I is for . . . The ABC's of Pelvic Health

Understanding the Risk Factors for Pelvic Organ Prolapse (POP) Pelvic organ prolapse (POP) is a condition where one or more of the pelvic organs (such as the bladder, uterus, or rectum) shift downward and push into the vaginal wall due to weakened support from the pelvic floor. It’s more common than many realise, and while it can feel overwhelming, knowing the risk factors can help you take steps to protect your pelvic health. Key Risk Factors 1. Vaginal Birth Childbirth is one of the most significant contributors to POP. Vaginal deliveries, particularly when forceps are used, when the baby is large, or after multiple births, can place considerable strain on the pelvic floor muscles and connective tissues. 2. Age As we age, our muscles and tissues naturally weaken. This includes the pelvic floor, which means the likelihood of prolapse increases over time. 3. Obesity Carrying extra body weight increases pressure on the pelvic floor. Over time, this added strain can contribute to the development of POP. 4. Genetics Sometimes, pelvic health challenges run in families. If you have a close relative with POP or connective tissue disorders, you may be more predisposed to experiencing prolapse yourself. 5. Menopause Hormonal changes associated with menopause—particularly lower oestrogen levels—can lead to thinning and weakening of pelvic tissues, making them less supportive. 6. Prior Pelvic Surgery Procedures like a hysterectomy can affect pelvic support structures and increase the risk of prolapse later on. 7. Chronic Strain Repetitive straining from chronic constipation, persistent coughing (such as from smoking or lung disease), or frequent heavy lifting can all place continuous pressure on the pelvic floor, increasing the risk of POP. 8. Connective Tissue Disorders Some people have naturally weaker connective tissues due to genetic factors. Conditions like hypermobility can make the pelvic floor less resilient and more prone to prolapse. What Can You Do? While not all risk factors can be avoided, there are proactive steps you can take to support your pelvic health: Maintain a healthy weight to reduce pressure on the pelvic floor. Address chronic straining by managing constipation, cough, or lifestyle factors that increase abdominal pressure. Strengthen your pelvic floor muscles through targeted exercises. A pelvic health physiotherapist can guide you in learning the right techniques. Final Thoughts POP is influenced by many factors—some you can’t control, like age and genetics, and others you can actively address. By understanding your risk profile and making supportive lifestyle changes, you can strengthen your pelvic health and reduce the likelihood or severity of prolapse. If you’re concerned about your pelvic floor or would like personalised guidance, our team at Pelvic Health Melbourne is here to help.

The Perimenopausal Changes No One Warns You About Perimenopause — the transition period leading up to menopause — is a natural phase in every woman’s life. While symptoms like hot flushes and mood swings are widely discussed, there are other, less talked-about changes that can have just as much of an impact on daily life. Let’s explore some of the more surprising changes to your bladder, bowel, and periods — and what you can do to manage them. Bladder: “Why Do I Always Feel Like I Need to Go?” If you've noticed you're heading to the toilet more often — or feeling an intense need to go, only to pass a small amount — you're not alone. As oestrogen levels decline, the tissues supporting the bladder and urethra can become thinner and less elastic, leading to: Increased bladder urgency More frequent urination A lingering sensation of not quite emptying What You Can Do Try not to respond to every urge straight away. Bladder retraining can help your body adjust and reduce the frequency of urgency over time. Avoid common bladder irritants that can make urgency worse. These may include: Coffee Alcohol Artificial sweeteners Fizzy drinks Spicy or acidic foods (depending on your individual sensitivity) Bowel: Slower, Smellier, and More Sensitive Digestive changes are also common during perimenopause. Hormonal fluctuations can slow gut motility, which may result in: Increased constipation New food sensitivities More noticeable (and often smellier) wind These changes are often unexpected but entirely normal. Supporting your gut health with fibre-rich foods, hydration, and regular physical activity can make a significant difference. Periods: Heavier, Irregular, and Less Predictable For many women, perimenopause brings changes to menstrual cycles well before periods stop altogether. You may experience: Heavier bleeding than usual Irregular cycles — sometimes longer, sometimes shorter Spotting or bleeding between periods Important: Any new spotting or unusual bleeding should be checked by your GP. While often harmless, it’s important to rule out any underlying issues. You Don’t Have to Just “Put Up With It” These changes are common, but that doesn’t mean you have to live with discomfort or uncertainty. At Pelvic Health Melbourne, we specialise in supporting women through perimenopause and beyond. We provide expert care to help you: Manage bladder urgency Reduce or eliminate after-dribble Improve bowel function Strengthen pelvic floor health What We Offer Personalised pelvic health assessments Evidence-based treatment plans tailored to your needs Compassionate, confidential care at every stage of menopause Book your pelvic health consultation today and take the first step toward feeling more in control of your body — and your life.

