A growing body of research sheds new light on pelvic floor dysfunction (PFD), a health condition now recognized as impacting up to half of all women at some point in their lives. According to a recent report in The Conversation, PFD is not only common after pregnancy and childbirth but is increasingly affecting physically active women and is a more significant issue than previously believed (The Conversation). This revelation prompts vital questions for Thai readers about prevention, early detection, and the importance of pelvic health for daily life and wellbeing.
Pelvic floor dysfunction refers to the inability of the muscles and ligaments in the lower pelvis to function effectively, often resulting in a range of symptoms, from urinary incontinence to pelvic organ prolapse and sexual discomfort. Are Thai women aware of their pelvic health? With Thai society witnessing an increase in exercise trends—such as high-intensity interval training (HIIT), CrossFit, and marathon running—this issue’s relevance may be greater than ever. Statistics cited in the latest research highlight that for women engaged in high-intensity exercise, the rate of symptoms rises to an alarming 63%. The implication is significant: pelvic floor health extends far beyond pregnancy and childbirth and is of concern to women of all ages and activity levels.
Pelvic floor muscles form a “hammock” structure that supports vital organs such as the bladder, bowel, and uterus. These muscles are responsible for maintaining continence and contribute to posture and core strength. Life events—including pregnancy, childbirth, menopause, and even everyday activities such as lifting—can all weaken or strain these essential muscles. Contrary to popular belief, even women who have never been pregnant or given birth may suffer from PFD, particularly those who participate in strenuous or repetitive physical activities. The repetitive increase in intra-abdominal pressure associated with heavy lifting or high-impact sport can gradually weaken the pelvic floor, especially if untrained.
Thai culture has traditionally placed emphasis on modesty, making open conversations about pelvic and reproductive health uncommon, which may obscure the true extent of the problem. However, symptoms such as leaking urine or faeces when coughing or exercising, a dragging feeling in the lower abdomen, visible vaginal bulging (prolapse), painful sex, bowel habit changes, and associated psychological effects—including embarrassment and reduced confidence—are prevalent and adversely impact quality of life. International studies, like those referenced in the article, mirror findings from Thai and regional hospitals, where urogynecology departments are reporting a steady rise in female patients presenting with such symptoms (BMJ Open).
Health experts stress that, while hormonal changes and physical stresses during pregnancy and childbirth are well-established causes, societal trends—including increased gym attendance, physical labor, and chronic constipation—also increase risk. According to a Thai physiotherapist specializing in women’s health at a leading Bangkok hospital, “Many of our patients who present with pelvic floor weakness or incontinence are fitness enthusiasts or young professionals—not just mothers or older women.”
Despite the rising prevalence, PFD often goes undiagnosed as symptoms may be perceived as a normal part of ageing or womanhood. Specialists urge early recognition. Typical symptoms include involuntary leakage of urine or feces, a heavy or bulging sensation in the vagina, difficulty emptying the bladder or bowels, recurrent urinary infections, and pain during intercourse. “Embarrassment is a major barrier to help-seeking,” reports a reproductive health nurse at a government hospital in northern Thailand, “but prompt diagnosis and early physiotherapy make a tremendous difference.” (Australian Journal of General Practice, NHS Pelvic Floor Disorders).
What are the underlying causes? In Thailand, increased rates of overweight and obesity, diabetes, and metabolic disorders in the population intensify the risk factors for PFD. Chronic constipation, common amid diets low in fiber, and cultural tendencies to delay urination also contribute to muscle strain. Meanwhile, adopting certain sports and work routines without dedicated pelvic floor training further amplifies vulnerability.
While conservative management—such as pelvic floor exercises (Kegels)—remains the first line of defense, many women are unaware of preventive strategies or how to properly train these muscles. The Conversation’s report offers a simple exercise: “Imagine you’re trying to stop yourself passing wind—squeeze and lift those muscles. Then imagine stopping the flow of urine. Lift both sets of muscles upward inside your body, hold, then relax. Repeat.” Regular practice can strengthen pelvic floor muscles, making them more resistant to common causes of dysfunction—pregnancy, aging, or high-impact exercise. Thai gynecologists and physiotherapists now routinely recommend pelvic floor muscle training for women at all stages of life—not just postnatal or elderly patients, but the physically active, new mothers, and even school-aged girls as part of preventive health education (Cochrane Library).
Healthcare experts across Thailand echo research findings that prevention is effective, accessible, and practical—yet underemphasized. The public health system provides access to women’s health physiotherapists, yet awareness remains low outside urban centers. A Bangkok-based pelvic health specialist comments, “With the right training, most mild to moderate PFD cases resolve or improve significantly within months. We must normalize speaking about pelvic health and ensure women understand this is not something to be ashamed of or tolerate in silence.” In addition, experts note that good toileting habits—such as avoiding going ‘just in case’ and not straining on the toilet—are key preventive strategies. Adequate hydration, a high-fiber diet, and proper lifting techniques also reduce strain.
Historically, pelvic floor health in Thailand was supported by traditional postnatal care practices, such as the ‘yu fai’ (postpartum rest and warming rituals). However, urbanization and changing lifestyles have led to reduced attention to such foundational care. The country’s ageing population, together with later childbearing and increased participation in physically demanding jobs and sports, means proactive pelvic floor health is crucial for women’s lifelong wellbeing. Notably, studies suggest that over half of Thai women affected by PFD never seek help due to stigma or misconceptions (Siriraj Medical Journal), underscoring the need for greater openness and public campaigns.
Looking ahead, the paradigm is shifting as PFD is increasingly recognized as a public health priority by clinicians and policymakers. In 2023, the Thai Ministry of Public Health issued updated guidelines for obstetricians and physiotherapists, advocating routine screening for pelvic floor symptoms at health checkups and during antenatal and postnatal visits. There is also a growing movement, supported by Thai women’s organizations, to integrate pelvic floor awareness into health education at the community level. International trends mirror this focus, with new mobile apps and wearable technologies designed to support pelvic muscle training gaining traction in Southeast Asia.
For Thai readers, the actionable message is clear: Pelvic floor dysfunction is common but not inevitable. Early intervention, regular exercises, and lifestyle awareness are key. If you experience unexplained urinary leakage, pelvic heaviness, or any of the symptoms described, speak with a healthcare provider. Clinical support—both in public hospitals and private practices—is available nationwide, and many physiotherapists specialize in women’s pelvic health. For those seeking more information, leading Thai hospital websites, the Department of Health, and international organizations like the International Urogynecological Association offer accessible, reliable resources.
Ultimately, every Thai woman, regardless of age or life stage, will benefit from understanding her pelvic floor and taking proactive steps to protect it. Starting the conversation with daughters, mothers, and friends is an act of empowerment—and a critical step towards normalizing pelvic health as a vital part of overall wellbeing.