Common Pelvic Floor Issues in Women (and How Physio Can Help)
Pelvic floor health is a topic many women don’t hear much about until they experience problems. Yet pelvic floor dysfunction is extremely common, impacting women across all life stages, from teenage years through pregnancy, postpartum, and into menopause. While these issues can be uncomfortable or even distressing to talk about, help is available. Women’s health physiotherapy offers evidence-based, non-invasive treatment options that can significantly improve symptoms and quality of life.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, and connective tissue that form a sling-like structure at the base of your pelvis. These muscles support the bladder, uterus, and bowel, help control continence, and play a role in sexual function.
When working well, the pelvic floor tightens and relaxes as needed, like when holding in urine or passing wind, or during sexual activity. But when these muscles become too weak, tight, or uncoordinated, problems can occur.
1. Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the pelvic organs (bladder, uterus, or bowel) descend from their normal position and push into the vaginal wall. This is often due to either damage to the pelvic floor muscles or the connective tissue supporting the pelvic organs, commonly from childbirth, heavy lifting, chronic coughing, or menopause.
Common symptoms include:
A sensation of heaviness or “dragging” in the pelvis
Feeling or seeing a bulge in the vagina
Trouble emptying the bladder or bowel
Discomfort with sexual intercourse
Lower Back Pain
How physio can help:
A women’s health physiotherapist can assess the type and degree of prolapse and tailor a pelvic floor rehabilitation plan. This may involve strengthening exercises, pessary fitting advice, and lifestyle modifications (like lifting techniques or bowel health strategies) to reduce symptoms and prevent worsening.
2. Stress Urinary Incontinence
Stress incontinence refers to involuntary leakage of urine when coughing, sneezing, laughing, or exercising. It’s caused by weakened pelvic floor muscles and is common during pregnancy, after childbirth, or around menopause when oestrogen levels drop.
How physio can help:
Pelvic floor exercises (often called Kegels) are the gold-standard treatment. A physiotherapist will teach correct technique (since many women unknowingly perform them incorrectly), use real-time ultrasound or biofeedback for training, and prescribe a structured plan to improve strength and endurance over time.
3. Urge Incontinence and Overactive Bladder
Urge incontinence involves a sudden, strong urge to urinate and sometimes not making it to the toilet in time. Overactive bladder (OAB) includes frequent urination and nighttime trips to the bathroom (nocturia).
Common triggers:
Running water
Unlocking the front door
Cold weather
Caffeine or alcohol
How physio can help:
Physiotherapy for OAB and urge incontinence includes bladder retraining techniques, urge suppression strategies, and pelvic floor strengthening. Your physio may also help you track bladder habits and modify fluid intake if needed.
4. Pelvic Pain and Painful Intercourse (Dyspareunia)
Pelvic pain can arise from conditions like endometriosis, vaginismus, vulvodynia, or overactive pelvic floor muscles. Pain during sex is not normal, and many women suffer in silence, believing it's just something they have to put up with.
Symptoms may include:
Pain with penetration or tampon use
Burning, stabbing, or aching in the pelvic area
Muscle tightness or spasms
Discomfort sitting for long periods
How physio can help:
A pelvic floor physiotherapist can identify if the muscles are too tight or reactive and create a treatment plan that may include manual therapy, relaxation techniques, breathing strategies, biofeedback, or dilator training. Education plays a large role - many women benefit simply from understanding what’s happening in their bodies.
5. Bowel Issues
The pelvic floor also supports bowel function. Women may experience:
Faecal incontinence (involuntary loss of stool or wind)
Constipation
Incomplete emptying
These issues can arise after childbirth, pelvic surgery, or due to long-term repetitive straining.
How physio can help:
Women’s health physios can guide you on how to properly relax the pelvic floor during bowel movements, address contributing factors (such as posture, breath, or diet), and teach exercises to strengthen and coordinate muscles for bowel control.
6. Postnatal Pelvic Floor Dysfunction
After pregnancy and childbirth, it’s common for women to experience a range of pelvic floor issues, including prolapse, incontinence, pain, and abdominal separation (DRAM). Even if you had an uncomplicated birth, the pelvic floor undergoes enormous strain and deserves care during recovery.
How physio can help:
Postnatal physiotherapy focuses on gentle, progressive recovery, helping you restore function, manage symptoms, and safely return to exercise. An internal or external assessment may be offered, and a tailored plan will help you move forward confidently.
Why See a Women’s Health Physio?
Women’s health physiotherapists are specifically trained in pelvic floor assessment and treatment. They take a compassionate, private, and supportive approach and help you understand that:
Your symptoms are real and valid
Many pelvic issues are common, but not “normal”
You do not have to just live with them
Best of all, pelvic floor physio is first-line treatment for most pelvic dysfunctions before considering surgery or medication.
How to Get Started
If you’re experiencing pelvic floor symptoms, or even if you’re not but want to take a preventative approach, booking an appointment with a qualified women’s health physiotherapist is a great first step. Early intervention can mean faster, simpler recovery.
At Wholesome Physiotherapy, we offer pelvic health assessments in a safe, supportive environment, right here in Townsville.
Reach out to book a session with one of our experienced women’s health physiotherapists.