Australian Women’s Weekly NZ

STAY STRONG:

look after your pelvic floor

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The challenge posed by pelvic floor health problems has come into sharp focus in recent years, as women experience­d lifechangi­ng side effects from pelvic mesh implants.

The mesh implants were used in surgical procedures to treat women with prolapse and urinary incontinen­ce, but left many women with chronic debilitati­ng pain or suffering from recurring infections. They are no longer used in New Zealand and, since the mesh debacle, women are searching for more conservati­ve and non-surgical but low risk, effective options for the treatment of pelvic organ prolapse (POP) and urinary incontinen­ce.

So, what is POP?

One in two women have a degree of POP, where the “sling” of muscles and ligaments supporting the pelvic organs (bladder, bowel, uterus and cervix) drop down with age or vaginal childbirth. It can vary from a minor inconvenie­nce to severely limiting your lifestyle. Symptoms include:

● Tampons not feeling right.

● Sensations of dragging or pressure in vagina or low back.

● Slow urine stream.

● Incomplete bladder emptying.

● Incontinen­ce with sneezing, coughing, jumping or straining.

● Trouble emptying the bowel without using finger pressure.

Pelvic health physiother­apist Angela James treats many women with POP and other pelvic issues. “We know that with pelvic floor training in pregnancy, there is a 50 per cent less chance of incontinen­ce in the postnatal period. Women know they should be doing pelvic floor muscle exercises but they are not sure what to do,” she says.

When it comes to treatment, according to Angela, there are plenty of options: “Many women I see say they didn’t realise there was something other than surgery that could help them. They need to know that there are really effective non-surgical options available, such as muscle training to support the pelvic organs, vaginal pessaries and lifestyle measures. It is not a downhill slide.”

Surgery for POP is not inevitable. There are conservati­ve measures you can take to maintain your pelvic health:

● Seek advice from an experience­d pelvic health physiother­apist.

● Learn pelvic floor muscle training to do at home, from an expert practition­er.

● Try a pessary (silicone device inserted into the vagina to hold the pelvic organs in place) that suits your anatomy and condition.

● Maintain a healthy weight.

● Avoid repetitive heavy lifting, including lifting children.

● Take measures to avoid constipati­on by making sure you have a high fibre diet and drinking plenty of water.

● Never strain to open your bowels. Instead, sit and relax with feet on a small stool.

● Make sensible exercise choices. Trampolini­ng may not be right for you right now!

By managing prolapse effectivel­y with pelvic muscle exercises, pessaries and lifestyle techniques, you can reclaim your normal life and get back to doing the things you love. For informatio­n on pelvic mesh visit medsafe.govt.nz; for resources to help with pelvic floor health visit continence.org.nz.

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