Male Pelvic Pain: Understanding the Many Faces of Discomfort Pelvic pain in men is a complex issue involving various muscles, nerves, organs, and psychological factors. Since the pelvic region houses key structures such as the bladder, prostate, urethra, bowel, and the pelvic floor muscles, pain may present differently depending on the underlying cause. Recognising the specific types of pelvic pain and related symptoms can help men seek appropriate care early and improve outcomes. Common Types and Examples of Male Pelvic Pain Prostatitis and Chronic Pelvic Pain Syndrome (CPPS) Pain Types: Dull aching in the lower abdomen, sharp stabbing pain in the perineum (the area between the scrotum and anus), burning during urination, and discomfort after ejaculation. Additional Symptoms: Urinary frequency and urgency, weak or interrupted urine stream, and sometimes flu-like symptoms in bacterial prostatitis. CPPS, a non-bacterial form, often features muscle tightness and nerve irritation causing persistent discomfort without infection. Pelvic Floor Muscle Tension and Spasms Pain Types: Intermittent or constant burning sensation deep in the pelvis, a "stuck" feeling during urination, testicular or penile pain not explained by infection. Often worsened by sitting for long periods, sexual activity, or stress. May also cause referred pain to the lower back, hips, or thighs. Pudendal Neuralgia (Nerve Entrapment) Pain Types: Sharp, burning, or electric shock-like pain primarily localised to the perineum and genital area. Pain often worsens when sitting on hard surfaces and improves when standing or lying down. May include numbness, tingling, or altered sensation around the genitals and anus. Urethral Pain Syndrome and Urethritis (Non-infective) Pain Types: Burning or raw sensation at the urethral opening, pain with urination, or persistent pelvic discomfort. This can happen without bacterial infection and is sometimes related to pelvic floor dysfunction or inflammation. Testicular Pain and Epididymitis Pain Types: Sharp or aching pain localised to one or both testicles, sometimes radiating to the groin or lower abdomen. May be associated with swelling, tenderness, or warmth. Causes include infection, trauma, or referred pain from pelvic floor muscles. Bladder Pain Syndrome / Interstitial Cystitis Pain Types: Persistent pressure, discomfort, or burning in the bladder and perineal region. Symptoms often worsen with bladder filling and improve after urination. May be accompanied by urinary urgency and frequency. Hernia-Related Pelvic Pain Pain Types: Dull aching or sharp pain in the lower abdomen, groin, or pelvic area, especially when coughing, lifting, or standing. Often associated with a noticeable bulge or lump in the groin. Irritable Bowel Syndrome (IBS) and Gastrointestinal Pain Pain Types: Cramping, bloating, and lower abdominal discomfort that can refer to pelvic areas. May be associated with bowel changes such as diarrhea or constipation. Bowel problems often coexist with pelvic floor dysfunction, complicating pain presentation. Musculoskeletal Pelvic Pain Pain Types: Aching or sharp pain stemming from muscles, ligaments, or joints of the pelvis and lower back. Causes include poor posture, pelvic instability, trauma, or overuse injuries. Pain may radiate into the groin, perineum, or thighs and can worsen with sitting, standing, or movement. Sexual Dysfunction-Related Pelvic Pain Pain Types: Pain during or after ejaculation, penile or perineal burning, and pain associated with erectile dysfunction. Often linked with pelvic floor muscle tension or nerve irritation. When to Seek Help Men experiencing any of the following should consult a pelvic health physiotherapist or healthcare provider: Persistent or worsening pelvic, perineal, testicular, or genital pain Pain worsened by urination, ejaculation, sexual activity, bowel movements, or sitting Difficulty starting or maintaining urine flow, weak or split stream Urinary urgency, frequency, dribbling, or incontinence Numbness, tingling, or unusual sensations in the pelvic or genital area Visible lumps, swelling, or signs of infection (fever, chills, burning urination) How Pelvic Floor Physiotherapy Can Help Pelvic floor physiotherapists specialize in diagnosing and treating pelvic pain related to muscle dysfunction, nerve entrapment, and biomechanical issues. They use techniques such as: Manual therapy to release muscle tension and trigger points Tailored exercises to strengthen or relax pelvic muscles Education on bladder, bowel, and posture habits Neuromodulation techniques like TENS or biofeedback Collaborative care with urologists, gastroenterologists, and pain specialists Early assessment and intervention can greatly improve pain relief, bladder and sexual function, and quality of life. Expert Tips for Managing Pelvic Pain at Home Maintain regular bowel habits to prevent constipation and straining Practice relaxation techniques and mindfulness to reduce pelvic muscle tension Avoid prolonged sitting or pressure on the perineum; use cushions and take breaks Stay hydrated and avoid bladder irritants like caffeine and alcohol Use warm baths or heat packs to relax muscles and improve circulation Engage in gentle stretching and low-impact exercise as advised by your physiotherapist At Pelvic Health Melbourne, all our physiotherapists are trained to help manage all types of pelvic pain men encounter. You don’t have to live with pelvic pain—help is available.