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.

Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder. Symptoms of bloating, abdominal pain and diarrhoea or constipation (or alternating) are frequent. These impact daily life, mental wellbeing, increase absenteeism from work/school and affect social activities.

Exercise is a vital part of cancer management. The benefits are not only physical. Exercise can improve mood, symptoms of depression, and also have an impact on the body’s immune system and chances of overall survival. The benefits of exercise in cancer are so widely supported that it is now recommended by the Clinical Oncology Society of Australia that exercise be a part of everyone’s cancer care.

The research is now undeniable - educating a patient about the science of pain is an essential component of persistent pain care. Unfortunately, pain education is not easy and finding the right language is challenging for many health professionals. We know that education is therapy but just like all education, there is no one size that fits all. Everybody has a different story, different ways of learning, a different lived pain experience, different culture, different pelvic pain presentation and different biopsychosocial contributing factors. The skill and the ‘art’ of pain education lies in being able to nuance the core messages (the target concepts that we explore in this piece) in a way that makes sense to and for the patient.

Life is complicated. Sex is complicated. Sex is profoundly influenced by everything that’s happening in our lives, and sex reciprocally influences what is happening in our lives. They are not separable. Many of the ideas that we develop about sexuality and our bodies begin with familial and socio-cultural beliefs, and the sex education we receive at school. Most of us went into puberty education classes only to learn boys have erections and ejaculations, and girls have periods and unwanted pregnancy. Subsequent conversations were usually framed in terms of risk and danger.

Erectile dysfunction affects up to 1 in 2 men. Current typical treatment options include medication and lifestyle modification. A systematic review published this year has found a new “wonder drug” for erectile dysfunction and premature ejaculation. This magic pill has no side effects, is affordable, and is easy to administer. And you will never guess what it is….. Pelvic Floor Exercises!