Dear Sharae:

Fifty percent of women who have had a child will have pelvic organ prolapse (essentially a hernia of the vagina and or uterus) and approximately 20 percent of these women will seek medical care for bothersome symptoms.  In addition, 11 percent of women will have surgery for prolapse or incontinence by age 80. Pelvic organ prolapse, as well as urinary and fecal incontinence can have a debilitating impact on a woman's quality of life. 

But, despite the high prevalence of pelvic floor disorders, many women fail to receive treatment for their symptoms because they do not realize that a cure exists. Awareness of incontinence and pelvic medicine problems - uniquely women's problems - is still growing. Much has improved, but we need to improve screening for these problems. A woman might be embarrassed to talk about incontinence if her physician does not bring up the topic, or she might think nothing can be done. Especially these days, with so many advances in women's health, it is important to seek out physicians who will listen and take your concerns seriously.  This may be especially true for many African American females who are seen as a largely underrepresented population seeking treatment for these conditions. 

The relatively new field of urogynecology (also called female pelvic medicine and reconstructive surgery) is another example of how health care is developing to more thoroughly understand the specific health needs of women. The field, which is a subspecialty within obstetrics and gynecology or urology, takes a unique approach to the evaluation and treatment of conditions affecting the female pelvic organs, like prolapse and bladder and bowel incontinence. The specialty also is advancing the science of women's pelvic health by seeking ways to prevent problems or catch problems early, so that less invasive treatments can be used.

Women who partner with their physicians often come to appointments with prepared questions - and once a mutually acceptable treatment plan is selected - follow instructions and communicate any concerns. After all, incontinence is not life threatening, it is a quality-of-life disorder. There is a broad spectrum of what treatment is preferable to different women. Some women will not tolerate a single drop of leakage; others would rather put up with three diapers a day than undergo surgery. Therefore, one should look for a physician who offers a full range of treatment options, including fitness classes, vaginal devices and other innovative treatments.

The goal is to create open lines of communication in which patients and physicians can agree on their goals for treatment.

Take care,

Dr. Oldham

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