Anyone working in pelvic health knows all too well that the symptoms of female pelvic floor dysfunction (PFD)  — from bladder leaks and pain with vaginal penetration to anal pain and fecal incontinence —  are vastly underreported. Most providers do not screen for pelvic health symptoms and patients are either reluctant to bring them up or assume that they’re ‘just the way it is’ if you own a uterus (and especially if you’ve had kids).

Just how underreported are pelvic health symptoms? That’s one of the questions that the 2024 Origin Pelvic Health Study sought to answer. The consumer-facing study consisted of a 10-minute, double-blinded, online, quantitative survey conducted by the market research firm Ipsos, with a base sample of 612 U.S. women, ages 18-59.

Study participants were asked whether they had experienced bladder, bowel, and sexual symptoms in the past year, how those symptoms had impacted their lives, and whether they had gotten care for their symptoms. Additional questions were asked of those who had given birth within the past five years or who were in peri/menopause to both explore how these major life events impact pelvic health symptoms and reveal gaps in related care and education.

As a clinical reviewer of the study and an APTA Pelvic Health grant recipient working on my own research, I’m excited that companies like Origin are collecting this valuable data, which not only garners media attention that can be hard for pelvic health researchers to attain (the Origin study was written up in Vogue), it can help inspire and steer our research in important new directions.

The study includes too many eye-opening statistics to list here, but below are 3 high-level takeaways:

1. The majority of U.S. women ages 18-59 are dealing with multiple pelvic health symptoms.

PFD has most recently been found to impact 1 in 3 women, based on a 2022 study that examined the medical records of 25,425 women seeking primary care. ICD-10 codes were used to determine presence of PFD, including urinary incontinence, pelvic organ prolapse, bowel, dysfunction, and difficult defecation. Other pelvic floor-related conditions like vulvovaginal pain or orgasm difficulty were not included.

In contrast, the Origin study included a long list of pelvic health symptoms described in terms women often use themselves, with the goal to expose just how common these symptoms really are. What they found was that most women had one or more symptoms, and only a tiny minority had received care for them.

75% of U.S. women between the ages of 19 and 58 have dealt with two or more pelvic health symptoms within the past year. The average number of pelvic symptoms reported was 5.

Some of the symptoms experienced most often in the past year by U.S. women ages 18-59:

Bladder sypmtoms:

• 48% report bladder leaks when they cough, sneeze or exercise
• 38% report peeing more than once every 2 hours
• 37% report feeling like they had to pee again right after going
• 33% report feeling like they could barely hold their pee
• 27% report feeling like they couldn’t fully empty their bladder

Bowel symptoms:

• 52% report straining to have a bowel movement
• 48% report feeling like they can’t fully empty their bowels
• 29% report pain with having a bowel movement 
• 21% resort leaking gas or poop

Sexual symptoms:

• 33% report inability to orgasm
• 25% report unsatisfying orgasm
• 22% report pain with sex
• 18% report delayed orgasm

Interestingly, the study also found that Millennial women were more likely to report a host of symptoms in the past year, compared to Gen X.

2. Pregnant and postpartum patients are left in the dark when it comes to preparing for and recovering from the immense physical strain of childbirth.

As major health organizations seek to improve the current dire state of postpartum care, mentions of pelvic health and pelvic floor physical therapy are often limited to recommendations that postpartum patients be evaluated for urinary and fecal incontinence and referred to pelvic floor PT as needed.

Those of you who are women’s health specialists who focus on prenatal and postpartum PT, know that we have so much more to offer. The Origin Study highlighted the need for the exact guidance and expertise that pelvic floor PTs can provide.

Among women who had given birth with in the past 5 years:

• 85% report receiving no guidance on reducing their risk of tearing during childbirth.
• 65% report receiving no guidance on how to effectively push out a baby.
• 50% report receiving no guidance on how to manage pregnancy pain.
• 86% report receiving no guidance on how to heal their pelvic floor after childbirth.
• 83% report receiving no guidance on how to heal their abdominals after pregnancy and childbirth.
• 71% said they received no guidance on how to exercise safely before or after childbirth.

In addition, 44% of women who had a baby in the past 5 years say providers did not help them understand what is or isn’t normal in terms of their pelvic health systems. And 23% said they felt “not at all supported” by their medical providers during their postpartum recovery.

3. Pelvic floor PT continues to be underutilized, resulting in unnecessary pain and suffering for women of all ages.

It’s unlikely to surprise you that, of the Origin study participants who reported pelvic health symptoms within the past year, 96% had not received medical care for their symptoms. Of study respondents who had given birth within the past 5 years, 92% said they had not seen a pelvic floor PT to support their recovery after their most recent delivery.

Without proper screening by providers and referrals to pelvic floor PT, women will continue to suffer in silence, confused about what is and isn’t normal when it comes to their pelvic health.

The Origin study reiterates what pelvic health specialists and their patients already know — pelvic health symptoms significantly disrupt women’s lives. 64% of study respondents who report pelvic health symptoms in the past year say that these symptoms negatively impact their lives. And that number is even higher among women who have given birth within the past 5 years, at 79%.

Despite how discouraging it can be to read through these statistics, it’s important to get loud about them and continue to demand better. I’m grateful to my colleagues at Origin for making research part of their mission and am excited to see this data is used to fuel more research, draw more attention to pelvic health, and drive positive change in our healthcare system.

AUTHOR BIO:

Jessica Swartz, PT, DPT, CCI

Jessica Swartz, PT, DPT, CCI, is a physical therapist at Origin, a leading provider of pelvic floor and whole-body physical therapy with a special focus on pregnancy and postpartum. She is also working on her PhD in Public Health with an emphasis on Health Behavior in the Joint Doctoral Program of Public Health at UC San Diego/San Diego State University, where the focus of her research is developing ways to use physical therapy as a tool to improve women’s and maternal health outcomes and address health disparities.