2023 In-Depth

The pelvic health awakening

For many women, discussing the topic of our bodies’ reproductive system is not something that arises in casual coffee conversation. Instead, it’s often a subject confined to private discussions behind closed doors. But what if this taboo were to change? What if we openly discussed pelvic health, periods, sex, and how these aspects affect our everyday lives in public spaces? Could this lead to faster diagnoses for conditions like Endometriosis, reduce spending on pain relief medications, and diminish the frequency of women being turned away from medical practices?

The taboo surrounding women’s reproductive health stems from an era when the medical system saw anything gynecological was considered to be ‘in your mind’, ‘something women just had to wear’, and they were often told ‘you’ll be fine, just relax, it’s just part of being a woman’. Unfortunately, this mindset echoed in our society and only in recent years has the topic of women’s health been talked about in the mainstream media. 

As these conversations gained momentum, more women became aware that their concerns were valid. They realised that seeking help or gaining more education carried no judgment.

The 2023 National Women’s Health Survey, found that one in two women (47%) in Australia over the age of 18 experienced pelvic pain in the last five years. Of those women, four in five reported that pelvic pain impacted their daily activities or caused them to miss days off work, study or to miss exercise.

Figure 1. Proportion of Australian women who have experienced pelvic pain in the last five years. 2023 National Women’s Health Survey
So what is pelvic health?

Pelvic health refers to the best possible functioning and management of the area in between your tailbone and your pubic bone, comprising organs, bones, muscles, ligaments, joints and nerves. Unlike a broken arm, pelvic health issues are often less straight forward to diagnose and treat. Women facing pelvic health problems may receive diagnoses such as Endometriosis, pelvic floor dysfunctions, vaginismus, or irritable bowel syndrome, among others.

So whether you are in your teens, twenties, thirty’s, fourties’, fifties, sixties, seventies, eighties, nineties or you have just blown out the candles on your 100th birthday

  • Period should be a bit uncomfortable, but never consistently painful.
  • Using a tampon should be easy and not consistently painful
  • Having sex should be enjoyable not consistently painful 
  • Having ongoing issues with needing to go to the bathroom more often than usual or not being able to fully empty your bladder or bowel function is abnormal

Recognising that if these symptoms are persistent that is not normal and may be an indicator of pelvic health issues, which is crucial for one’s overall wellbeing.  

Dr Irmina Nahon is a pelvic floor physiotherapist and Associate Professor at the University of Canberra, she has dedicated more than 20 years to assessing and researching pelvic health. Although pelvic health wasn’t a focus during the early days of her career, she gradually became aware of how profoundly it affects people’s lives. This awareness fueled her commitment to helping women and men in her everyday practice.

“Pelvic health is actually quite a fascinating area to work with, partly because of the taboos and because there is such a huge amount that we can do to help people in order to improve their pelvic health,” she says.

Dr Nahon has seen hundreds of patients over the last few years, essentially providing sex education to educated adults who, despite their knowledge, have never had the opportunity to discuss these issues openly.

“These are adults, who are not naive people, these are educated young women who just have never had the opportunity to talk to someone,”. 

“Essentially providing sex education to educated adults.”

— Dr Irmina Nahon, Pelvic Health Physiotherapist & Senior Lecturer

“It takes on average 7 years to be diagnosed with endometriosis, so it is very important that we educate people of all ages that if you’ve got pain, there’s something you can do about it” she said.

The recent study also found that one in three Australian women reported pelvic pain has impaired their mental and emotion wellbeing or relationship with their partner. 

Elizabeth Kilby, a Pelvic Health Physiotherapist at Fundamental Health based in Canberra has had a number of women that have come to see her who are currently at university. 

“Many have just begun their sexual journey and are confronted by pain in each experience they have, which prompts them to seek help,” she said. 

“Women are confronted by pain in each experience they have”.

— Elizabeth Kilby, Pelvic Health Physiotherapist at Fundamental Health

When a woman comes into their clinic, they personalise the treatment based on the patient’s underlying conditions. Some may benefit from education about pain pathways or referrals, while others may require multiple clinic sessions as part of their management and treatment plan.

Ms Kilby explained “the end goal is always self management for all people, with the earlier you can get support the more likely symptoms can be managed”. 

As conversations around pelvic health continue and the education in this field expands, individuals will hopefully become empowered to take charge of their well being. 

Dr Nahon asks women to do one thing, “listen to their body as it is you and only you that know one’s bodies the best”. 

“If your GP dismisses it as ‘normal’ saying ‘you’ll grow out of it’. Well I can tell you this is not normal. Ask if you can be referred to someone who’s going to investigate it? If you don’t stand up for yourself, you’ll be fobbed off and that happens way too often” she said. 

So whether you are a parent, partner, educator, friend, or you are on the journey to discover what your body needs everyone plays a role in the future ahead- as being informed you can recognise symptoms and help prevent problems in the future, to ensures humans can become their best self. 

Want to know more?

Women’s Health Matters

Pelvic Health Foundation Australia

Jean Hailes for Women’s Health


Pelvic Floor First