‘People don’t want to talk about it’: Physiotherapist seeks to combat pelvic health stigma

Pelvic floor dysfunction can affect people of all ages and backgrounds.

It can be overwhelming, or perhaps embarrassing, if you’re experiencing pelvic floor issues. However, physiotherapist Ainslee McCann says it doesn’t have to be.

“Anyone who has a pelvis has a pelvic floor,” she said.

McCann, who provides pelvic floor treatment at Kachan Physiotherapy in Halifax, says there is still a stigma attached to anything to do with bowels, bladder, and sex.

“People don’t want to talk about it, they don’t want to hear about it. They’re so embarrassed to even kind of come forward and have that conversation with any kind of health-care provider. They don’t even necessarily know that there are resources available and that so many of the resources are primarily education-based,” said McCann.

“Pelvic floor physiotherapists are exceptional at just meeting you where you are. So, if you’re not comfortable with undressing or even talking about your pelvic floor, we could still meet with you and provide you some resources, some education that can be game-changing.”

Support system

McCann says pelvic floor health is a big part of people’s overall health.

“Our pelvic floor extends from our pubic bone to our tailbone … and then we have our right and our left ilium where we have our attachment points and this would be called like your deep pelvic floor,” she said.

The pelvic floor supports our limbs and torso, as well as organs like the bladder, prostate, uterus, and rectum.

“It really is like the bowl or the support system of our whole abdominal canister,” said McCann.

In addition to acting as a support system, McCann says the second main function of the pelvic floor is urinary control and function.

“We shouldn’t pee more than we want to pee. We should be able to stop peeing when we want to stop peeing, we should not be leaking,” she said.

The third main function of the pelvic floor is bowel control.

“So same thing, we should be able to poop when we want to poop and not poop when we don’t want poop,” said McCann.

“Then lastly is sexual health, function and pleasure. That’s our pelvic floor.”

Pelvic floor dysfunction

Pelvic floor dysfunction can lead to issues like:

• urinary incontinence
• emptying disorders of the bladder
• fecal incontinence
• emptying disorders of the bowel
• pelvic organ prolapse
• chronic pelvic pain
• sexual dysfunction

If pelvic floor issues are impacting your life in any way, McCann says you should consider getting professional help.

“So, if you’re not going to pickleball or you’re not going out with a friend to dinner because you’re worried about leaking or gas or something like that, or you can’t sit in the chair because you have too much tailbone pain,” said McCann.

“The moment that it starts to impact your life where you’re starting to narrow your world, that is a wonderful time to come in.”

All ages can be affected

The pelvic floor can be affected at all ages and stages of development, according to McCann.

“One in 10 Canadians live with urinary incontinence and then it’s broken down into one in three women over 40 and one in 19 men,” she said.

“One in four Canadian women will experience pelvic floor disorders, so that can be like painful sex, urinary changes, pelvic pain.”

McCann says pre-pregnancy, pregnancy and during the postpartum period are good times to see a pelvic floor physiotherapist. In addition, the pelvic floor can be affected by menopause, which can lead to organ displacement or pelvic organ prolapse.

“While it is very common, especially if you’ve had children vaginally, it’s something that can absolutely be benefited from by pelvic floor physiotherapy, a lot even just by education and knowing how to manage your pressures, getting your constipation under control,” said McCann.

“There’s a new term that came out, the genitourinary syndrome of menopause. It’s a cluster of symptoms that affect, not only your urinary and vaginal health, but also externally at the vulva. So, you can have painful sex, vulva soreness, you can have urinary frequency, urinary urgency. So, lots of things that can be really, really addressed just by going to speak to your doctor.”

Pilot program

A pilot program on Prince Edward Island will provide pelvic floor physiotherapy for Islanders that are underinsured or have no insurance coverage.

Nine physiotherapy clinics across P.E.I. with physiotherapists who have specialized training and authorization will participate in the program.

“Reception, as you can imagine, has been super positive. We’ve had we’ve had some really amazing stories from Islanders who have reached out and they’ve shared their stories of pelvic floor disorder and dysfunction and their inability to access care. And it’s been it’s been really satisfying to be able to direct them to care that they otherwise wouldn’t be able to get,” said Sheila MacMurdo, president of the PEI Physiotherapy Association.

“I’ve had physiotherapy associations from other provinces reach out and ask for information on this and the physiotherapy village is great for that. We’ll share all of our challenges and our successes and hopefully we can model this across the country.”

The province says pelvic floor physiotherapy is the gold standard of care for many pelvic floor conditions.

Eligible patients will receive an initial pelvic floor assessment and follow-up treatment sessions at no cost.

“So, this program essentially removes the financial barriers, so it’s completely covered for them. There’s no fee at all. It removes the geographic barriers because we have participating clinics located east to west across the Island, which is phenomenal and we’re really hoping that along the way we’re going to help improve education, both to the public and to the people who will refer to these services,” said MacMurdo.

To qualify, patients must have a clinical diagnosis and a completed referral form from a physician or nurse practitioner.

With files from CTV Atlantic’s Stephanie Tsicos