here’s what you need to know about pelvic health
A new survey conducted by Origin, a provider of women’s pelvic floor and whole-body physical therapy focused on millennial women, aged 18 to 59, exposing a generational divide in pelvic health. “Contrary to popular belief, pelvic floor issues aren’t just affecting women in later stages of life. The rates among millennials were either higher or equal to those of Gen X,” explains Carine Carmy, co-founder and CEO of Origin, discussing the study’s findings.
Released yesterday, the company’s study conducted in partnership with market research giant Ipsos, found that 8 in 10 women, many of them millennials, are dealing with pelvic health problems. The study fills a gaping research gap.“The data around women’s health, and especially pelvic health, is lacking,” adds Carmy. There have also been issues with how research has been done historically. The scope of what’s studied has been limited and it’s looked at pelvic health over a lifetime, versus a moment in time, which makes our understanding of how it affects women at different stages insufficient.
What did the study reveal?
Origin’s new survey reveals that millennials experience higher rates of bladder issues compared to their Gen X counterparts, such as the sensation of needing to urinate again immediately and difficulty fully emptying their bladder. Additionally, more than half of millennials report urinary leakage when coughing, laughing, or exercising, while a greater proportion of millennials than Gen Xers face challenges such as pain during intercourse and difficulty achieving orgasm.
The most common cause for repetitive leakage (or stress urinary incontinence) among millennial women is childbirth (both vaginal and C-section deliveries), says Michele McGurk, PT, a Brooklyn-based certified pelvic rehabilitation practitioner and clinical specialist in women’s health. “Scar tissue from muscle and fascia tearing or cutting will change the integrity of the abdominal pelvic canister resulting in abnormal pressure distribution, and an inability to contract the deeper core and pelvic floor muscles to prevent leaking,” says McGurk.
Due to muscle laxity, activities like exercise, jumping, coughing, or sneezing can result in leakage. According to New York-based board-certified OB/GYN Heather Irobunda, MD, a prior fall onto the pelvis may also contribute to this issue. Although research on this topic is limited, there could be a genetic predisposition, as Dr. Irobunda suggests: “If your mother, sister, or aunt experienced leakage issues, you are more likely to as well.” While strengthening exercises like kegels can be beneficial, McGurk emphasizes the necessity of manual treatment conducted by a pelvic floor PT to restore muscle tone, function, and symmetry beforehand.
The bladder urgency and frequency that millennial women are experiencing can be caused, in part, by irritants like caffeine, alcohol, seltzer water, and chocolate, says McGurk, and also poor water intake and prolonged sitting. “Removing the irritants along with bladder retraining techniques such as diaphragmatic breathing in the moment of an abnormal urge can make a big difference,” says McGurk. He said that the goal is to retrain the bladder to tolerate longer stretches of storing urine. One reason more millennial women are having problems fully emptying their bladder could be a history of UTIs, says McGurk, which can cause scarring. A temporary fix to help fully empty the bladder, she says, is to move the pelvis forward and back 5-10 times while sitting on the toilet.
Frequent UTIs can also contribute to the higher number of millennial women experiencing pain during sex, as explained by McGurk. She also points to other factors such as irritation caused by chemicals in soaps, endometriosis, hormonal reactions, and conditions like vulvar vestibulitis, which can develop in younger women taking the pill, leading to painful penetration. McGurk adds that similar issues can arise during postpartum and menopause, as well as prudendal neuralgia, a painful genital condition often misdiagnosed as a yeast infection due to constant itching, caused by prolonged sitting, bike riding, and pelvic trauma.
Moreover, there’s a significant mental component involved. “We know that sexual arousal and sometimes chronic pelvic pain can be associated with emotional stress and mental health,” says Irobunda. “It’s important to remember that general health issues also affect pelvic health. Unfortunately, sometimes we tend to view pelvic issues in isolation.”
Why are millennials experiencing this?
There is a deep connection between mind and body, and specifically the pelvis. Increased fear, stress, and anxiety can all manifest as a tight pelvic floor. “We know that millennials today, particularly post-Covid are experiencing incredibly high rates of depression and anxiety,” adds Carmy. Stress and anxiety have a strong association with bladder urgency and frequency, says McGurk and studies have confirmed this. The adverse effects are also true–experiencing pelvic health issues like incontinence can cause women to develop anxiety, something Irobunda sees frequently among her patients. “Urinary continence is something we teach children and it becomes unnerving when you feel like you’re regressing in that way and you’re unable to hold it,” she adds.
What Irobunda does see most frequently among millennial women patients, more than other generations, is a willingness to discuss pelvic health issues and a concerted seeking of solutions. Many of these pelvic health problems aren’t new; what is new is the openness about them and the desire to address them. “These issues have been known among women for generations but were either normalised or dismissed by the medical community and society, but we’re at a turning point now where things that have been the subject of whisper networks are now entering the mainstream,” says Carmy. Search trends back that up–Origin has seen a 300 per cent increase in search interest around pelvic floor health over the past year and the number of people visiting their free educational blog is in the hundreds of thousands every month.
This article first appeared on vogue.com
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