Elizabeth E. Houser - A Womans Guide to Pelvic Health: Expert Advice for Women of All Ages

A JOHNS HOPKINS PRESS HEALTH BOOK

Expert Advice for Women of All Ages

ELIZABETH E. HOUSER, M.D.
and
STEPHANIE RILEY HAHN, P.T.

Note to the Reader: The information in this book should by no means be considered a substitute for the advice of qualified medical professionals. The descriptions and illustrations of womens pelvic problems provided in this book are examples only. A person may have pelvic problems that do not look like or act like any of the examples in this book. If you are worried about any pelvic symptoms, you need to consult a qualified medical professional. An examination with a qualified medical professional is recommended at least once a year. The services of a competent professional should be obtained whenever medical or other specific advice is needed.

All efforts have been made to ensure the accuracy of the information contained in this book as of the date of publication. The author and the publisher expressly disclaim responsibility for any adverse outcomes arising from the use or application of the information contained herein.

2012 Elizabeth E. Houser and Stephanie Riley Hahn
All rights reserved. Published 2012
Printed in the United States of America on acid-free paper
9 8 7 6 5 4 3 2 1

The Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryland 21218-4363
www.press.jhu.edu

Library of Congress Cataloging-in-Publication Data
Houser, Elizabeth E.

A womans guide to pelvic health : expert advice for women of all ages / Elizabeth E. Houser and Stephanie Riley Hahn.

p. cm.

Includes bibliographical references and index.

ISBN 978-1-4214-0691-6 (hdbk. : alk.paper) ISBN 978-1-4214-0692-3 (pbk. : alk.
paper) ISBN 978-1-4214-0757-9 (electronic) ISBN 1-4214-0691-8 (hdbk. : alk.
paper) ISBN 1-4214-0692-6 (pbk. : alk. paper) ISBN 1-4214-0757-4 (electronic)

1. Pelvic floorDiseasesPopular works. 2. Pelvic floorDiseasesTreatment
Popular works. 3. Urinary incontinencePhysical therapyPopular works.
4. WomenHealth and hygienePopular works. 5. Self-care, HealthPopular
works. I. Hahn, Stephanie Riley. II. Title.

RG482.H68 2013

616.620082dc23 2012008905

A catalog record for this book is available from the British Library.

are by Mary Crisler.
are by Holly Williams Photography.

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The Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible.

To all women who need help with their pelvic disorders

Millions of women begrudgingly toss adult diapers or feminine pads into their grocery carts each week, unaware that effective solutions are available to treat their leaking bladders. As a family physician, I know that many of my patients are embarrassed to talk about their symptoms, even when I raise the topic. Women often believe that major surgery is the only option. Most have never even heard of physical therapy for issues such as urinary or sexual problems.

Urologist Elizabeth Houser and physical therapist Stephanie Hahn have 33 years of combined clinical experience directly helping thousands of women overcome bladder and sexual dysfunctions. This book provides answers to questions that many women are too nervous or embarrassed to ask their doctors.

The authors clearly explain how weakened pelvic floor musclesas a result of childbirth, aging, or other lifestyle issuescan lead to distressing symptoms such as urinary incontinence. Each condition is covered individually, with detailed and easily understood descriptions. In the privacy of their homes, women with pelvic floor disorders can learn about the specific symptoms of their condition, medical tests to confirm their diagnosis, and myriad treatment options, from Kegels or acupuncture to medication or surgery. Side effects and success rates for each treatment option are discussed, as well as ways women can ask their doctors for help. The detailed at-home pelvic floor retraining program offers women a chance to alleviate symptoms on their own, step by step and week by week. This book is a practical guide delivered with compassion and understanding.

Women must seek help sooner rather than later since the probability of symptom improvement decreases over time, and conservative approaches, which may help some women avoid surgery, are more effective when used soon after symptoms occur. This book will give readers the confidence and knowledge to successfully address their bladder and sexual concerns with their health care providers, plus the tools to immediately begin a home program.

You need not be doomed to decades of accidents and extra laundry. The compassionate, practical information packed in this book will help you start jogging down that road to a healthier, drier you.

Jill Grimes, M.D.

Family Physician and Author of Seductive Delusions:
How Everyday People Catch STDs

www.JillGrimesMD.com

Associate Editor, 5-Minute Clinical Consult
Medical Professionals Leading Choice for Trusted
Clinical Content

Thanks go out to all the women in our urology and physical therapy practices who showed us how best to help them with their pelvic disorders; their requests paved the way for the content in this book. We want to thank our editor, Stephanie Yeh, who partnered with us from the start to turn our passion into this completed project. Thanks also go to our agent, Jeanne Fredericks, who worked tirelessly to find a home for this book. We are grateful to Johns Hopkins University Press executive editor Jacqueline Wehmueller and to editorial assistant Sara Cleary, who have made this process so smooth. We want to thank Mary Crisler for her ability to turn ideas into incredible illustrations. Our gratitude goes to Holly Williams for her beautiful photography and to Natalie Gauci, our model. Last but not least, we thank our friend and cheerleader Jill Grimes, who helped us immensely with the logistics of this book.

I WANT TO THANK MY HUSBAND , Chuck, who supported me while I laughed and cried writing this book. I also want to express my deep gratitude to my parents, Edward and Kay Houser, and my siblings, Melissa and Bruce Houser, who taught me to pursue my dreams without reservation. Thanks also go out to my extended family and friends, who acted as both cheerleaders and sounding boards throughout this whole process. Special thanks to my colleagues and mentors, Shelley Green, Douglas Flemons, Melody Denson, George Webster, and Jill Grimes, who have all inspired me to share my medical experiences and expertise with women in need. I will not forget the hundreds of women who have entrusted me with their most private, pelvic healththis book is for you. Finally, I especially thank my partner in this book, Stephanie Hahn, who brought her depth of knowledge of pelvic floor anatomy and function to this book. Without her partnership, this book would not be complete.

Elizabeth E. Houser, M.D.

I WANT TO FIRST ACKNOWLEDGE GOD for giving me the unique talents and interest I have for helping women with pelvic floor disorders to heal and recover a more active lifestyle. Thank you to my extremely supportive and loving husband, Michael, who first experienced my anguish at becoming incontinent at the age of 30 with a brand-new son. Michael has championed me these last 16 years as I have continued this journey both personally and professionally. I want to acknowledge my three sons for their understanding and encouragement during the three-plus years of writing this book. Next, thanks go to my parents, Bob and Peggy Riley, for instilling in me the desire to set and reach a goal that will enrich the lives of others around me. My gratitude goes to Mark Strickland and Resa Mein-holdt, who both believed in the need for physical therapy to help address pelvic floor disorders and who offered support as we opened the first physical therapy practice in Austin, Texas, to focus on womens health issues. Thanks to Diana Feltz, my mentor and friend, who taught me the art of Pilates. For my many patients and Pilates clients, who over the years have taught me how to help others, this book is for you. Thank you to my amazing friend and book partner, Elizabeth Houser, who has shared with me her passion and knowledge, and so much more, during these many years. Finally, to my extended family and friends, who have been encouraging and praying for me as I have walked this path, thank you!