Pelvic health? What is it and why does it matter? Today we’re taking a deep dive into the topic with Dr. Rachel Gelman, who spoke to us about her work in the women’s and more specifically pelvic health space, the trends she sees and which companies she’s following.

Dr. Rachel Gelman is a clinician, writer and educator. She holds a Doctorate in Physical Therapy from Samuel Merritt University. She is the owner and founder of Pelvic Wellness & Physical Therapy in San Francisco. She specializes in treating pelvic floor dysfunction with her passion being sexual health/dysfunction. She is a member of  the International Society for the Study on Women’s Sexual Health, the Sexual Medicine Association of North America and the International Society for the Study on Sexual Medicine. She is an adjunct instructor at Samuel Merritt University where she teaches the pelvic health curriculum in the Doctor of Physical Therapy program. 

(c) Courtney Stockton Photography

Rachel, can you tell us a little more about yourself and your work? Why did you develop an interest in pelvic health?

I am a physical therapist who specializes in pelvic floor dysfunction. The pelvic floor is a bowl of muscles inside the pelvis that supports the pelvic organs: bladder, colon, prostate or uterus. So I treat the muscles inside and around the pelvis. My patients usually have bowel, bladder, sexual dysfunction and/or pelvic pain. 

Outside of clinical care, I have worked with various companies in the sexual wellness space. I love being able to apply my clinical knowledge and develop other skills around strategy, development and marketing while working with these brands. 

I wish I had a cooler story. Like I saw a cloud that looked like a vulva. In reality, it was a speciality I discovered early on in physical therapy school and I just fell in love with it. I have always had an interest in sexual health and when I discovered this speciality existed it seemed like it was meant for me. 

Maybe let’s start with a definition: What is pelvic health, what are some conditions and symptoms and what are common treatments?

Most often I am talking about the pelvic floor muscles and the organs that live in the pelvis. So optimal pelvic health would be a well functional bowel and bladder, no issues or pain with sex and no pelvic pain. 

Some common conditions and symptoms include: Urinary Urgency. Urinary Frequency. Pain with Urination. Urinary Incontinence. Nocturia. Post-void dribbling, Constipation. Pain with bowel movements. Pushing or straining with Bowel Movements. Feeling of Incomplete Bowel Movements. Hemorrhoids. Anal Fissures. Fecal Incontinence, Vaginal Pain. Vulvar Pain. Penile Pain. Scrotal Pain. Pain in the Perineum. Tailbone Pain. Rectal Pain. Low back Pain. Hip Pain. Dysmennorhea. Endometriosis. Chronic Prostatisis (CPPS). Vulvodynia. Interstitial Cystisis. Pudendal Neuralgia, Dyspareunia (Pain with sex). Genito-Pelvic Pain/Penetration Disorder. Vaginismus. Persistent Genital Arousal Disorder (PGAD). Pain with Erections and/or Ejaculation.  Pain with orgasm. Erectile Dysfunction. SIJ dysfunction. Diastisis Recti. 

That is not a comprehensive list. Most of the conditions and symptoms may require an interdisciplinary team. Treatment may include: pelvic floor PT (unsurprisingly), medications or other medical management (injections), acupuncture, yoga, psychotherapy or counseling, meditation or dietary changes. It really depends on the person, but there are a lot of treatment options available for anyone experiencing the symptoms or conditions listed above. 

How has the space evolved over the past years and months? Is there a change in patient behavior? Have treatment options and preferences evolved?

In the world of pelvic PT, things have changed a lot. In general it is a relatively new speciality but people are talking about the pelvic floor more which is great because so many people suffer in silence and they shouldn’t have to. I see a lot of people who have had pain with sex or incontinence for years and thought it was just their new “normal” and nothing could be done about it. 

A lot of businesses, like Ohnut, Private Packs and Elvie are talking about the pelvic floor and/or pelvic pain which is shedding light on these issues. 

Let’s talk a little more about pelvic health products created by those femtech companies. What are consumers looking for in a product and what should they be looking for?

It is such a big market that it is hard to say. Pelvic health can include pregnancy/postpartum, sexual wellness (lubricants, dilators, vibrators etc), urinary care (incontinence), bowel care or things to address pain. Then there are telehealth and digital health companies that are providing direct patient care. In general, it seems like consumers want products that are convenient and would help them between appointments with their providers, or in many cases people don’t have access to a specialist and need to address their symptoms at home. 

So, I also think consumers value when products have a healthcare professional backing the product in some fashion.

Are there any trends worth noting?

The pelvic health market is definitely growing. I see a lot of products popping up and again it is exciting to see more people wanting to learn about the pelvic floor. It isn’t talked about enough and it should be!

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