Health issues that women are afraid to talk about

Dr. Roger Lefevre is a board certified OB/GYN with advanced training in Pelvic Floor Medicine and Reconstructive Surgery. If you’d like to learn more about this topic, Dr. Lefevre  is giving a free webinar on Pregnancy, Birth and Pelvic Floor Issues on Wed, Aug 21.  You can register to watch the talk live or to receive an email when it is posted online at: https://cc.readytalk.com/cc/s/registrations/new?cid=kpm74trj6h7t 

As an Urogynecologist, I don’t make life and death decisions on a daily basis and I am not usually in situations where my surgery is necessary to save a life. The main reason why I love my job is that at the end of the day I am here to help women improve their quality of life as they see fit. However, at least once a week, women tell me stories of how they rationalized or ignored symptoms that they found uncomfortable or even scary.  

1st story:

I recently cared for a 42 year-old women.  She was a very driven aesthetician, who spent most of her day standing on her feet and who for the last 5 years had been changing “panty liners” several times a day to deal with her urinary incontinence issues.  A simple sneeze or having to bend to pick up something off the floor would cause some leakage.  She admitted that her growing popularity with her clients had helped her justify why using sanitary pads and worrying about “odors” was an acceptable option for all these years. She came to me saying that, “One day, I was mortified when a simple hug from my husband at the airport caused urine to run down my leg. I know it sounds ridiculous but that’s what got me to call your office.” After admitting to her that I hear stories like this almost daily, it helped her to understand she wasn’t alone. I reviewed various treatment options with her, including working with our pelvic physical therapists on strengthening her vaginal muscles. This particular patient ultimately opted to have an outpatient procedure to correct her incontinence. After the surgery, she was back to work in a week without the leak she had lived with for so long.

 2nd story:

My “younger” patients are definitely more creative in finding ways to deal with their pelvic symptoms. I also recently cared for a 37 year-old woman who has had issues with constipation for several years.  Within a few months of her last vaginal delivery, she started noticing “a ball of tissue” protruding from her vagina that got larger every time she had a bowel movement (BM).   Initially, she used her fingers to push it back inside and noticed that this caused her to strain less and overall helped facilitate her BM’s.  As you can imagine, this was not a comfortable thing for her to admit to me and she was relieved to hear that this was such a common issue that there was a term to describe this maneuver: “splinting”.  Fortunately, within 2 visits, this patient was able to be fitted with a comfortable pessary device that she now inserts and removes with ease to help control her symptoms.

In both of these cases, once they decided to seek treatment these women’s lives changed in simple but dramatic ways. All it took was for them to speak up. 

Over the past decade women are starting to realize that they don’t need to live with these symptoms, but the change is coming very slowly. Urogynecologists like myself, pelvic floor physical therapists, and national groups are all working to change women’s attitudes about pelvic floor health. Organizations like the National Association for Continence (NAFC), the American Urogynecologic Society (AUGS) and the International Urogynecological Association (IUGA) have helped promote women’s awareness of pelvic floor disorders and treatment options.

My sincere hope is that with more knowledge about these illnesses women will feel empowered to open the discussion with their caregivers, seek treatment when they need it and prevent future problems when they can.