We see people with a range of pelvic health issues that impact those born with male genitalia and reproductive, urinary and ano-rectal anatomy. International Men’s Health Week 2022 aimed to increase awareness of mental health issues. A staggering 1 in 8 Australian men experience depression and 1 in 5 experience anxiety at some stage in their lives.

Stress Urinary Incontinence (SUI) is defined as a complaint of involuntary loss of urine upon effort or physical exertion (eg, sport) or on sneezing and coughing and is often attributed to Pelvic Floor Muscle Dysfunction (PFMD). More and more, we are seeing that SUI as a major cause of reduced performance in female athletes. Why is this happening and how can we treat it?

Overactive bladder (OAB) is an idiopathic symptom-complex defined by urinary urgency (often with frequency, nocturia and incontinence) that appears to encompass multiple different underlying mechanisms. Despite support for behavioural therapy as first line treatment for OAB, the literature doesn’t address the specific impact of the cognitive aspect of bladder training. We need a better understanding of the rationale of bladder training and specifically develop urgency management strategies that are more effective in those presenting with a central component to their symptoms.

Shan, Leonie, Jane and Kathryn attended the ICS conference in October, which was held virtually this year. Associate Professor Helena Frawley, the original founder of Women’s & Men’s Health Physiotherapy was on the scientific committee and contributed to bringing together a stimulating program. There were so many fascinating and inspiring workshops and presentations (which we watched bleary eyed very early in the morning or late at night!). We have included some of our favourite ‘pearls’ from the conference below.

Recently, there has been an explosion of research into endometriosis associated pain and the influence of central mechanisms in the pain experience. Endometriosis-associated pain syndrome (EAP) is defined as “chronic or recurrent pelvic pain in patients with laparoscopically confirmed endometriosis”, and the term is used when the symptoms persist despite adequate endometriosis treatment.

Traditionally, high impact exercise (including heavy weight lifting and running) has been discouraged in women with pelvic organ prolapse (POP). There is little research to support this, however, expert opinion hypothesised that high impact exercise results in significant increases in intra-abdominal pressure (IAP). This pressure may contribute to worsening POP symptoms by weakening the pelvic floor structures. This is a logical and reasonable assumption, however, is it correct?

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.