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Breaking Pelvic Health Myths

Nov/03/2023 / by Abhijit Masih

Dr. Rena Malik is a board-certified urologist and specialist in female pelvic medicine and reconstructive surgery. She has been recently honored with the Young Urologist Award. She is passionate in helping patients manage complex concerns, including pelvic organ prolapse, urinary incontinence and neurogenic bladder. Dr. Malik busts some common myths and gives professional advice on how to tackle pelvic related issues.

What are some of the common issues faced by women pertaining to pelvic health?

I see patients for many things. Some of them include urinary incontinence. And there are two different types of incontinence. For the average person, you just know you’re leaking. The other things we deal with is an over active bladder. About 16% of people in the United States have over active bladder, which is probably an underestimate. So people go to the bathroom more often and they need to go very urgently or having leakage related to that. That can be a huge distraction for people day to day. I also deal with prolapse, which is a vaginal bulge. I also take care of any problems with urination in general and sexual dysfunction for both men and women. So if you’re having issues with sexual functions, you’re not meeting orgasm or you’re having insufficient lubrication or pain. Those are really important things to talk about, and we don’t talk about them enough, especially in the South Asian household. I think it’s important that you shouldn’t suffer in silence. 

South Asian women tend to not make their health a priority. Why is that? What advice do you have for them?

We’re raised in a certain way—to be calm, quiet, obedient, beautiful and not draw too much attention. Where if you’re having this problem, just deal with it. Don’t bring it up. Don’t talk about it. Take care of your family, take care of your kids, take care of everyone else and we come last. I think that’s just a shift. I can be a better person if I feel better right. I can perform better in every other aspect of my life, if I prioritize my health. I think we just forget that step.

What advice would you have for women who are facing problems? How do they bring their issues forward?

For many patients it can be very nerve wracking. Oh, how do I bring this up? What do I say? And then you forget because you’re so stressed. So I would recommend before you go to the doctor, write down the things that are bothering you. Also take notes so that you remember what you heard, because you’re a little nervous. Fortunately there are so many wonderful resources available now for education. You can learn about the condition that you have before you go to the doctor so that you can ask more educated questions. There is no reason to be embarrassed. Whatever it is, we’ve heard it. There is nothing you can do to embarrass us. So please feel comfortable.

What are some of the lifestyle changes one can make in their lives so that they do not have problems of the pelvic?

If you’re overweight, losing weight can help improve all of these symptoms. Second, watching what you’re drinking and eating. Certain things can irritate the bladder, like coffee or tea, alcohol, spicy food, tomato based products and even sparkling water. So people drinking a lot of carbonated beverages can notice some irritation. So what I tell people is don’t get rid of everything all at once. Try one thing at a time. Remove it from your diet. If you are having constipation, try to fix that, because constipation makes urinary symptoms worse. Those are the easy things that you can do. The other thing is to do pelvic floor exercises to help strengthen the pelvic floor and potentially improve symptoms. I caution, though, if you’re having any pain stop doing those exercises and see a specialist.

What are some of the common myths about women’s sexual health that you would debunk?

One that’s very common is that lubrication is entirely associated with arousal. If she’s not lubricated, she’s not aroused, or if she is lubricated, she is aroused. That’s not always the case. As women enter pre menopause and menopause, their lubrication can decrease. It doesn’t mean that you’re not aroused that there’s some something wrong with you. Similarly, if you’re on certain medications, even as a young woman, it can interfere with the amount of lubrication you make. Our body is lubricating for protective reasons. So this is completely normal. Your body is completely healthy the way it is. Your vagina cleans itself. A big myth is that you need to use all these products, but really you just need to use a very gentle soap on the hair bearing areas and then let soapy water rundown. And then the last one is that people who are getting recurrent bladder infections or UTI’s, they often feel like they’re dirty or they’re doing something wrong when in reality, that’s not the case. Usually there’s some problem with hormones, or there’s a problem with the microbiome in that area. That’s not something you did or got from your partner. It’s not that you are not clean. I want people to feel comfortable. 

One of the most common ailments for women is UTI, what are some ways to treat it at home, without antibiotics?

Increasing your fluid intake is the cheapest and the easiest way to reduce your risk of UIT’s. That includes the fluid you’re drinking with your tea or the fruits, but certainly 2 or 3 liters is going to be really beneficial. Making sure you urinate after having sex can be helpful as well. There’s a lot of misinformation about cranberries. If you just drink the juice from the store that’s not going to do anything. You need a concentrated amount of a substance called proanthocyanidins, found inside the berry. It has been proven to also reduce the risk of recurrent UTI.

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