When you were young, did you learn about menses, defecation, and voiding? In other words, did you learn about periods, poop, and pee? Did you learn about these subjects in home or in school? Were you taught by your mom or another trusted female? 

Many of us learned from our friends and this often lead to miscommunication and the spread of misinformation. 

As a young girl, what did you know about your pelvic floor? Was it normal? 

The majority of us are embarrassed and even ashamed of this part of our anatomy. We don’t know how to begin the conversation. Instead of asking each other questions, we turn to Dr. Google. But even Dr. Google can be misleading and share incorrect information! We need to learn how to take care of our pelvic region and become pelvic floor evangelists!

I first heard the term “pelvic floor evangelist” from Missy Lavender, coauthor of Below your Belt: How to be Queen of Your Pelvic Region (1). She ends her teaching sessions with the motto, “Now go and be a pelvic floor evangelist!” The term “evangelist” means to be an enthusiastic advocate (2). Missy’s goal is to teach young girls, between the ages of 10-14, about the pelvis, including what’s inside, what it does, and how to keep it strong and healthy for the rest of their lives. 

In Missy’s research, she found that adolescents, particularly those from lower income households and ethnic groups, are poorly educated about their pelvic health. In a study, she found that 50% of girls aged 10-14, especially those involved in sports, are already experiencing bladder leaks (3). More surprisingly, 66% of these girls do not participate in sports a few days each month because of painful periods. The study shows that 30% or girls endure constipation lasting more than 3 days. 

The authors of Below your Belt believe that if these young girls are taught how to use and care for their pelvic floors, they will prevent a lifetime of issues. Missy and her team are creating an app so that this information is easily accessible to the younger generation.

Like Missy Lavendar’s study shows, pelvic problems can begin at an early age, including the conditions dysmenorrhea and endometriosis. These painful conditions are related to the fluctuations of a female’s hormones and menses. Dysmenorrhea often begins in a girl’s teenage years. Many women suffering from dysmenorrhea do not receive sympathy from their families or partner who tend to view menstrual pain as an expected nuisance that should be endured in silence. 

One study discovered the correlation between dysmenorrhea, endometriosis, and dyspareunia (painful sex). The researchers found that site specific manual physiotherapy techniques are effective non-surgical and non-pharmacological options for those suffering from endometriosis (4). A different study found that acupuncture and acupressure can provide relief from symptoms of dysmenorrhea (5). It has been reported that connective tissue massages are beneficial in reducing the painful symptoms of menses. 

Many people are surprised to hear that children and teenagers can be treated for bladder and bowel issues and that teenage girls can be treated for period issues. During these ages, mostly only external myofascial work is done, including teaching proper breath recruitment patterns and pelvic floor relaxation, strengthening and coordination. 

Education is such an important part of treatment. Pelvic physiotherapists, like myself, strive to help women of all ages understand what is happening in their bodies. There are solutions to help women control pelvic issues that can sometimes dominate their lives. We need to share proper information! We can all become pelvic floor evangelists!

Resources

1.  Lavender, M., Ihm, JD, Dolby, Jan: “Below your Belt: How to be Queen of Your Pelvic Region”; Women’s Health Foundation, Chicago Illinois, 2015

2.  https://www.merriam-webster.com/dictionary/evangelist

3.  Jennifer M. Hebert-Beirne, PhD, MPH; Jeni Donatelli Ihm, BS; Molly Kirk Parlier, MA; Missy D. Lavender, MBA;  Linda Brubaker, MD, MS; A Pelvic Health Curriculum in School Settings: The Effect on Adolescent Females' Knowledge. University of Illinois Chicago, School of Public Health, Community Health Sciences, Chicago, Illinois

4. Belinda F. Wurn, Lawrence J. Wurn, Kimberley Patterson, C. Richard King, Eugenia S. Scharf; Decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual physical therapy:Results from two independent studies. Journal of Endometriosis 2011; 3 ( 4): 188-196

5. Ukachukwu Okoroafor Abaraogu*, Chidinma Samantha Tabansi-Oc; As Acupressure Decreases Pain, Acupuncture May Improve Some Aspects of Quality of Life for Women with Primary Dysmenorrhea: A Systematic Review with Meta-Analysis. Journal of Acupuncture and Meridian Studies 2015; 8(5):220-228