuade more GPs to prescribe the PelvicToner?
Send it to them so that they can see what it looks like and how it works.

[sillymummy11]

PS I agree- website is dire. It looks highly unprofessional. Get a web designer!!!

[LittleBugsMum]

As far as advertising is concerned, you guys aren't as wet behind the ears as you make out. This thread on Mumsnet is exactly how you market this product and I think you know it...

Cynical as I am, I would love this product to work.

The main issue for me - and this has been briefly mentioned - is sex after having 2 big babies. Although 'leakage' too as I do have to wear a panty liner for when I sneeze...

Frankly, orgasms are just plain rubbish without the strong muscles inside to carry you over and combined with a decreased sex drive anyway, I'd rather have a cup of tea and an early night these days...as you can probably imagine, my marriage is a little bit stale at present.

That's why I'm going to the GP to get one!

(And if it doesn't work then I'm coming back to tell everyone, remember that Mumsnet works both ways, clever marketing people)

[MDM]

Is it like the Epi-no?

[NonnoMum]

Agree with poster who says you should quote from medical professionals who use more medically-accurate language than "vaginas you could drive a bus up". Would have considered buying this product from you but after reading that you sound like a really inconsiderate, patronising and uncaring organisation.

[cardamomginger]

I sustained serious birth injuries the symptoms of which included urinary incontinence. I consulted my GP, several gynaecologists and two specialist gynae physiotherapists. My treatment has included both physio and surgery.

Right - that's my introduction over with! I think that if a woman's continence issues can be resolved with pfes that she is able to carry out without the need for any specialist physiotherapy or other input, then this improvement can most probably be achieved with plain and simple pfes without any need for any sort of gadget.

In fact, I think that asking a woman to do pfes and seeing if this helps is a useful test of whether she needs a referral to a specialist gynae physio for assessment and treatment, e.g. if after 1 month of pfes there is still no improvement, then she should get referred.

Other posters here have said that the best way to strengthen pf muscles is by doing little and often - remembering to do a few sets when having breakfast, feeding the baby, on the bus, doing the washing up, sitting in a boring meeting, etc. A gadget cannot be used in this way.

Some women (myself included) have such weak muscle function that they need some sort of gadget to get things going. But then you are in the realm of electronic stimulators such as NeuroTrac Continence. I am dubious about the claims concerning the results of clinical trials - the data referred to doesn't prove it is superior to NICE Gold Standard of pfes, it demonstrates that the PelvicToner is not inferior, which is very different. I am particularly dubious about the claim "In clinical trials the PelvicToner has been proven to be much more effective than other systems such as expensive electro-stimulation devices" - no references are given to back up this very strong statement. If the best research presented only shows that PelvicToner is not inferior to the NICE Gold Standard of pfes, I find it unlikely that it produces superior results for those patients who require electronic stimulation.

I think women with stress incontinence should have more access to better services, but I would be concerned that the PelvicToner could be prescribed to women without specialist input. If the plan was to make it available on the NHS via gynae physios or other specialist gynae services, then that would be another matter - it would be prescribed to those patients who need this type of intervention and who can benefit from it.

As a last point, the manufacturers also need to understand that a severely traumatised pelvic floor that is in spasm can mimic a pelvic floor that has no tone and strength. The treatment for the former, however, is very different from the treatment for the latter. Pelvic floor spasm is likely to be diagnosed only by specialists.