The pelvic floor is made up of ligaments, connective tissue, and muscles that support the function of urination and bowel movements as well as sexual function. Maintaining your pelvic floor health is critical to help prevent the onset of certain issues. For women, pelvic floor issues can arise at various times in their lives – from puberty, pregnancy and post-partum through perimenopause, menopause, and post-menopause – causing discomfort, severe pain, ineffective control of bodily functions, embarrassment, and/or affecting quality of life.
During menopause, for example, estrogen levels dip causing the pelvic floor muscles to get thinner and dryer, which can lead to pelvic floor muscle tightness or pelvic pain. Menopausal women may also develop conditions such as bladder prolapse; vaginal vault prolapse; vaginal atrophy; frequent urination; urge urinary incontinence; and pelvic floor dysfunction.
Without treatment, pelvic floor issues can persist and get worse over time, leaving many women to suffer with no relief. That was the case for Potossi, Mo. resident, Jane*, 70, who’d been battling various pelvic floor issues for years. Some of these included bladder prolapse; vaginal vault prolapse after a hysterectomy; vaginal atrophy; frequent urination; urge urinary incontinence; and pelvic floor dysfunction. For Jane, the worst part was the bladder control.
“I’ve had bladder problems all my life, which I thought was normal,” recalled Jane. “So, I just learned to learn to live with it – getting up four to five times every night to use the bathroom; and going to the restroom 15 to 20 times on any given day. I’ve been afraid of accidents on long trips, cutting back to necessary travel only. I even know where every bathroom is in most businesses across three counties.”
Tired of feeling fearful, aggravated, and embarrassed, Jane mentioned something about her bladder issues to her primary care doctor, Scott Kirkley, MD, at Parkland Health Center. She knew if she didn’t say something, her condition would never get better – or it might even get worse.
Dr. Kirkley referred Jane to Jerry Lane Lowder, MD, MS, a gynecologist and female pelvic medicine and reconstructive surgeon with BJC HealthCare. At her first appointment with Dr. Lowder, Jane underwent an exam and was surprised to hear his recommendation: pelvic therapy.
“I really thought it wouldn’t do any good,” said Jane. “But Dr. Lowder asked me to try it. That way, if I ended up having to have surgery (a last resort), my pelvic floor would at least be stronger.”
Pelvic Therapy Services at Parkland Health Center
Dr. Lowder suggested Jane make an appointment with Parkland Therapy Services at Parkland Health Center, which offers a multidisciplinary rehab team that includes physical, occupational, speech, lymphedema, and pelvic floor therapists.
“Our pelvic floor therapy involves certified physical therapists and/or specialists, who provide a thorough evaluation before creating an individualized treatment plan specific to a patient’s unique symptoms,” said Lisa West, physical therapy manager at Parkland Therapy Services. “We also provide some education to explain the pelvic floor’s anatomy and how different components work together. Patients learn how certain habits and hygiene can affect his or her symptoms.”
With pelvic therapy, some of the recommended treatments may include bladder retraining; manual therapy; electrical stimulation or biofeedback; pelvic muscle relaxation exercises; pelvic muscle strengthening exercises; vaginal dilators; etc.
At Jane’s first appointment, she worked with Emily Dattoli, DPT, a certified physical therapist at Parkland Therapy Services to conduct the initial evaluation and create a customized plan.
“She was very thorough in her questioning and offered up some possible results,” said Jane. “I wanted to believe her, because she seemed optimistic, but I still wore my Depends everywhere I went to be safe.”
Jane met with Emily every week for her therapy, getting instruction and guidance with various pelvic floor exercises.
“Emily really encouraged me and empathized with my situation,” said Jane. “She continued to remind me that it was up to me, and it couldn’t hurt me. I felt that she gave me good information and advice. I always felt very comfortable with Emily and that she cared about my success.”
Getting Results and Restoring Confidence
Ten weeks into her therapy with Emily, Jane has made extraordinary progress as she works to improve her pelvic floor issues. She does her exercises during weekly therapy sessions as well as at home for just 15 minutes, twice per day. The results have been well worth it.
“Now, I only get up once at night or not at all, and I only use the restroom six times a day or less,” said Jane. “I don’t wear Depends anymore, and I don’t have accidents when I sneeze or cough.”
Jane is relishing this newfound success and how it’s restored her confidence, allowing her to enjoy an active lifestyle without the worry and fear that used to plague her.
“These exercises have been a gamechanger for me, and I’ll continue doing these for the rest of my life,” said Jane. “I feel confident, no longer smell, and get out more now. My only regret is that I didn’t know these exercises were helpful or even existed. I imagine there are a lot of women like me, who could benefit from pelvic therapy. My sincere thanks to Dr. Kirkley, Dr. Lowder and Emily for their help. They’ve been a God-send to me.”
If you’re struggling with bladder prolapse, urge urinary incontinence, or any type of pelvic floor dysfunction, physical therapy may be a good option for you. Starting this summer, Parkland Health Center will be offering pelvic therapy services to address a wide range of issues. Relief is possible. Talk to your doctor or call (573) 760-8429 for more information.
*Patient’s name has been changed for privacy reasons.