RCOG calling for action to reduce number of women living with poor pelvic floor health

29 August 2023

New data reveal over 60% of UK women have at least one symptom of poor pelvic floor health.

Nearly one in four women have never done pelvic floor exercises that can prevent and improve symptoms.

The Royal College of Obstetricians and Gynaecologists is calling for improved information and education about pelvic floor health throughout women’s lives.

The Royal College of Obstetricians and Gynaecologists (RCOG) is calling for action to tackle the impact of pelvic floor dysfunction, affecting millions of UK women. This comes as new data reveal a lack of awareness about pelvic floor health, including the benefits of pelvic floor exercises and symptoms of a weakened pelvic floor.

A survey of 2,000 women* revealed one in five (21%) experienced urinary incontinence and a quarter (25%) experienced a frequent urge to wee. Despite symptoms being common, over half (55%) do not currently do, or have never done pelvic floor exercises, with nearly a quarter (23%) not knowing how to do them.

The survey also revealed that:

The majority (69%) of women had not spoken to anyone in the NHS about their pelvic floor health.

Over half (53%) of the women who had experienced symptoms of pelvic floor dysfunction did not seek help from a healthcare professional. Of these, 39% thought their symptoms were normal and 21% were too embarrassed.

Only 22% of women do their pelvic floor exercises regularly.

15% could not identify any common symptoms caused by a weak pelvic floor.

The RCOG has published a policy statement today identifying key opportunities to tackle pelvic floor dysfunction through improved education and access to information. This should be tailored to the individual, and provided from a young age and throughout women’s reproductive life cycles (e.g. during pregnancy and the menopause). Women should always have access to information and support on how changes to their lifestyle such as maintaining a healthy weight, exercising regularly and reducing or stopping smoking, as well as practicing pelvic floor exercises, can prevent and reduce symptoms of a weak pelvic floor. It is vital that this work looks to reduce inequalities in access to care and information, as well as education that exists across women’s health.

The RCOG is also stressing the importance of all healthcare professionals having the knowledge and confidence to talk to women about pelvic floor health. Routine healthcare appointments (particularly for pregnancy and ante and postnatal care) can be used to provide information on maintain good pelvic floor health, helping women to prevent issues throughout their life. 

The College is also calling for any woman with symptoms of pelvic floor dysfunction to have access to timely support, and where necessary, specialist healthcare professionals, including continence nurse, women’s health physiotherapists and urogynaecologists.

Studies have shown that symptoms of pelvic floor dysfunction such as pelvic organ prolapse and incontinence can have a huge impact on quality of life, impacting on their family life, wellbeing and personal relationships.

Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists, said:
“Our research shows too few women are receiving information about pelvic floor health, or the risk factors that can increase the chance of developing pelvic floor dysfunction. It also found many women either don’t know, or are too embarrassed to ask, about help for symptoms that may be having a real impact on their lives.

“We are calling for improved information provision and education throughout women’s lives. Every health professional has a role to play in tackling stigma and giving women the ability to protect their pelvic health, to improve symptoms they may develop and to recognise when to seek help by making every interaction count.

“Across all four nations women should be able to access support to maintain good pelvic floor health following pregnancy and birth. We welcome NHS England’s commitment to improve perinatal pelvic health, and hope we can work with the NHS to ensure that all women have access to high quality information about pelvic floor health. Efforts must also focus on eliminating inequalities in access to health information, education and care.”

Emma Crookes, a member of the RCOG Women’s Network who started suffering incontinence during pregnancy, said:
“When I started leaking urine from quite an early stage of pregnancy in my twenties, I was shocked and embarrassed, and wanted to hide away. I was told by friends, the media and even my GP that it’s completely normal, it’s what happens when you have children. It was only by a chance meeting with a specialist that I had the courage to go back to my GP and demand better help.

“By the time I was referred to a pelvic floor physiotherapist and urogynaecology services, I was suffering with a vaginal wall prolapse and urinary stress incontinence. With pelvic floor muscle training and weeks of intense personalised exercises and support my symptoms improved and I was able to get back to my usual routine.

Dr Kate Lough, Chair of the Pelvic Obstetric and Gynaecological Physiotherapy (POGP) group, a professional network of the CSP said:
“POGP congratulate the RCOG for producing such a comprehensive statement clearly identifying the future needs in pelvic floor health whilst acknowledging the challenges for implementation into healthcare. Increasing and improving the access points for good information for women across their lifetime will help to build long term pelvic health. 

“Women having easier access to specialist pelvic health provision will help to reduce the deconditioning effect of waiting too long for access to the right care. Multidisciplinary provision allows women to address the full extent of their pelvic floor dysfunction in a coordinated and pragmatic way. Pelvic health physiotherapy seeks to support women to minimise urinary or anal incontinence and prolapse and to maintain their activity levels and overall health. POGP members across the UK look forward to continuing working together to help to deliver all the recommendations in the RCOG policy statement.”

Back