Skip to main content

'Say No to Power Peeing': Latest Insights on Pelvic Floor Therapy and What Thai Women Need to Know

6 min read
1,342 words
Share:

The latest recommendations from leading pelvic floor therapists emphasize a surprising set of tips for women’s health, such as “Say no to power peeing”—advice that challenges some common restroom habits and highlights new approaches to managing pelvic floor disorders. Drawing on recent research and expert interviews, the movement for improved pelvic floor care is rapidly gaining traction globally and is increasingly relevant for Thai women, given the high prevalence of related disorders here and the emerging options for therapy in Thailand.

Pelvic floor dysfunction can have a profound impact on quality of life, causing symptoms that range from urinary leakage, constipation, and painful sex, to weak orgasms and pelvic organ prolapse. As discussed in a recent NPR interview with a veteran pelvic floor physical therapist, one in three women will experience some form of pelvic floor disorder during their lives. In Thailand, rates of conditions like urinary incontinence (UI) mirror global data, with studies showing that UI affects up to 36.5% in community surveys and as much as 75.3% in hospital-based studies among Thai women (IUGA report). Genital prolapse, another major pelvic floor issue, has a prevalence of 70% among elderly Thai women in some reports (PubMed).

The pelvic floor is a “basket” of muscles at the base of the pelvis supporting the bladder, bowels, and reproductive organs. These muscles coordinate with the abdominal and spinal muscles to enable core strength and continence. Yet, as experts point out, few people—even women—can confidently identify these muscles or know how to assess them for dysfunction. A lack of public awareness leads to long delays in seeking help, while social taboos about intimate health issues in Thailand often prevent open discussion and timely intervention (Bumrungrad International Hospital).

Research and clinical practice confirm that targeted pelvic floor physical therapy (PFPT) is highly effective in managing and preventing symptoms. Women are often surprised to learn that the muscles contracting during orgasm are pelvic floor muscles; weakness or tension in these muscles can lead to painful or weak orgasms, and even sexual dysfunction. More common, perhaps, are daily life symptoms like straining to urinate or move bowels, which result from having too tight or too weak pelvic floor muscles.

One of the most counterintuitive pieces of advice from leading therapists is to avoid “power peeing”—forcefully pushing out urine. Instead, the bladder should be allowed to empty passively while sitting relaxed on the toilet, as straining builds unnecessary pressure and eventually weakens the pelvic floor muscles. Squatting or hovering, while sometimes practiced for hygiene in Thai public restrooms, is also discouraged because it prevents full relaxation and can contribute to chronic tension or incomplete emptying.

Tense pelvic floor muscles are directly linked to chronic constipation, incomplete bowel emptying, and even hemorrhoids or anal fissures. Likewise, tightness can create sexual pain during intercourse, tampon use, or medical exams, causing women to avoid needed care. On the other end of the spectrum, weakness in the pelvic muscles is associated with involuntary leakage of urine during coughing, sneezing, or exercise—and pelvic organ prolapse, where organs descend into or outside the vaginal canal.

Experts recommend exercises to improve both strength and flexibility—quick and sustained “Kegel” contractions, performed in various positions and integrated into daily activities like squats and lunges. Deep slow breathing, mindful posture adjustments, and stretches such as yoga’s “child’s pose” or “happy baby” are also strongly encouraged. Home tools like therapy wands or vaginal dilators are emerging adjuncts to relax tight muscles, though they should be used under professional guidance (Wikipedia: Pelvic Floor Physical Therapy).

Access to qualified therapists remains a challenge. In the United States, physical therapists with specialized pelvic floor certification can assess patients without a doctor’s referral, and best practice calls for a combination of manual therapy, exercise, and home programs tailored to each woman’s needs. In Thailand, options for assessment and therapy are expanding. Major private hospitals and specialized centers now offer PFMT (pelvic floor muscle training), often using advanced techniques like high-intensity electromagnetic field devices (Bangkok Hospital, Revival Clinic Bangkok). However, knowledge and acceptance remain limited: a study found most Thai women are not initially aware of pelvic floor exercises but are “very interested” in practicing them after learning about their benefits (PubMed study).

Drilling down to the cultural context, the reticence to discuss intimate health issues is amplified by traditional norms about modesty and privacy in Thai society. Many women may hesitate to seek help for symptoms they consider embarrassing or private. Yet, the relatively high rates of pelvic floor disorders observed in both older and younger Thai women highlight an urgent need for broader public education and destigmatization campaigns. Historically, pelvic floor dysfunction was considered an unavoidable consequence of aging or childbirth, with little recourse beyond surgical repair. Today’s evidence-based approach recognizes the value of preventive care, conservative therapy, and early intervention.

