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What is Pelvic Health?

Pelvic health pertains to all parts of the body "below the belt" and includes bladder and bowel health, vaginal health, uterine health, sexual health, and muscles and structures.

Why Pelvic Health?

More than 50 million (1:3) women suffer from pelvic health disorders in the United States, a number that is projected to nearly double by 2050, and which currently cost the U.S. healthcare system more than $100 billion annually. Issues “below the belt” can dominate a woman’s physical and emotional life, and as research demonstrates, often lead to depression, anxiety, inactivity, and diminished intimacy in relationships.

Pelvic health disorders (PHDs) can negatively affect education and employment opportunities and often are associated with higher rates of obesity, diabetes, and inactivity. While many issues surrounding pelvic health arise following childbirth and continue into old age, growing evidence demonstrates that some conditions like constipation, fibroids, endometriosis and even bladder control may start as early as the beginning of menses (occurring roughly between nine and 14 years of age.) Very often PHDs can be improved or even cured through early detection, basic education, and behavioral therapies.

 

Not Only Adults 

In 2015, we published a study in the Journal of Pediatric and Adolescent Gynecology titled A Pelvic Health Curriculum in School Settings: The Effect on Adolescent Females’ Knowledge. Our findings suggest that Girls+, across socioeconomic, racial, and gender divides, know very little about their bodies “below the belt”.

The study made clear that young women experience chronic constipation, urinary tract infections, and bladder leakage early in life, conditions seldom covered in traditional general health classes or later in sex education. Additionally, Girls+ with painful periods were missing school at least once per cycle, making them vulnerable to lost academic credits. Without intervention or education, these symptoms can follow adolescents into adulthood, creating both physical and social discomfort.

Adolescents without agency over their pelvic region become adult patients with chronic conditions. Many women with pelvic pain, excessive bleeding, or incontinence go years without seeking treatment because they believe that their symptoms are normal or feel uncomfortable talking to a provider. The result: treatable conditions worsen and become chronic, leading to infertility, prolapse, or avoidable hysterectomies. The impact of pelvic health disorders extends beyond the pelvis, with connections to depression and anxiety, lack of physical activity, poor sleep quality, and interference with intimacy.

The good news is that with the right combination of information, awareness, and resources, many pelvic health disorders can be managed, improved, or prevented altogether.

Pelvic Health Education is not Sex Education

Addressing the gap between general health education and sex ed, pre-sex ed equips Girls+ with pelvic health knowledge to help them care for their bodies and take on puberty with confidence.

As a more accessible point of entry into potentially uncomfortable conversations, it also opens the door to good communication between parent and child.

Establishing a foundation of self-assurance and understanding can empower Girls+ with bodily autonomy and healthy, safe practices long before they begin thinking about sex.

Access and Disparity

People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.” Health disparities are social inequities manifested in the healthcare system, creating negative health consequences for those who experience systemic disadvantage due to race, ethnicity, nationality, religion, socioeconomic status, gender, gender identity, sexual orientation, age, size, or ability.

Pelvic health education and treatment can be difficult for any woman to reach, but they are particularly inaccessible to those who experience intersecting marginalizations. Having received little knowledge about conditions below the belt, many women suffer in silence for years, either assuming their conditions are normal or feeling too uncomfortable to report them to a healthcare provider. Findings from various research studies illustrate the issues creating barriers to care:

  • African American women were significantly less likely to recognize childbirth as a risk factor for urinary incontinence and pelvic organ prolapse, to know that exercises can help control leakage, or to recognize treatment options for Pelvic Organ Prolapse (POP)

  • The CARDIA study found African American women were four times more likely to undergo a hysterectomy in comparison to white women

  • Patient-related barriers for Spanish-speaking women in the US include a lack of understanding anatomy and medical terminology, as well as inhibited discussions due to embarrassment. Provider-related barriers included interpreters with little knowledge of pelvic floor vocabulary or office staff without interpreting credentials. System-related barriers included limited access to information.

  • Heterosexual women are significantly more likely than lesbian and bisexual women to report a physician's office or health maintenance organization as their regular source of health care.

Access to education and care that is identity-affirming and culturally informed is an essential step towards reducing pelvic health disparities faced by minority women.

Girls+

Whether they are 18 or 80, members of the LGBTQ+ community struggle to find pelvic healthcare that affirms their identity and meets their specific needs, and many providers report feeling unprepared to care for them with confidence. LGBTQ+ individuals are especially vulnerable to increased risk behaviors and negative health outcomes, leading to varying physical and mental health disparities. Research suggests that affirming and inclusive healthcare reduces these disparities, and can also be a source of support.

We see no reason why anyone should expect anything less than great pelvic health and believe proper education and care should be accessible to people of any gender identity.