By Sue Sveum
Many women experience pelvic health issues, which can lead to stress, embarrassment and even isolation. Younger women, especially, often feel self-conscious. But ask anyone who’s sought and found help for these types of conditions, and they’ll tell you the same thing: They wish they’d done it sooner.
Dr. Sarah McAchran, a urogynecologist at UW Health Eastpark Medical Center’s Integrated Specialty Care for Women, says the top three concerns she sees are urinary and fecal incontinence, and pelvic organ prolapse. Pelvic issues can be caused by a variety of conditions, explains Dr. McAchran.
“For some, it’s just bad luck,” she says. “For others, it’s lifestyle. Repeated pressure on your pelvic floor can put you at higher risk for damaging nerves, muscles or ligaments in your pelvis that can lead to these [aforementioned issues].” Common reasons are pregnancy and delivery, repetitive weight-bearing activities, smoking and having a chronic cough.
For Sherri Erickson, childbirth and smoking were likely factors that led to her bladder incontinence. But when she quit smoking and began running, she became aware of irritating and embarrassing leakage. Physical therapy helped, but not enough.
“Running was a huge part of my life,” she says, “so I’d wear black and run in the dark so I wasn’t ashamed when doing what I loved.”
A referral to Dr. McAchran led to successful bladder repair surgery. “It was life-changing,” adds Erickson.
Sexual health is another common pelvic health concern, according to Certified Sex Therapist Madelyn Esposito, LPC, program manager at UW Health Eastpark Medical Center’s Sexual Health Clinic. But thanks to a partnership with Integrated Specialty Care for Women, most insurances cover sex therapy under talk therapy.
“Our work is multidimensional — covering everything from painful sex to incontinence,” she explains, “along with psychological factors such as pain, causing anxiety and depression.” She adds that desire can also be negatively impacted by pain, noting it’s hard to want sex if it’s painful.
Natalie Seaton knows first-hand that sex therapy is a game-changer. Oral medication after breast cancer left her with a highly unusual side effect — an overactive libido causing her to feel overstimulated and physically uncomfortable.
“I knew something was wrong,” she says. “Sex therapy with Madelyn was an absolutely critical component to my recovery.”
Her core issue was overcome by medication management. Combined with therapy, Seaton’s past sexual traumas were also addressed — leading to a diagnosis of PTSD — and the help she needed.
“Most, if not all, of my clients feel much better knowing they’re not alone. They feel empowered,” stresses Esposito. “Other people have these issues, too. We just don’t know how to talk about it very well.”
“A friend once told me that nobody does it alone in life,” Seaton adds. “If I can help reduce or eliminate the stigma and help somebody else to not feel embarrassed and to reach out for help, it’s worth telling my story.”
No matter the pelvic health concern, many women might feel embarrassed or alone. And often, they tell themselves they need to tough it out.
“So many women are ashamed of having leakage or prolapse or pain — they just choose not to talk about it to anyone,” says Erickson. “But you’re actually limiting your life by not reaching out.”
WHAT TREATMENT IS RIGHT FOR YOU?
While it’s important to see your provider or OB/GYN about any new or bothersome pelvic concerns, surgery isn’t always necessary, according to Dr. Sarah McAchran.
“It’s really very patient-specific with different treatment paths depending on what we’re treating,” she says. “Just know you don’t have to ‘tough it out.’ With the right treatment, you can participate in everyday life again with confidence.”
Common Pelvic Health Conditions and Treatments
Stress Incontinence
This occurs when urine leaks during physical activity or movement that puts pressure or stress on the bladder.
Treatments include:
- Physical therapy
- Pessary (a vaginally inserted device to support pelvic organs)
- Surgery
- Sexual therapy
Urge Incontinence
Individuals may experience a sudden, intense urge to urinate — followed by an involuntary loss of urine.
Treatments include:
- Physical therapy
- Pessary
- Oral medication
- Limiting fluids
- Eliminating caffeine/dietary triggers
- Surgery
Fecal Incontinence
This is the inability to control bowel movements, leading to the accidental leakage of stool (solid or liquid) or gas.
Treatments include:
- Physical therapy
- Pessary
- Surgery
Prolapse
A condition in which an organ (bladder, uterus or rectum) drops from its normal position, and bulges into or outside of the vaginal canal, due to weakened pelvic floor muscles and tissues.
Treatments include:
- Physical therapy
- Pessary
- Surgery
Chronic Pelvic Pain
This can stem from a variety of causes, including pelvic floor dysfunction, surgery, painful periods and more.
Treatments include:
- Physical therapy
- Sexual therapy
