Pelvic floor health—once a neglected topic in both medical curricula and public awareness—is in the spotlight again as leading physicians urge a rethink of common misconceptions. According to recent insights from international specialists, as highlighted in a May 2025 report from The Guardian, the pelvic floor’s crucial role in a wide spectrum of physical wellbeing is too often misunderstood by both patients and practitioners, potentially leaving millions—including Thais of all ages—in the dark about effective prevention and care strategies (The Guardian).
For many in Thailand, particularly women, knowledge of the pelvic floor is limited or associated only with childbirth or ageing. However, as the report clarifies through multiple expert perspectives, the pelvic floor—a complex “basket” of muscles supporting the bowel, bladder, uterus, or prostate—plays a foundational role in posture, continence, and sexual health. Dr. Sara Reardon, a board-certified pelvic floor therapist, describes how this group of muscles supports vital organs and daily life functions, yet most people receive little to no formal education about them.
Urogynecologists and pelvic health experts interviewed explain that pelvic floor disorders are much more common than recognised and not confined to women. Men and even children can experience conditions such as urinary or fecal incontinence, pelvic pain, and organ prolapse. “Everyone has a pelvic floor,” notes Dr. Reardon. Dr. Ekene Enemchukwu, director at the Stanford Pelvic Health Center, adds that dysfunction—ranging from pain to incontinence—can dramatically affect quality of life for all genders. Stress, emotional trauma, and lifestyle factors impact the pelvic region’s health, as chronic tension or strain can disturb muscle function.
The article challenges the notion that pelvic floor disorders are inevitable, merely a byproduct of age or childbirth. While symptoms such as urinary leakage are indeed prevalent—affecting up to 50% of adult women and three-quarters of women over 65—expert clinicians stress that these are common, not normal, and should not be passively accepted. “Patients can seek effective treatment and improve their quality of life,” urges Dr. Cassandra Kisby, urogynecologist and assistant professor at Duke University Hospital.
Another major concern is that primary healthcare providers rarely screen for pelvic floor issues. “Physicians aren’t screening women for these issues,” says Dr. Reardon, highlighting systemic gaps in holistic care. The medical system’s segmented approach—gynaecologist for uterus, gastroenterologist for the colon, urologist for the bladder—means pelvic muscles are often overlooked. This problem also affects Thailand, where many patients are unaware of pelvic health subspecialties such as urogynecology, and may delay seeking specialist care until symptoms are severe.
A persistent myth in both Western and Asian cultures is that Kegel exercises—repetitive contraction of pelvic muscles—are a one-size-fits-all solution. The article debunks this, pointing out that for individuals whose pelvic floor disorders stem from overly tight or tense muscles, Kegels may exacerbate the problem. For some, “yoga-type stretches, breathing, and external or internal muscle release” are more appropriate, emphasises Dr. Reardon. Experts unanimously recommend seeking professional assessment before starting any exercises, highlighting the complexity and variability of pelvic floor issues.
A final misconception is that pelvic floor health is only relevant at younger ages or soon after childbirth. Dr. Kisby explains that many women present with symptoms years—even decades—after initial childbirth injury, but “it’s never too late” for improvement. Dr. Reardon concurs: patients, whatever their age or duration of symptoms, can benefit from targeted therapy and lifestyle modification.
For Thai society, this new wave of pelvic health awareness comes at a crucial time. With Thailand’s rapidly ageing population—one of the fastest in Southeast Asia—conditions like incontinence and pelvic pain are poised to increase dramatically (WHO). Yet research by local academic institutions finds that cultural taboos, modesty, and lack of information often prevent people from seeking help for pelvic floor symptoms, particularly older women in rural areas (Mahidol University Journal). There is also a dearth of urogynecological specialists in Thailand’s public health system. Most local maternity clinics counsel patients on childbirth recovery but rarely screen specifically for pelvic floor dysfunction unless symptoms are reported, compounding the knowledge gap.
Recent years have seen some signs of progress. Thailand’s Ministry of Public Health and leading hospitals such as Siriraj Hospital have begun to include pelvic floor workshops and physiotherapy referrals as part of postpartum care and menopausal health check-ups, focusing especially on women at higher risk for incontinence or prolapse (Siriraj Hospital). Digital health platforms are also making inroads: Telemedicine consultations for pelvic pain and urinary symptoms increased during the COVID-19 pandemic, helping to reduce stigma for those uncomfortable seeking in-person care.
Globally, scientific research is also rapidly advancing. A review published in the International Urogynecology Journal asserts that “multidisciplinary management”—involving physiotherapists, gynecologists, and psychologists—is best for most patients (International Urogynecology Journal). Experts recommend early intervention and regular self-assessment, including awareness of symptoms such as pain during intercourse, unexplained back pain, and urinary leakage with sneezing or exercise.
How should Thai readers respond? First, increased public education is vital: schools, public health campaigns, and community-based clinics should begin to incorporate pelvic floor health into the conversation. Individuals, regardless of gender, should feel empowered to mention pelvic symptoms to their doctor and not dismiss signs like leakage or pain as “just age” or “part of life.” Physical therapists with pelvic health expertise can personalise exercise plans according to individual needs, rather than relying solely on Kegels. Digital resources and telemedicine platforms are also valuable for accessing care in privacy, especially for those in rural provinces. For medical professionals, incorporating pelvic floor assessment into routine check-ups could help thousands avoid years of unnecessary discomfort.
The societal implications are clear: raising awareness about the true nature of pelvic floor health and dispelling persistent myths can dramatically improve quality of life for Thais of all ages. This requires coordinated action across health education, professional training, and addressing cultural taboos. As physicians globally reiterate, it’s never too early or too late to take pelvic health seriously—and the benefits extend far beyond the individual, impacting families and communities across Thailand.
For further practical steps, readers are encouraged to seek information from their local health center, request pelvic floor assessments during health check-ups, and advocate for the inclusion of pelvic health in national public health strategies. By opening the conversation and listening to expert advice—rather than outdated social narratives—Thais can take control of pelvic health for a better future.