While sipping coffee, tea, or mimosas with girlfriends, you might dish on your latest Amazon find, your new skin care routine or even the hot new TikTok.
What you probably don't discuss is not being able to get through a workout class without some embarrassing leakage or how things are so dry and painful down there that you tell your partner you've "got a headache" more often than you'd like.
Yep, pelvic health is the last topic to get picked at just about any gathering.
What is pelvic health, exactly? "It refers to the study and treatment of all of the organs within the pelvis, as well as the musculoskeletal nervous and vascular system," explained Lily Dawson, PT, DPT with Women's+ Health Collective. These organs and muscles work in concert with one another to keep daily functions working smoothly and help make sex more enjoyable.
As a pelvic health physical therapist, Dawson is passionate about helping women understand more about this often-overlooked part of health and wellness. "We think about working out, drinking water, and eating right, but we forget about the seat—literally—of our physical body," she said.
Pelvic health isn't just a female issue.
"The most common dysfunctions we see in men are sexual dysfunction and bladder control," said Dawson. It's not fun for either gender and can cause mental and emotional stress, as well. "When you have bowel and bladder issues, you're embarrassed and limit your interaction with the world. That can be very isolating."
The good news: If you're experiencing any of these symptoms, help is available:
1. Ayyy, what's that unusual feeling? If you're experiencing a heavy, pulling sensation in your nether regions, you may have pelvic organ prolapse, which means a pelvic organ has dropped from its normal position into the vagina or rectum. "If you're constantly bearing down to have a bowel movement or pee, you're encouraging those organs to descend," explained Dawson. She suggested taking a more laid-back approach to going to the bathroom. "It's called the 'restroom' for a reason! Rest in there. Relax and let your body perform as it was engineered."
2. Excuse me ... I need a restroom, stat! If you're experiencing changes in bowel habits, including urgency or frequency of urination, constipation or diarrhea, it could be a sign of abnormalities in your pelvic muscles.
3. Oops! Difficulty controlling your bladder or, yikes—the passing of gas or feces, is embarrassing, but you're not alone. Anal and urinary incontinence are common symptoms of pelvic floor dysfunction.
4. Oh, my lower back hurts. Again. "It's astounding how many of us have experienced or are struggling with pelvic pain concerns," said Dawson. "It can be associated with things like endometriosis, interstitial cystitis and more." But chronic low back pain or hip pain that hasn't been resolved through traditional PT can also be related to the pelvis.
5. Not tonight, honey. When getting busy with your partner doesn't appeal because all you can think about is the pain, it's not in your head. Painful sexual intercourse, called dyspareunia, is legit. Another symptom of pelvic health dysfunction can be elusive orgasms. Chalk up another great reason to consult a medical professional.
Dawson suggested using your annual checkup as an opportunity to discuss pelvic health with your medical provider. "If you're experiencing any of these conditions, you can say, 'I've heard there's physical therapy for that,'" she suggested. "Medical providers are generally happy to provide a referral."
Regarding pelvic health, keep in mind that what you want is pelvic floor muscles that function well. "That doesn't mean strong and tight," Dawson clarified. "It means that the pelvic floor muscles can contract. They can relax and support the organs but also allow for regular urinary and bowel functions and facilitate sexual climax."
At Women's+ Health Collective, where Dawson works, patients can see providers for pelvic floor physical therapy, sex counseling, gynecology and psychiatry.
"This is a safe place, with practitioners who've been specially trained to make sure a patient's health journey is dictated by them," Dawson said. "We work with patients towards their goals instead of having patients think they're here to get 'fixed.' Nobody is broken. It's important for people to know that."
As you work to improve your pelvic health, Dawson suggested seeking providers who work together as a team and make recommendations that are in line with one another for your optimal health. That sounds like advice we can "cheers" to over drinks with girlfriends anytime!
Kirsetin Morello is a Michigan-based author, speaker, writer, travel-lover, wife and grateful mom of three boys. Read more about her at www.KirsetinMorello.com.
This article originally appeared in the Aug/Sep '24 issue of West Michigan Woman.
