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Pelvic floor education for teenagers? How wonderfully progressive.

The Bladder and Bowel Foundation (B&BF), a non-profit organization in the UK, has recently published an educational brochure for teenagers that teaches them about the pelvic floor muscles. The publication was also written in part by teenagers, and it has a look and feel that is appropriately "younger." If you click here, and then scroll through the announcement about the leaflet, you can view it on-line. You will note that many topics are covered, such as the where and why of pelvic floor muscles, and even the how to contract and exercise them. Conditions or habits that can interfere with pelvic floor health are described, including childbirth, smoking, coughing, and underactive abdominal and pelvic muscles.

Teenagers are struggling with pelvic pain, bladder, bowel, and sexual dysfunctions, and may feel uncertain about with whom they can discuss the issues. We know from the adult pelvic floor literature that in general, physicians don't ask and the patient is embarrassed to tell. What would make a teenager any more likely to share such private information? Teenagers may experience painful sexual encounters, bowel issues such as constipation or fecal incontinence, and bladder issues including urgency, pain, or leakage. (Have you noticed how many teens stop at Starbucks on the way to school now? Who is educating them about bladder irritants?) Athletes may also have increased risk of leakage, especially when engaged in high-impact sports.

I have often wondered how we can better impact the health of children and young adults if we discussed their pelvic floor as well as bowel, bladder, and sexual health beginning at younger ages. In this country, we certainly come up against the controversy of discussing the pelvic floor as it relates to sexual health, as well as the challenge of speaking about bodily functions that are not typically discussed. It may not be possible at this time to have pelvic floor education taught throughout middle and high schools, but it may be possible for pelvic rehab providers to improve the knowledge of parents and teens in our own communities. Perhaps offering a program at a local community center, with a session for adults and one just for teenagers would work. To better inform the parents, each adult could be given a detailed outline of what will and will not be included in the teen session. Better yet, the adults could be instructed in the same information so that the chances of dialog between parent and child may be more likely.

You may find the new teen pelvic floor resource useful in designing a brochure or a handout that could be offered in your own clinic or at a local event. As we continue to educate our colleagues, referral sources, and patients about pelvic floor health and function, we may be able to broaden the age base and improve the help that is offered to teenagers.

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