What is a pessary?

Pelvic Organ Prolapse, or POP, is a symptom that affects many people but is not always openly discussed. It occurs when one or more pelvic organs—such as the bladder, bowel, or uterus—shift from their normal position and descend, often resting against the vaginal wall. While some degree of movement is considered normal, a prolapse is diagnosed when symptoms are present. What Does POP Feel Like? People with POP often describe a sense of heaviness or dragging in the pelvis. Others may notice a bulge in or outside the vagina, discomfort during daily activities, or a feeling that something is “coming down.” POP can also affect bladder and bowel function, leading to symptoms like incomplete emptying or frequent urgency. What Increases the Risk of POP? The most significant risk factor for developing POP is vaginal childbirth. However, it's not just childbirth itself, but certain factors around the delivery that play a role: Birth weight over 4kg Pushing for less than 20 minutes or more than 2 hours Obstructed labour or instrumental delivery (forceps, vacuum) Other contributing lifestyle factors include: Chronic constipation or long-term straining Persistent coughing (e.g., due to asthma or smoking) Heavy lifting over extended periods Family history of prolapse Menopause, due to hormonal changes affecting tissue support Conservative Treatment Options For many people, POP can be managed conservatively without surgery. Treatment may include: Pelvic Floor Muscle Training : Strengthening these muscles improves the support they provide to pelvic organs. Horizontal Rest : Lying down throughout the day can help reduce the sensation of heaviness and give your body time to recover. Hormonal Therapies : Your doctor may prescribe topical oestrogen to help strengthen vaginal tissues, particularly after menopause. Pessary Use : A pessary is a small silicone device inserted into the vagina to provide internal support for the organs. Lifestyle Modifications : Addressing chronic constipation or cough and avoiding unsafe repetitive heavy lifting can reduce strain on the pelvic floor. For personalised guidance, it’s important to consult a qualified pelvic health physiotherapist who can tailor your treatment to your specific needs and goals. When Is Surgery Considered? In more severe cases of prolapse, or when conservative measures do not relieve symptoms, surgery may be recommended. If this is the case, your healthcare provider will refer you to a specialist for a comprehensive assessment and to discuss your surgical options. Conclusion Pelvic Organ Prolapse is common, but with the right support and management strategies, it doesn’t have to limit your quality of life. Early intervention through physiotherapy and lifestyle changes can significantly improve symptoms and help you feel confident in your body again. If you're experiencing symptoms or want to know more, reach out to a pelvic health physiotherapist to explore your options.

The pelvic floor muscles play a crucial role in supporting your bladder, bowel, and reproductive organs. While much attention is given to strengthening these muscles, it’s just as important to understand when they are overactive —meaning they have difficulty relaxing or letting go. Overactivity in the pelvic floor can contribute to a wide range of symptoms, often overlooked or misdiagnosed. What Are Overactive Pelvic Floor Muscles? Overactive pelvic floor muscles are muscles that remain tense or tight when they should be able to relax. This tension may be constant or triggered by certain activities, positions, or stressors. Some common causes include: Ongoing pelvic, hip, or lower back pain Chronic conditions like endometriosis, adenomyosis, or bladder/urethral pain Recurrent vaginal infections (e.g., thrush or UTIs) or vulval skin disorders Holding stress or anxiety in the abdomen or pelvis High-intensity or repetitive exercise Past trauma, including childbirth or emotional/sexual experiences Even athletes or those who do frequent pelvic floor exercises may develop tightness—sometimes without realizing it. Signs and Symptoms of Overactivity Symptoms can vary, but people with overactive pelvic floor muscles often report: Bladder symptoms: Difficulty starting urination Slow or interrupted urine stream A feeling of incomplete emptying Bowel symptoms: Thin or pellet-like stools Incomplete evacuation Difficulty releasing wind Intimacy-related symptoms: Pain with penetration or deep intercourse Discomfort or pain during tampon use or pap smears Vaginal burning, aching, spasms, or tenderness Difficulty achieving orgasm These symptoms are not “just in your head”—they are often signs that your pelvic floor may be holding more tension than it should. Treatment Options If you suspect your pelvic floor muscles may be overactive, a pelvic health physiotherapist can help. At Pelvic Health Melbourne , our team is trained to assess your pelvic floor function and tailor a treatment plan specific to your needs. Treatment may include: Manual therapy to release tight pelvic floor muscles Pelvic floor downtraining and stretches to improve relaxation Relaxation techniques like deep breathing, mindfulness, gentle movement, or listening to calming music Use of heat packs to reduce muscle tension and pain We’ll also help you explore lifestyle changes and emotional support to address any underlying contributors to pelvic tension. You Don’t Have to Live With Discomfort. If you’re experiencing any of these symptoms, don’t hesitate to seek support. Many people live with pelvic floor dysfunction for years without realising the cause of their discomfort. Early assessment and treatment can make a significant difference. Book an appointment with our team at Pelvic Health Melbourne and take the first step toward feeling better in your body.

