The pelvic floor has an important function that, when not working properly, affects women’s quality of life. In fact, three out of five post-menopausal women struggle with symptoms of pelvic floor problems but don’t openly discuss them.
Jean Marie McGowan, M.D., and her team at the Pelvic Floor Clinic at Sanford Health are aiming to change that by normalizing this topic and providing relief to patients. She discusses addressing urinary issues, the complete care available all in one location and continuing the conversation about disorders of the pelvic floor.
Addressing urinary issues
The Pelvic Floor Clinic, located in the Sanford Women’s clinic on the first floor of the Southpointe Clinic in Fargo, North Dakota, addresses several disorders that occur with the pelvic floor.
“We are treating anything from urinary incontinence, urinary frequency, overactive bladder, chronic urinary tract infection and pelvic pain to fecal incontinence, constipation and diarrhea,” Dr. McGowan said.
Many post-menopausal women deal with these issues. According to Dr. McGowan, 60% will have some vaginal issues such as dryness, significant pain, urinary infrequency and irritation.
The clinic, which opened in July 2017, has made a steady impact on those who struggle with these kinds of disorders. Since the clinic’s opening, they have received about 700 referrals and seen close to 400 patients.
“Changing what they’re eating, what they’re drinking and the products that they’re using as well as adding physical therapy can make all the difference,” Dr. McGowan said. “If it doesn’t make any improvements, we will then consider medications, depending on the issue.”
When medications are needed, the specialists at the Pelvic Floor Clinic also are able to work with specialists in other areas such as urology, gynecology and general surgery for possible surgical interventions, including newer surgical techniques.
“If it needs more specialization, we’re connected with specialists in those departments, and we can get the patient in to see them,” Dr. McGowan said.
Complete pelvic care
The Pelvic Floor Clinic, which is held half-days on the first and third Thursday of each month, does not take self-referrals.
“We ask that referrals come from patients who have seen their primary care providers,” Dr. McGowan said. “Sometimes they see a gynecologist or urologist, and those providers decide if the first-line therapy we provide at this clinic can address some of the overlapping issues.”
Once the patient has consulted their primary care provider and received a referral, the patient can begin receiving treatment. First, expect to complete some paperwork, which usually includes questionnaires about urinary function. If you are having some fecal incontinence, expect to answer questions about that, too.
“We also have them keep track of their habits in a ‘voiding diary,'” Dr. McGowan said. “It has to occur over three days and includes their fluid intake, how often they’re going, if they’re having leakage and if they’re getting up to go during the night.”
Next, you’ll visit the office, talk about your medical history and get a pelvic exam. You also will learn about better bladder habits.
When your exam is complete, the clinic sets up your first appointment with physical therapy and give you information about the class you’ll attend.
“Our goal is to do this in the same day so it’s very convenient for patients as everything is right here at Southpointe,” she said.
Exercises and classes
The physical therapists who work with patients are specially trained in the pelvic floor. Different kinds of exercises strengthen the pelvic muscles that influence urinary habits and other functions.
The class covers the anatomy of the pelvic floor and changes that occur from a variety of events such as childbirth, constant strain from constipation and other issues.
Additionally, the class touches on bad habits patients may have formed. A couple of these habits: going to the bathroom every time there is an urge even though you just went; and drinking beverages that irritate the bladder such as pop and coffee.
“I mean, we’re not unrealistic. I would suffer without my coffee,” Dr. McGowan said. “But we counsel on how much you can get by with.”
Continuing the conversation
When it comes to issues of the pelvic floor, a stigma can prevent women from discussing them and getting care.
“People don’t really talk about it,” Dr. McGowan said. “A lot of the urinary issues, women are told, ‘Well, it’s inevitable when you have kids and get older,’ but it doesn’t have to be like that.”
Continuing the conversation about the pelvic floor disorders that many individuals suffer from is important for their quality of life.
“We have therapies that help people who struggle with these issues, and it makes a huge difference,” Dr. McGowan said. “If I didn’t have to worry about having an accident in public, I’m going to be going out more and enjoying life and not be so anxious.
“Some women weren’t running anymore because they weren’t able to control their bladder. This clinic is a big deal for them. I’ve had some women hug me because they’re now able to go out with friends and not worry about having an accident.”
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