A growing body of international research and recent expert commentary has exposed common myths about pelvic floor health, raising crucial questions for Thai readers about prevention, treatment, and societal awareness. As pelvic floor issues increasingly surface in medical and lifestyle conversations, Thai health professionals and the public alike must reconsider the idea that pelvic floor disorders are inevitable, unpreventable, or exclusive to women — and whether the all-popular Kegel exercises are always the answer.
Despite being fundamental to wellbeing, the pelvic floor — a “basket of muscles that sits at the base of your pelvis” supporting pelvic organs such as the bladder, bowel, and uterus or prostate — is rarely discussed openly, even in medical consultations. According to Dr. Sara Reardon, a board-certified pelvic floor therapist, “We’re never really taught about it… We don’t really get any education about how these muscles work and what’s normal” (The Guardian). Yet problems with these muscles can dramatically affect quality of life, manifesting as urinary incontinence, sexual dysfunction, pelvic pain, and more.
The lack of awareness is compounded by persistent misconceptions, particularly the idea that pelvic floor disorders only impact women. While risk factors such as pregnancy, childbirth, and menopause do disproportionately affect women, experts clarify that “everyone has a pelvic floor—males, females, children,” notes Dr. Reardon. Male patients, too, present with incontinence, pelvic pain, or rectal prolapse from chronic straining (The Guardian). Local Thai urologists collaborating with international bodies have echoed these findings, especially as Thailand’s aging population faces rising rates of urinary and fecal incontinence (National Science and Technology Development Agency).
Another damaging myth suggests pelvic floor disorders are simply an unavoidable part of aging, particularly for women. Dr. Cassandra Kisby, a urogynecologist at a US hospital, cautions, “Many things that happen to the pelvic floor are common, but don’t need to be accepted as the norm… I really urge patients to think about quality of life and what we can do about it because there are treatment options” (The Guardian). In Thailand, where it’s customary for elderly women to treat urinary leakage as ‘normal,’ a culture of silent acceptance prevails—older adults often avoid seeking help for symptoms that disrupt their daily lives (ThaiHealth).
Despite these barriers, global and Thai medical perspectives agree: pelvic floor disorders must be medically addressed, not endured. Unfortunately, many Thai physicians may not proactively inquire about pelvic floor symptoms during regular checkups, leaving patients to self-advocate or seek out specialized care such as urology or physical therapy services (Siriraj Hospital). The challenge is compounded by limited awareness of urogynecology—the subspecialty focused on pelvic floor disorders—both among the public and mainstream clinicians.
For those aware of pelvic floor exercises, “Kegels” are a household name, championed by online influencers and celebrity wellness brands. But are Kegels a universal fix? Not necessarily. Experts point out that strengthening the pelvic floor with Kegels may help individuals with weakness or mild incontinence, particularly post-childbirth. However, some patients’ pelvic floor issues stem from over-tight, rather than weak, muscles; indiscriminate Kegel practice can actually worse symptoms in these cases. “Ideally, care should be individualized and guided by a professional,” urges Dr. Ekene A Enemchukwu, director of a pelvic health center (The Guardian). For those struggling with pelvic pain or excess muscular tension, guided relaxation, mindful stretching, or targeted physiotherapy may prove more beneficial than Kegel exercises alone (PubMed).
Notably, the idea that there’s an “expiry date” for pelvic floor interventions is also outdated. Pelvic floor injuries can manifest or worsen years after childbirth or other risk events. “At any age you can start working on this and you can get improvement,” says Dr. Reardon (The Guardian). These findings underscore the urgency of Thailand’s movement toward “active aging” — a national policy framework emphasizing healthy longevity and prevention of disability among its senior population (Ministry of Public Health).
From a sociocultural perspective, pelvic health is heavily stigmatized in Thai society, with taboos and misconceptions lingering across generations. For example, postnatal recovery often involves traditional beliefs about ‘confinement’ and ‘wind in the body,’ which may prevent women from seeking contemporary pelvic floor therapy even when available (Journal of Health Research). Limited dialogue in schools and families perpetuates the problem, as many Thais only encounter pelvic floor terminology when symptoms become severe.
Public health researchers in Thailand are sounding alarms about the need for education, both in the medical curriculum and among the general populace (Mahidol University). Campaigns advocating pelvic floor health—especially targeted at teachers, expecting mothers, and seniors—could radically reduce preventable suffering and lower the national burden of age-related incontinence or sexual dysfunction. Increasingly, Thai hospitals are training specialized therapists and deploying resources in community health centers, yet much work remains (Thai Urogynecology Society).
Looking ahead, experts advocate for improved screening and interdisciplinary care, emphasizing early intervention and expanding access to urogynecological services across Thailand’s provinces and urban centers. Integrating pelvic floor health assessment into routine check-ups for women and men—especially those with childbirth trauma, prostate conditions, or chronic constipation—could identify problems before they escalate.
Well-informed patients also play a vital role in de-stigmatizing pelvic health. Learning to recognize ‘normal’ versus ‘unacceptable’ symptoms, and seeking care promptly, ensures that both somatic and emotional aspects of pelvic floor dysfunction are addressed.
For Thai readers wishing to safeguard their own pelvic health, recommendations include: (1) proactively discuss pelvic floor symptoms with a primary care physician; (2) avoid self-prescribing Kegels until consulting with a specialist, especially if experiencing chronic pelvic pain; (3) promote pelvic health education within families and communities; and (4) support local and national initiatives expanding access to pelvic floor therapy and professional screening.
As understanding deepens and taboos are brought to light, pelvic floor health needn’t remain a hidden burden. With the right knowledge, tailored support, and a commitment to overcoming myths, Thais of all ages and genders can reclaim confidence, mobility, and dignity.