Pelvic Floor Health is a Feminist Issue

Tomorrow is International Women's Day 2023 and the theme for this year is #embraceequity. Equity means that all people are treated the same. 

International Women's Day is a great opportunity to remind ourselves of the changes we still need to make to #embraceequity and make sure that everyone's needs are treated equally. For women, this can mean challenging some of the societal systems that are in place and adding our voices to the discussion. 

While pelvic floor issues can affect anyone, they disproportionately affect women as some of the big risk factors for pelvic floor issues, like pregnancy, birth and menopause are unique to women. 

More women will suffer pelvic floor issues in their lifetime than almost any other medical dysfunction and yet, they are less likely to receive care for these issues than for other common issues like diabetes, hypertension or osteoporosis [Source: BJU International: the Global Burden of Female Pelvic Floor Disorders].

Why is that? 

Pelvic floor issues are common but not normal and that means there are ways to prevent, manage and treat these issues at any age. 

But many women do not know this and that prevents them from seeking help. 

These issues are simply not discussed. 

When I suffered a pelvic floor injury and was managing my symptoms, believe me, it was the last thing I wanted to talk about. I desperately wanted to just hide my head in the sand and ignore the problem as much as possible. What upset me most about the birth injuries I sustained was that I really didn’t know about them beforehand - I knew tearing was a possibility but I didn’t know what that meant or how to heal myself afterwards. 

Women are used to dealing with pain and mess. 

Having periods from a young age habituates us to phases of not feeling well and managing messy bodily fluids. We become very good at hiding when we’re bleeding so it’s not a huge stretch to become good at hiding when we’re leaking or managing other symptoms. 

We are conditioned to feel like it’s our duty to hide our symptoms to save our own embarrassment and that of those around us too. 

Our society is based on a historically patriarchal system that places higher value on the needs and desires of men than those of women. As periods, pregnancy, birth and menopause are all uniquely female experiences, they fall outside of the area of interest of men and were layered with shame and secrecy to oppress women and keep them in more servile roles. 

Our medical system has evolved within this patriarchy too. 

Training and testing in western medicine is still based predominantly on the male form (usually the white male - but that’s another story). Women weren’t even included in clinical trials until the 1990s and as of 2021 there are no guidelines from the Medical Research Council in the UK to redefine trials taking this gender bias into account [source: The Happy Vagina]. 

The study of female anatomy has always had less attention than male anatomy. This lack of academic interest (and funding) in female anatomy meant that the anatomy of the uniquely female organ, the clitoris, was not studied in its entirety until 1998, and of course, the person who led that study was a woman (brava Helen O’Connell). The clitoris is not just a nub at the top of the vulva - almost 90% of the organ is below the surface. Given how intimately intertwined the 3D clitoris is with the urethra, vagina and labia, the lack of knowledge of its whereabouts and its incredible sensitivity (a clitoris has 2-3 times the nerve endings of a penis) led to a whole host of painful disasters for many women. 

If we think about this in terms of pelvic floor issues like urinary incontinence, the implications are shocking. One way to ease incontinence symptoms is surgical interventions which are performed on both men and women. During surgeries on men, care is taken to avoid damage to nerves and erectile tissue while in urological surgeries for women, prior to 1998 no one even knew these clitoral nerves or tissues were there [source: TheGuardian.co.uk]. 

The neglect that the clitoris has historically suffered in medical academia illustrates the point that women have been an afterthought in the medical system. This doesn’t mean that doctors don’t care or there is no work being done in this area but it does mean that the system isn’t set up to support us and that means if we are going to get the help and support we need, we need to educate ourselves so we can advocate for ourselves. 

“Education is the most powerful weapon you can use to change the world" - Nelson Mandela

Education is the best weapon we have against inequality. 

Knowing what is normal for you, how to adjust your lifestyle to support your pelvic floor health and where to go for help when things aren’t working properly are just some of the ways education can empower you to navigate the system and improve your health outcomes. 

You are entitled to know your body and get the support you need to have the best quality of life that is available to you.

Because you’re a woman, you might have to shout a little louder to get what you need. 

At Sheela, we want to help you get that support. 

We’re creating tools and resources to help you build a road map for pelvic floor health that is as unique as you are.

We’re very proud of what we’ve created so far and that’s why we’re celebrating International Women’s Day by getting as many women as possible to read Sheela’s Guide - 5 Habits for a Happy Pelvic Floor. It’s available to download for free here. 

In this guide you’ll uncover 5 simple habits to support your pelvic floor health you can easily integrate into your lifestyle without having to adopt any complex exercise programs or even figure out how to do a kegel. Please share widely #sheelasguide.

For more accessible content like this, follow us on Instagram (@sheela.ie) and YouTube (@sheelawomen). 

Lastly, if there is a woman out there you think might need to hear any of this, please share. Talking about these issues is essential if we're going to help women move past them.