Your pelvis is a bony bowl that connects your body to your legs, which contains and protects internal organs like the womb, bladder and bowel. Keeping your pelvis and the organs it protects healthy is important for physical, mental, social and sexual health.
Concerns about your pelvic health
If you are experiencing problems with your pelvic floor or have any concerns, it’s always best to talk to your doctor. Tracking your pain/bowel habits/leakages will help you to tell your doctor about your experience.
When and where to get help
Pelvic floor problems
If the muscles of your pelvic floor become weak or uncoordinated, you may find that you leak urine or poo, have pain when going to the toilet or during sex, or feel a dragging or heaviness in the lower tummy or pelvic area.
Anyone can experience pelvic floor issues at any stage of life, but particularly after pregnancy, giving birth, during, or after the menopause.
If you have new unexplained symptoms or changes in your bowel or bladder, new pain, unexpected vaginal bleeding or bleeding from your back passage, talk to your doctor.
More information on your pelvic floor:
Common pelvic floor problems
Incontinence
Incontinence is the loss of control of bladder and/or bowels that results in leakage of urine and/or poo. The amount of leakage can vary between individuals or at different times.
If you have new, unexplained symptoms or changes in your bowel or bladder habits and are not seeing an improvement after three months of regular pelvic floor exercises, talk to your doctor.
Some long-term medical conditions that cause you cough a lot, like asthma, can affect your pelvic floor. Your doctor can refer you to the right support services.
Pelvic health concerns during pregnancy and after childbirth
Urinary incontinence is not unusual during and after childbirth. Pelvic floor exercises and physiotherapy can help.
Other useful information:
Constipation
Many people experience constipation at some point. For most it is temporary and not serious, but for some it can be chronic and cause ongoing issues. Understanding its causes, prevention and treatment can help to manage and control your symptoms.
Talk to you doctor if you:
Useful links
Pelvic organ prolapse
A prolapse in the pelvis or pelvic floor area can feel like heaviness or dragging in the lower stomach, vagina, bowel or anus. It is usually because one of your organs has slipped down from its usual position and is pressing on your vagina, bowels or anus. Pelvic organ prolapse is common, affecting one in ten women over the age of 50. Its symptoms should not be ignored or endured.
Symptoms can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed. Treatment choices for prolapse include physiotherapy, support pessaries or surgery.
Vaginal mesh
Vaginal mesh is a surgical mesh that is implanted through the vagina and was used to treat pelvic organ prolapse and urinary stress incontinence. Vaginal mesh is no longer routinely used on the NHS due to concerns regarding complications.
If you had vaginal mesh surgery as an NHS patient in England, and experience any of the following symptoms, talk to your doctor.
Symptoms include:
Useful links
Vaginal pessary
A vaginal pessary is a device made of plastic or silicone inserted into the vagina to support a prolapsed uterus, vaginal wall, your bowel or bladder. It can be used as an alternative to surgery. There are different types of pessaries, and your doctor or healthcare professional will help determine the best type and size for you, which sometimes takes more than one visit.
Once correctly fitted it can help to reduce your symptoms and improve comfort. A specialist doctor (gynaecologist) or nurse will usually fit the pessary.
You will be able to continue with your everyday activities including exercising, working and caring for your family.
Self managed pessaries
Self-management of pessaries for pelvic organ prolapse can be a safe and cost-effective alternative to regular clinic visits.
Some women only have intermittent symptoms, such as during exercise or when out and about, and so wish to insert and remove the pessary regularly. Many choose to remove it for sexual intercourse. Others simply want to have the ability to remove it when they choose, even if they keep it in most of the time.
Pelvic health and menopause
Changes in your hormones during and after menopause can weaken the muscles in your pelvic area. This can increase the risk of urinary incontinence, pelvic organ prolapse or changes in your bladder. Regular pelvic floor muscle squeezes can improve these symptoms.
While hormone replacement therapy (HRT) doesn’t directly treat pelvic organ prolapse, it can relieve symptoms like vaginal dryness or discomfort during sex. Talk to your doctor for more advice on what would be a suitable treatment for you.
Pelvic pain
Pelvic pain can range from a sharp, stabbing pain that comes on suddenly, to a dull, heavy ache. There are also lots of causes including constipation, urinary tract infections (UTIs) or sexually transmitted infections (STIs). On rare occasions, it could be something more serious. Talk to your doctor if you are experiencing pelvic pain.
Sexual dysfunction
Pain or a change in the sensation in your vagina and/or leaking during sexual intimacy can have many underlying causes. Some are biological, some are psychological, and others are social.
Sexual challenges, such as an inability to orgasm, can be unrelated to pain.
Some of the conditions which lead to pain with sexual intercourse can lead to pain in other activities, such as experiencing pain or difficulty inserting a tampon.
Medication
Medications and recreational drugs such as ketamine can affect your bladder and bowels, causing leaks or problems passing urine. If you notice any changes since taking a new medication, talk to a pharmacist or your doctor.
