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!

“Isn’t it good for my pelvic floor to be tight? Isn’t a tight pelvic floor a strong pelvic floor?” These are two questions we are often asked, and the answer to both is NO! More and more commonly we are diagnosing pelvic floor muscle overactivity as a contributing factor to bladder and bowel dysfunction, pelvic pain and dyspareunia. Shan and Leonie attended a workshop at the International Continence Society 2018 conference run by prominent researchers in this field. The workshop explored the latest in pelvic floor muscle overactivity, and how it is best managed.

Gynaecological cancer is the third most commonly diagnosed cancer among women. Thankfully the survival rates are increasing, but, as a consequence, many women are now having to live with the adverse effects of treatment. These often include bothersome bladder, bowel and sexual dysfunction. Research and awareness in this area is improving, with Associate Professor Helena Frawley from Monash University leading a project investigating pelvic oncology and the side effects of treatment. Ms Carina Siracusa, American pelvic floor Physiotherapist, also presented at the International Continence Society meeting late last year, exploring what can be done to enhance recovery for these women.

Anthony was referred to WMHP with incontinence and painful voiding 3 months after a transurethral resection of the prostate (TURP). This case study explores the complex and diverse aetiology of lower urinary tract symptoms (LUTS) and highlights the contribution of increased tension in pelvic floor muscles.

Endometriosis, a disease affecting 1 in 10 Australian women, is rarely spoken about but can have devastating effects on many aspects of a woman’s life. Thankfully, this should change, with the release of a National Action Plan (NAP) for Endometriosis, delivered by Health Minister Greg Hunt last year.

Many health professionals endorse drinking 2 litres of water each day, despite a lack of scientific evidence to support this1. In patients with overactive bladder (OAB), excessive fluid intake is known to exacerbate urinary frequency and urgency. A new systematic review has just been published, investigating fluid intake and OAB, and the results are fascinating.

Vulvodynia affects 10-20% of women, and its prevalence is on the rise. It affects women across the lifespan, and its pathophysiology is still poorly understood. Associate Professor Melanie Morin, Canadian researcher and Pelvic Floor Physiotherapist, recently presented an update on Provoked Vestibulodynia (PVD) at the International Continence Society 2018 in Philadelphia. Her fascinating presentation outlined the latest in pathophysiology and management of PVD, and the exciting results of a soon-to-be published large randomised clinical trial of multimodal physiotherapy in women with PVD.

Jill was referred by a Urologist to WMHP for management of Urgency Urinary Incontinence, but during subjective assessment disclosed that Faecal Incontinence was actually her most bothersome symptom. This case study highlights the absolutely devastating effect Faecal Incontinence can have on a person’s quality of life, and how a structured treatment program can cure this highly bothersome condition.