Doctor at UK says you don't have to live with pelvic pain

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By Dr. Johnnie Wright Jr.

University of Kentucky

Pelvic health is crucial to a woman’s overall well-being but is often misunderstood or overlooked. When symptoms such as urinary incontinence, pain or discomfort, or pain during intercourse occur, they are dismissed as a byproduct of pregnancy and childbirth or just something that comes with age like arthritis. But those symptoms can have a profound effect on a woman’s physical, emotional and social well-being and can lead to more serious complications if untreated.

One of the most common conditions is pelvic organ prolapse. This condition occurs when the muscles, ligaments and fascia of the pelvic floor weaken, causing one or more of the pelvic organs – uterus, vagina, bladder or bowel – bulges into or out of the vagina.

Symptoms of prolapse include:

• A heavy dragging feeling in the vagina or lower back
• Feeling of a lump in the vagina or outside the vagina
• Bowel symptoms, such as difficulty moving the bowel or a feeling of not emptying properly
• Pain or discomfort during sexual intercourse
• Urinary symptoms such as slow urinary stream, a feeling of incomplete bladder emptying, urinary frequency, urgency and urinary stress incontinence

Prolapse occurs in one of three women who have had one or more children. Prolapse can occur immediately after childbirth or take years to develop. Aging and menopause can lead to further weakening of the pelvic floor. While prolapse is common, only one in nine women need corrective surgery. Obesity, chronic cough, chronic constipation and heavy lifting or straining can put excessive pressure on the pelvic floor and exacerbate prolapse. Depression and anxiety are linked to urinary dysfunction; someone who feels they no longer can control their bladder may withdraw and become more socially isolated.

Physical therapy can help restore strength and function to the pelvic floor. Light-intensity exercises such as walking and yoga can stretch and strengthen the pelvic floor muscles, and there are a number of free apps with exercises for maintaining continence and preventing prolapse.

If you are experiencing pelvic pain or urinary issues such as urgency or a feeling of not completely emptying the bladder, talk to your primary care provider about a referral to a urogynecologist to discuss treatment options.

Johnnie Wright Jr., M.D., is division firector, Female Pelvic Medicine and Reconstructive Surgery, at UK HealthCare.