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Study shows pelvic floor muscle exercises can relieve misery which affects one in 10 women

28 November 2013

A condition which leads to discomfort, pain and poor quality of life for thousands of women in Scotland every year can be improved using a simple set of pelvic floor muscle exercises, according to a GCU study published today in the world’s leading medical journal The Lancet.

Pelvic organ prolapse – when the bladder, womb or bowel moves downward from its normal position – is common and is associated with childbirth and increasing age.

The symptoms of prolapse affect between 5 and 10 per cent of women, however 40 per cent of the over 50s in one study had prolapse on examination. Seven per cent of women will undergo surgery for prolapse.

Women are often advised to do pelvic floor muscle exercises, but evidence supporting the benefits of such exercises has been limited up to now.

In the largest trial of its kind to date, Professor Suzanne Hagen, Programme Director at the Nursing, Midwifery and Allied Health Professions Research Unit, and her team have shown that the approach is effective and should be recommended to women with prolapse.

Professor Hagen said: “Although pelvic floor muscle exercises have been used to treat pelvic organ prolapse and more commonly urinary incontinence for a number of years, there was a surprising lack of literature to back up the use of these exercises for prolapse.

“We have now shown that one-to-one pelvic floor muscle training for prolapse is effective for improvement of symptoms associated with prolapse such as the feeling of pelvic heaviness and a bulge in the vagina, discomfort when standing, and interference with bladder and bowel function”

The study – ‘Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial’ – is published in the November 28 edition of The Lancet.

The pelvic floor muscles run from the pubic bone at the front of the pelvis to the base of the spine. They are shaped like a sling and help support the womb, bladder and bowel. The exercises, which should be decided for each woman individually after examination and teaching, involve regular and repeated squeezing of the muscles, with both short and long holds, to increase the muscle strength, stamina and bulk to offer better support for the organs above.

The team conducted a multicentre, randomised controlled trial at 23 centres in the UK, one in New Zealand, and one in Australia.

447 women took part in the study, with half being given a personalised programme of pelvic floor muscle training by women's health physiotherapists during 5 visits over 16 weeks and the other half being assigned to a control group who did not receive the exercises or the training.

Women in the intervention group reported fewer symptoms 6 months and again twelve months after entering the study.

Professor Hagen said: “Although this is the largest robust trial of its kind to date with more than 400 women taking part, more work needs to be done in this area. We have so far followed women up for one year but this may not be long enough to assess whether the effects of the exercises are maintained, and whether in the longer term women are prevented from going on to have surgery. Also we do not yet know if there are specific groups of women who will get more benefit from the exercises than others. These are questions we would like to address in further research.”

The Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU) where the research was undertaken is funded by the Chief Scientist Office (CSO) of the Scottish Government and hosted jointly by Glasgow Caledonian University and the University of Stirling. The study was funded by the CSOs Health Services and Population Health Research Committee.

Professor Brian Williams, Director of the Nursing, Midwifery and Allied Health Professions Research Unit, said: “This is an excellent piece of work which is of great benefit to the large number of women across t