A woman’s body goes through extreme changes throughout her lifetime; from puberty, to pregnancy, childbirth, postnatal recovery and then menopause. Women’s health encompasses a variety of conditions that can be associated with a women’s body and these changes that occur depending on the stage of her life. Some of these conditions can include:
- Leakage or incontinence of the bladder or bowel:
1 in 3 women who have gone through childbirth will experience leakage. It is common during pregnancy, childbirth and menopause for the pelvic floor muscles to weaken, due to stretching of the muscles and hormonal changes.
- Chronic pelvic pain and pelvic floor overactivity:
Pelvic floor overactivity can occur when the pelvic floor muscles are protecting an area due to a history of pain in that area. For example, endometriosis, painful periods or chronic lower back pain can sometimes result in overactivity of the pelvic floor rather than weakness.
- Low back or sacroiliac joint pain associated with pregnancy:
Pain in the lower back is common during pregnancy as weight around the pelvis begins to shift, adding abnormal stress and load on the joints of the lumbar and sacroiliac areas. The pain may or may not travel down the legs. Hormonal changes can also result in a stretching of the ligaments around the lower back and pelvis.
- Other pregnancy associated conditions such as wrist pain (carpal tunnel syndrome, De Quervains syndrome) or rectus abdominus diastasis (abdominal separation)
- Mastitis or inflammation of the breast tissue
- Osteoporosis or osteopenia
A decrease in bone density can occur as a result of ageing. Due to changes in hormones, 25 percent of bone mass is lost in the 2 years either side of menopause.
Physiotherapy for management of incontinence and prolapse is now the first line recommendation, before medication or surgery, as outlined by the International Consultation on Incontinence. At Enhance Physiotherapy, our physiotherapists have expertise in managing and treating women’s health conditions, including assessment and retraining of the pelvic floor muscles using a non-invasive tool called a real time ultrasound (see Service).
The pelvic floor is made up of layers of muscles and tissues that attach from the front of the pelvis to the back of the tailbone. The pelvic floor has four main functions:
- To support the pelvic organs (bladder, bowel and uterus);
- To control the bladder and bowel;
- To improve vaginal tone to help with sexual enjoyment;
- To support the back by working with the abdominal muscles.
They can become weak or dysfunctional due to pregnancy, inactivity, constipation, lifting heavy weight, chronic coughing or ageing.
Possible signs of a dysfunctional pelvic floor (weak or overactive):
- Accidental leakage or incontinence
- Leakage with running or jumping
- Unable to make it to the toilet
- Frequent urge to go to the toilet
- Difficulty emptying your bladder or bowel
- History of a prolapse
- Lack of sexual sensation
- Pain with sexual intercourse
Pelvic floor dysfunction can be easily addressed through retraining exercises, relaxation and mindfulness training and general exercise advice to restore the coordination, endurance and strength of the muscles. It is recommended to start with a real time ultrasound assessment due to the deep nature of the muscles. Your Enhance Physiotherapist can then prescribe you with an individualized pelvic floor program designed specifically to suit your needs and goals or they may refer you onwards to a specialized Women’s Health Physiotherapist if internal examination is needed.
Your Enhance Physiotherapist or exercise physiologist can also tailor a general exercise program for you to address other areas of women’s health conditions such as:
- Pregnancy and post natal health and wellbeing
- Bone health during or after menopause
- Chronic pelvic pain or chronic lower back pain
- Specific programs for those undergoing cancer treatment
- Weight management or weight loss following pregnancy or menopause
Our remedial massage therapists also offer pregnancy massages specifically for the expectant mother (See Service).
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