Did you know that adverse experiences in childhood can have a big impact on health later in life? A landmark study in 1998 known as the ACE (Adverse Childhood Experiences) study followed over 17,000 participants, investigating the impact of emotional and physical trauma in childhood on physical and psychological health later in life. The results were overwhelmingly clear that childhood abuse and family dysfunction had a profound effect on adult mental health and wellbeing and increased the chance of developing chronic illnesses such as heart disease, diabetes, cancer, persistent pain and obesity.

Gestational diabetes (GDM) is associated with increased incidence of pelvic floor dysfunction and urinary incontinence, both during pregnancy and post-natally. An interesting study was published late 2020 on this topic, exploring the effect of GDM on the pelvic floor muscles. 110 pregnant women with and without GDM were assessed with 3D ultrasound at 24-28 weeks and 34-38 weeks gestation, and levator ani thickness and hiatal area were measured.

Urinary incontinence (UI) is a significant problem for Australian women. Affecting 1 in 3 women of all ages, this is an issue that needs to be taken seriously. When a woman is not able to control her bladder, it can affect her life profoundly. Women will often stop exercising, withdraw from intimacy, have reduced self-esteem, and avoid engaging in things they enjoy. Shockingly, a large population-based study found that 75% of affected women don’t seek help, and among those who do seek help, only 12% actually ended up receiving care¹. Incontinence is highly prevalent but very treatable – and pelvic floor muscle training is the grade A, first line recommended treatment for stress, urge or mixed incontinence². We know that you know this – but do women know this? It is our job to ensure the message is heard, understood and acted upon.

We have noticed a recent dramatic increase in pelvic pain presentations that appear to be triggered by higher levels of stress and anxiety during the COVID-19 pandemic. When a patient presents with chronic pain, it is no longer acceptable to view them through a narrow lens. More and more research now supports what we have long known, that chronic pain is driven by a sensitised nervous system. Unfortunately, stress and anxiety feed directly into sensitised nervous systems, further heightening the pain experience1.

For women with pelvic organ prolapse, the lifestyle changes associated with being at home during COVID-19 are having a big impact on their symptoms. Women are home with their kids more, and doing heavier house and garden work. As the gyms and pools are closed, many have also turned to running or high impact online exercise programs, all of which are contributing. Given the strong evidence base for conservative management of mild-moderate pelvic organ prolapse, we would like to share 5 treatment options.