Recent innovations in PFPT are driven by better understanding of anatomy and pathophysiology, but also by recognition of the impact on quality of life, mental health, and sexual wellbeing. New research published in international journals underscores the importance of addressing not just urinary symptoms but also sexual function and psychological burdens. For example, studies link pelvic floor health to reduced anxiety, depression, and better postpartum recovery, and confirm the effectiveness of therapy for conditions like post-prostatectomy urinary incontinence in men (PubMed review). In Thailand, the growing presence of urogynaecology clinics and women’s health centers offering comprehensive pelvic floor programs is an encouraging development.

Looking forward, several issues deserve close attention. First, there is a need for nationwide screening programs, especially targeting high-risk groups such as elderly women, postpartum mothers, and female athletes. Second, integrating pelvic floor health education into antenatal and school health curricula could empower more Thai women to take charge early. Third, more local research and awareness-raising among family doctors and gynecologists would help close the knowledge gap, ensuring women of all ages receive holistic care.

For Thai women experiencing symptoms—whether occasional leaks, pelvic pain, or difficulty with sexual function—the recommendations are clear: start by consulting a qualified provider for an assessment. Check with your primary care doctor or seek out specialized clinics at major hospitals. Inquire about whether the physical therapists are trained to perform internal pelvic floor muscle assessments and offer a mix of therapeutic interventions beyond machine-based treatments. If your symptoms suggest infection (burning, foul-smelling urine, unusual discharge), seek medical evaluation first to rule out underlying conditions.

Reflecting on the new paradigm, pelvic floor health is becoming a mainstream topic worldwide and should be normalized in Thailand as well. Simple steps, like avoiding straining while urinating and defecating, improving posture, and doing regular pelvic muscle exercises, can make a significant difference. Authorities could encourage open discussion and provide resources in public health campaigns, just as they have with other women’s health topics.

For individual Thai readers: If you experience unexplained urinary leakage, difficulty emptying your bladder or bowels, sexual pain, or pelvic pressure, remember that help is available and you are not alone. Talk to your healthcare provider openly about your symptoms and ask about pelvic floor therapy options. Explore educational resources provided by reputable hospitals such as Bumrungrad and Bangkok Hospital, and consider joining support groups or online forums to learn from others’ experiences. Practice the habit of relaxed, unhurried toileting, mindful sitting posture, deep breathing, and regular Kegel routines.

Broadening conversations about pelvic floor health—and bringing them into clinics, households, and classrooms—will improve the well-being of Thai women and help the country catch up with global trends. Encourage friends and family members who may benefit from this knowledge to seek help or simply start the conversation. Good pelvic floor health is a foundation for long-term wellness and should be a priority for women of all ages.

Sources:

Related Articles

6 min read

Breaking the Silence: New Research Sheds Light on Why Runners Experience Urinary Leaks

news exercise

For many Thai runners and fitness enthusiasts, the thrill of crossing a finish line can be dampened by an awkward, often embarrassing problem: urine leakage during strenuous activity. Recent international research and expert commentary reveal that “peeing your pants” while running is not only common, it’s a growing topic of open discussion and scientific scrutiny—which matters deeply in Thailand’s increasingly active, health-conscious society.

Urinary leakage during running, officially termed stress urinary incontinence (SUI), occurs when physical activity or exertion—like running or even a forceful cough—puts extra pressure on the bladder, leading to involuntary urine loss. This condition affects runners of all ages and backgrounds, but is reported most frequently among women, particularly those participating in high-impact sports. As the Thai running scene continues to boom, from Bangkok’s major marathons to local park joggers, understanding this phenomenon has fresh and profound relevance (Deseret News, MSN Health, RUN | Powered by Outside).

#UrinaryIncontinence #Running #WomenHealth +8 more
4 min read

US Syphilis Surge Raises Alarm After Federal STI Lab Closure with Lessons for Thailand

news health

A recent report by The Guardian has drawn attention to a dramatic surge in syphilis cases in the United States, a public health crisis made worse by a decision during the Trump administration to shutter a key federal Sexually Transmitted Infection (STI) laboratory within the Centers for Disease Control and Prevention (CDC) The Guardian. This controversial move, now under sharp scrutiny, has come at a pivotal moment as syphilis infections in the US hit record highs. For Thailand, this development is a stark warning of the critical importance of sustained investment in public health infrastructure—and offers valuable insights into local disease prevention strategies.

#Syphilis #STI #PublicHealth +7 more
5 min read

Beyond Crunches: Latest Research Reveals the Most Effective Core Exercises for Women

news exercise

A new wave of expert-backed recommendations is challenging the traditional set of core workouts, urging women to look beyond the classic crunches and planks. According to leading fitness and physiotherapy professionals, a diverse approach to core training—spanning from breathwork to resistance-loaded movements—offers the most significant health benefits and functionality for women across all life stages. This latest guidance is especially relevant for Thai women seeking effective, safe ways to build core strength tailored to their unique health needs and cultural routines (Well+Good).

#CoreExercises #WomensHealth #PhysicalFitness +6 more

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.