Prostate cancer is a significant health concern, particularly for men over 50, arising when abnormal cells in the prostate gland grow uncontrollably, forming malignant tumors. It is the most commonly diagnosed cancer in Australia , with over 26,000 cases in 2024 and a lifetime risk of 1 in 6 by age 85 . Early-stage prostate cancer often has no symptoms, but advanced cases may involve urinary frequency, pain during urination, blood in urine/semen, or bone pain. Risk factors include age, family history (especially BRCA gene mutations), and elevated testosterone levels. How Is Prostate Cancer Diagnosed? There’s no single test for prostate cancer. Diagnosis usually involves: PSA Blood Test: Measures a protein made by the prostate. High PSA can mean cancer, but also other prostate issues. PSA testing can help catch cancer early, but it’s not perfect-sometimes it leads to unnecessary worry or treatment. Talk to your GP about the pros and cons for you. Digital Rectal Exam (DRE) : Your doctor feels the prostate for lumps. This is quick and safe, but not always needed-especially if your PSA is normal. Imaging & Biopsy: If cancer is suspected, scans and a biopsy (removal of a small tissue sample) confirm the diagnosis. Your Role in Care Decisions A prostate cancer diagnosis can be overwhelming, but you’re not alone. At Pelvic Health Melbourne, we encourage you to: Ask questions and take notes. Bring a support person to appointments. Discuss all your options. Your treatment will depend on several factors, including the stage of the cancer, your overall health, and what matters most to you. Options may include: Active surveillance (monitoring the cancer closely) Surgery to remove the prostate Radiation therapy Hormone therapy Chemotherapy or participation in clinical trials Take your time. Most prostate cancers grow slowly. You usually have time to consider, seek a second opinion, and decide what’s right for you. Access support . Emotional and practical support-through family, friends, counsellors, or support groups-can make a big difference. The Importance of Pelvic Health Physiotherapy Physiotherapy is a key part of prostate cancer care-before and after treatment . Our team at Pelvic Health Melbourne works closely with you and your doctors and specialists to help you achieve the best possible recovery. Goals of Physiotherapy in Prostate Cancer Care Restore and Maintain Bladder Control: Regain continence and reduce urinary leakage with targeted pelvic floor muscle training and education. Enhance Pelvic Floor and Sexual Function: Strengthen and retrain pelvic floor muscles to support continence and sexual health, especially after surgery. Reduce and Manage Pain: Ease pelvic or post-surgical pain with evidence-based techniques. Support Physical Recovery: Improve strength, flexibility, and stamina to help you return to daily life. Promote Safe, Effective Exercise: Tailored activity helps manage fatigue and maintain muscle and bone health. Educate and Empower: Learn correct pelvic floor activation, self-management strategies, and lifestyle tips to support your recovery. Support Emotional Well-being: Address psychological impacts and help you return to the activities you value. Prevent and Manage Complications: Reduce risks like falls or bone loss, especially if you’re on hormone therapy. Coordinate Care: We work with your broader medical team and refer to other specialists as needed. What Can You Expect from Pelvic Health Physiotherapy? Faster recovery of bladder control and reduced urinary leakage Improved pelvic floor strength and function, supporting continence and sexual health Reduced pelvic pain and discomfort Better understanding of your body and how to manage symptoms Support in returning to daily activities, work, and exercise Improved confidence and quality of life Early referral to physiotherapy-ideally before surgery-can maximize your recovery. Research shows up to 94% of men regain bladder control within three to six months after prostate surgery with physiotherapy support. At Pelvic Health Melbourne, we’re here to help you take an active role in your prostate cancer journey. If you have questions about pelvic health, continence, or recovery, our team is ready to support you every step of the way. For more information or to book an appointment, contact us today.