BENGALURU: Holding your pee because you can’t find a clean washroom or sitting at your desk for hours without a break could contribute to long-term pelvic-floor problems, warn doctors in the city, as more women, including those in their teens and twenties, are visiting OPDs with problems such as incontinence, pelvic pain, and painful intercourse.
Women who have never given birth can also develop dysfunction.
“We’re seeing more young women with pelvic-floor symptoms, with greater awareness and willingness to seek medical help. Pregnancy and childbirth are important risk factors, as they can strain the pelvic-floor muscles, nerves and connective tissues. However, pelvic-floor dysfunction is not limited to women who have been pregnant or have given birth, nor is it synonymous with childbirth-related injury,” said Dr Rubina Shanawaz, additional director of uro-gynaecology, gynec-oncology, laparoscopic & robotic surgery, Fortis Hospital, Cunningham Road.She added, “Women who have never been pregnant can also develop problems such as an overactive or poorly coordinated pelvic floor, urinary urgency, pelvic pain, painful intercourse and difficulties with bowel movements.”What is causing these problems? Dr Prathima A, consultant-obstetrics, gynaecology and urogynaecology, Motherhood Hospitals, Banashankari, explained, “The corporate and tech-oriented nature of Bengaluru has contributed to pelvic-floor dysfunction among young women, with long hours at desks becoming an important factor. Sitting in offices for hours and commuting through city traffic for long periods can result in constant, passive strain on the pelvic region, with lifestyle factors playing as important a role as traditional causes.“Dr Varini N, senior consultant, obstetrics & gynaecology, Milann Fertility and Birthing Hospital, added, “Weight gain or obesity, chronic constipation and straining, reduced physical activity, high-impact exercise in some individuals, chronic coughing and certain musculoskeletal or neurological conditions can also contribute.”While awareness around these problems has increased, doctors said symptoms are still widely normalised and women often don’t seek help early. “Many women normalise these symptoms because they associate them with ageing, menstruation, pregnancy, childbirth or simply being a woman. There can also be considerable embarrassment around discussing urine leakage, bowel symptoms or painful intercourse, so women may adapt their routines rather than seek help,” Dr Varini said.She added, “The problem with delaying assessment is that persistent symptoms can affect a lot more than physical health. Women may start avoiding exercise, long journeys, social activities or intimacy because they are worried about leakage, urgency or pain. In some cases, symptoms can also become more difficult to manage when the underlying problem is left unaddressed.”Although Kegel exercises, which target the pelvic floor, have become widely popular thanks to the internet, doctors warned that these exercises could do more harm than good if performed incorrectly. “Kegel exercises can help strengthen a weak pelvic floor, but they aren’t right for everyone. In women with an overactive or tight pelvic floor, repeated contractions may worsen symptoms such as pelvic pain or pain during intercourse. Exercises should, therefore, be prescribed based on an assessment of symptoms and muscle function, rather than as a blanket approach,” said Dr Rubina.Dr Prathima added, “Pelvic-floor problems can have varied causes, including endometriosis, PID, STIs and declining estrogen. In younger women, urinary urgency and frequency may also stem from UTIs rather than muscle weakness. Treatment can involve pelvic-floor retraining, core exercises, biofeedback or medical intervention, making clinical assessment important before starting exercises such as Kegels.“