Incontinence issues can be successfully cured in most women by pelvic floor training

Three-quarters of women with incontinence issues who have pelvic floor muscle training see improvement or resolution of their symptoms, the IOS 2022 Annual Medical Conference heard. 

Pelvic floor training also leads to significant improvement in faecal incontinence, constipation, pelvic organ prolapse, and sexual dysfunction, and erectile dysfunction in men, Ms Aoife Ni Eochaidh, Chartered Physiotherapist, Clinical Specialist Physiotherapist, Women’s and Men’s Health and Continence, Bon Secour Consultant’s Clinic, Galway, reported during her presentation on women’s health. 

She noted that bowel obstruction and constipation are a key cause of hospitalisation in older adults, with an over-dependence on laxatives and surgery despite conservative methods giving good results. “Training the pelvic floor will help the bowel fill, store, and empty.” 

Ms Ni Eochaidh looked at issues caused by hormonal changes in menopause, which impact smooth muscle and affect the pelvic floor, “leading to atrophy, loss of bulk… and huge problems during menopause such as itchy vaginal skin… bacterial vaginitis, thrush, UTIs [urinary tract infections], etc.” 

She stressed the importance of regular exercise, pelvic floor training, and hormone replacement therapy and probiotics, and other suitable supplements, where indicated, in helping address these issues. 

She also noted the risk of osteoporosis in this cohort and the impact of osteoporosis on the pelvic f loor, ie, incontinence issues, which can raise the risk of falls. 

“The physical mechanical changes with osteoporosis affect the pelvic f loor… the woman needs to be doing weight-bearing exercise, but you need a good pelvic f loor so that it can be enjoyable. Start first with the pelvic f loor in any training programme. Don’t forget the fluids and the fibre and then the weight bearing [exercise].” 

Ms Ni Eochaidh said her clinic can also provide ‘blended’ pelvic floor training programmes, through online video sessions, which can be more convenient and cost-effective for some patients. 

Concluding, she stressed that “no amount of urine leakage is normal” and “pelvic floor muscle training is for life, it is not a quick fix. I think it should be called ‘patience floor training’ because you need patience. It can take 12 months, but in general six months… it is essential for good bone health and in menopause, as well as during and after pregnancy.”