Perimenopause: Bladder and Bowel

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.

Varicosities During Pregnancy: What You Need to Know Pregnancy is an exciting time, but it also brings a number of changes to the body. One of the common issues many women experience is varicosities — swollen, twisted veins that develop just under the skin. While they can be uncomfortable, they are generally harmless and can often be managed with simple strategies. In this blog, we’ll break down what varicosities are, why they happen during pregnancy, the signs to look for, and what you can do to relieve symptoms. What Are Varicosities? Varicosities are veins that become enlarged and visible under the skin. They most often occur in the legs, but pregnancy can also lead to vulvar varicosities and rectal varicosities (commonly known as hemorrhoids). These veins can appear blue or purple and may bulge above the surface of the skin. Some women experience discomfort, while others may simply notice the cosmetic changes. Why Do They Happen in Pregnancy? Several factors during pregnancy contribute to the development of varicosities: Increased blood volume: During pregnancy, your body produces more blood to support your growing baby. This extra volume puts added pressure on your veins. Hormonal changes: The hormone progesterone relaxes the walls of your veins, making them more likely to swell. Pressure from the uterus: As your uterus grows, it presses on the pelvic veins, slowing circulation and increasing pressure in the lower body. Genetics: If your family members experienced varicose veins, you may be more likely to develop them as well. Common Types of Varicosities in Pregnancy Leg varicose veins – swollen, bulging veins that often appear on the calves or thighs. Vulvar varicosities – swelling and visible veins in the vulvar area, which can cause heaviness or discomfort. Hemorrhoids – varicosities in the rectal area, often made worse by constipation and straining. Signs and Symptoms Varicosities may present with: Blue or purple bulging veins Aching or heaviness in the legs or groin Itching, throbbing, or tenderness Swelling around the affected area Discomfort that worsens after standing or sitting for long periods Prevention and Relief Tips While varicosities can’t always be prevented, there are many ways to relieve discomfort and stop them from worsening: Move regularly: Avoid sitting or standing still for long stretches. Get up and walk around every hour. Elevate your legs : Resting with your legs propped up helps improve circulation and reduce swelling. Wear compression stockings: These provide support and assist blood flow back toward the heart. Stay active: Daily walks and gentle exercise promote circulation. Hydrate well: Adequate water intake helps prevent constipation, reducing the risk of hemorrhoids. Eat a high-fibre diet: Fibre-rich foods keep your bowels regular and prevent straining. When to Call Your Doctor Most varicosities are harmless, but it’s important to seek medical advice if you notice: Sudden pain or swelling in the leg Skin discoloration or ulcers around a vein Bleeding from a varicosity Signs of a blood clot (deep vein thrombosis), such as warmth, redness, or severe pain in the calf The Good News The reassuring news is that most varicosities improve significantly after delivery as blood volume and hormonal levels return to normal. Conservative measures are usually very effective, and in most cases, varicosities don’t cause complications during pregnancy or labor. Final Thoughts Varicosities are a normal and common part of pregnancy for many women. While they can be uncomfortable, they are usually temporary and manageable with lifestyle strategies. If you’re experiencing varicosities, talk with your physiotherapist or healthcare provider. They can help guide you with safe management strategies to keep you comfortable and reduce symptoms throughout your pregnancy.

Supporting Transmasculine and Transfeminine Clients Through Bottom Surgery: The Role of Physiotherapy Bottom surgery is a powerful and deeply affirming step for many both transmasculine and transfeminine individuals. Whether someone is preparing for vaginoplasty, vulvoplasty or phalloplasty, the journey is not just surgical—it’s physical, emotional, and functional. Physiotherapy can play a key role in optimising outcomes and supporting a safe, confident return to daily life. At our clinic, we work closely with clients before and after gender-affirming surgeries to ensure their pelvic and overall health is considered throughout their surgical journey. Pre-Surgery Preparation: Laying the Foundation Before surgery, our physiotherapy sessions focus on building a strong foundation. This includes: Understanding Your Body’s Baseline We begin by gaining a thorough understanding of your current: Bladder and bowel function – Are there any concerns with urgency, leakage, constipation, or straining? Pelvic floor tone and coordination – We assess whether your muscles are overactive, weak, or uncoordinated, which can impact recovery. Intimate or sexual function – If relevant and comfortable for the client, we explore areas of sensitivity, pain, or tension that may influence post-op outcomes. These baseline assessments guide us in creating a tailored prehabilitation program that optimises your function and supports a smoother recovery. Optimising Pelvic Health Pelvic health plays a crucial role in: Managing urination and bowel habits post-surgery Supporting circulation and tissue healing Reducing pelvic pain or tightness Preparing muscles for dilation (if applicable) We also look at core strength, breathing, posture , and general mobility —especially important for improving blood flow, wound healing, and reducing post-op complications. Post-Surgery Recovery: Gentle, Guided Support After surgery, our work shifts to supporting your healing and helping you return to your life with comfort and confidence. Wound Care & Scar Management We guide you through: Gentle scar tissue mobilisations (when appropriate) Promoting circulation to reduce swelling Supporting healing around graft or donor sites (e.g., arm, thigh) Dilation & Tissue Care For clients undergoing phalloplasty or metoidioplasty involving a urethral lengthening or neo-vaginal closure, pelvic physiotherapy may include: Education around dilation (where applicable) Pain management strategies Breathwork and relaxation techniques to reduce muscle tension Returning to Life and Movement We support: Safe return to walking, lifting, cycling, gym or sports Managing fatigue and pacing during recovery Addressing any bladder, bowel or sexual function changes We also hold space for the emotional aspects of recovery. This is a major life transition, and our approach is compassionate, gender-affirming, and always client-led. We Are With You All the Way Our goal is to make your body feel more like home. Whether you're months away from surgery or already on the other side, we’re here to walk beside you with skilled hands, open minds, and affirming care. If you’re considering bottom surgery or in the recovery phase, get in touch to see how pelvic physiotherapy can support your goals and wellbeing.