2021 Hot Topics In Women’s Health

Science is limited by what research has been done. So, I always like to keep my patients informed on what research is on the horizon. Here are pelvic health topics that are being studied in 2021:

1.The relationship between sports and female anatomy. 

Researchers are looking at both short and long-term effects of all sports on the pelvic floor. Running and pelvic health is a particular area of focus. Runners have unique nutrition and biomechanical needs. These needs require special attention from their healthcare providers.  Runners often present to orthopedic specialists with knee and hip injuries. Often, these injuries do not resolve as expected due to pelvic floor impairments. 

2.Gender-Affirming Care. 

The section of physical therapy, originally known as “women's health” has shifted to "pelvic health". Now, they are expanding this category of expertise to pelvic and abdominal health. So much of the pelvis is connected with the organs, posturing, fascia, and pressure of the abdominal region. It’s fascinating to me that for so much of traditional PT --even massage--that the abdomen is such a no-go zone. Part of the inclusion path has been to train PTs to work with men. They have pelvises, pelvic pain, and incontinence too. The field is growing to include people of all gender identities, including transgender health. We are always looking to learn how we can better support people who are gender diverse. This includes pre and post-op support for gender change surgeries.  

3.Menopause

More research is being done on how to help support menopausal and perimenopausal women. Up to 30% of a woman's life can be involved in this process. Doctors are promoting the awareness that menopause is not a disease... and shouldn’t be treated as one. 

4.Pediatric Pelvic Health. 

Pregnant or postmenopausal women are not the only ones who get incontinence. Kids do too, for a variety of psychosomatic, environmental, and anatomical reasons. This is an important topic! 

5.Diastasis Recti prevention, treatment, management, and relevance. 

This is a hot topic for PTs and OBs alike. There are a lot of myths out there about it. No one likes the idea of the abdomen being separate. And the idea of preventing or fixing it is marketable. But current research says there aren’t any exercises (other than activating your transverse abdominis) that truly help close a separation. And unless the separation is significant, it may not matter at all. This is what has been discovered:

Women who perform routine daily exercise throughout their pregnancy are less likely to have sustained diastasis recti one year postpartum. 

6.Breastfeeding Support by a PT

Researchers are currently looking at how ultrasounds may help relieve compressed milk ducts and prevent/relieve mastitis. There is really no evidence that milk ducts get “clogged” or blocked. The vessels are highly collapsible and thus easily affected by inflammation. Lymphatic drainage techniques are also being applied. There is a bundle of lymph nodes under the armpit. These are responsible for maintaining cellular fluid balance and fighting infections. Ensuring they are working properly has promising potential for breastfeeding support and breast tissue health.

7.Use of Ultrasound Imaging 

Ultrasound imaging has been validated as a reliable and valid method to evaluate:

• Muscle structure
• Activity
• Mobility

Therapists are using it to help with their accuracy. There is also research in training patients neuromuscularly.  Basically, it's like, if you see it, you can believe it. Then you can use the muscle better since you're more confident that you are activating it “correctly”. This is called Rehabilitative Ultrasound Imaging (RUSI).

8.Use of technology. 

Yes, there’s telehealth. But there are also some pretty innovative apps out there.

• I personally like Elvie. It's a pelvic floor trainer device and app. I like it because it gives women the ability to “see” what their pelvic floor muscle strength is. This can help with Kegel confidence.
• There’s also Pocket Anatomy. This helps therapists teach patients about their bodies. It’s like having a virtual cadaver lab at your fingertips! And, it’s free!
• Then, there are the exercise apps. These help patients see, do, and perform their exercises efficiently and effectively.'

9.Being “Postpartum Positive” 

The US has been slow in promoting preventative pelvic care. Countries like Canada, the Netherlands, Belgium, Finland, and Spain all have great practices we could learn from.  

10. Prenatal care

• Incorporating a doula into prenatal care, not just for the birth-day
• My jaw dropped when I read about how Finland provides an antenatal care package. This includes over 50 items, including:
• Gender-neutral colored baby clothes
• Reusable diapers
• Bottles
• Supplies like panty liners and bra padding for the mother.
• Plus, the box the package comes in can be used as a baby bed. It’s part of their social security system! Parents who adopt are also eligible. It seems so innovative, but has been part of their system since 1937, initially as a “maternity grant”. Every year, 60,000 maternity grants are awarded.

11.Postpartum planning

• When a mother is about 34 weeks into her pregnancy, some countries put together a “postpartum plan”.
• In Spain, women receive a cartilla de embarazo (mother’s passport) to be able to check in with a community midwife monthly.
• The Netherlands and Belgium have a maternity nurse to provide a minimum of 24 hours of care within the first 8 days postpartum
• Making postpartum pelvic health visits part of the standard of care.
• Insurance coverage of midwifery, lactation consultants.
• Improved workplace practices to support breastfeeding.
• Specific nutrition guidelines for healing.
• Of course, there’s the parental rights issue of improving paid maternity leave policies…..only 14% of Americans have access to any paid time off.

Here are some fascinating charts, put together by UNICEF in 2019, measuring how family-friendly different countries in the world are: 

Sadly, the United States does not rank well. Let’s work together to make this hot topic even HOTTER and influence change in this department. Send me an email and let’s talk!