J is for . . . The ABC's of Pelvic Health

At Pelvic Health Melbourne (PHM) we are sensitive to the long and ongoing physical and emotional journey gender affirming surgery can entail. Your ongoing commitment to hormonal management, adjusting to the physical change, enduring the surgeries and the recovery process as well as the ongoing emotional journey and counselling required to help you along the way. Some of the components an individual may experience on their gender affirming journey may include: 1. Hormone Replacement Therapy (HRT): Estrogen (typically the primary female hormone) is used to develop female secondary sexual characteristics like breast development, redistribution of body fat, and skin changes. Anti-androgens (such as spironolactone or finasteride) block the effects of testosterone, which is important for reducing male-pattern hair growth, deepening of the voice, and other masculine features. Testosterone (typically the primary male hormone) is encouraged to promote features such as hair growth, muscle growth, voice changes and others. Ongoing contact with an experienced Endocrinologist - to monitor and adjust hormonal therapy to balance the ongoing changes of affects and side effects of hormonal therapy as we age. 2. Surgical Procedures: Breast Augmentation: While HRT can cause breast development, some individuals may opt for surgery to achieve a fuller chest. Orchiectomy (orchiedectomy) and penectomy: Surgical removal of both testes and the penis. Vaginoplasty: A common surgery for creating a neovagina, allowing for sexual function and appearance that is consistent with female anatomy. Vulvoplasty: surgery for creating a neovulva (vulva without a vagina) with the external appearance of female anatomy. Facial Feminization Surgery (FFS): Some transgender women may undergo surgery to soften facial features to achieve a more feminine appearance. Voice Feminization Surgery: This can alter pitch and resonance, though voice therapy is often used alongside or instead of surgery. 3. Psychological Support: Transitioning involves significant psychological changes and challenges, so counselling or therapy with a provider knowledgeable about transgender issues is often recommended. This helps with mental health, body image, and managing potential dysphoria during the transition. Your transition will be unique and we hope you have the support team helping you to navigate the bumps in the road, and provide resources and treatment you may need. At PHM we support individuals surgically transitioning with a prehab and rehab routine. Our prehab session involves receiving bladder, bowel, intimacy, and pelvic floor muscle baseline function to address any pelvic health concerns before surgery. Post-surgery we assist with vaginal dilators to maintain the vaginal space, advice and massage for wound healing, and return to exercise and life. We can also support you with pelvic pain conditions such as; vaginismus, vulvodynia and endometriosis. For all our community we can help with pelvic and/or intimacy pain. This may involve symptoms in the abdomen, hips, groin, and intimate areas.

There are so many wonderful elements experienced during pregnancy and we do our best to be healthy throughout. We remember to take our prenatal vitamins to ensure our body and bub are getting enough of what's needed. We stay clear of certain foods to avoid infections. We keep our body active by exercising but we don't always remember to care for our pelvic floor. During pregnancy, muscles of your pelvic floor are stretched and weaken. These muscles help to control your bladder. When your pelvic floor muscles are weak, they can't always stop your bladder from leaking. This leaking happens mostly when you cough, laugh, sneeze, lift or exercise. You may also find holding in a wee difficult, like when putting a key in the front door, suddenly the urge is greater. By performing pelvic floor exercises, you can strengthen the muscles. Pelvic floor muscle training will assist the body to cope with the growing weight of the baby. Stronger muscles before bub is born will help to reduce or avoid stress incontinence after pregnancy. It's never too early to start doing pelvic floor exercises, but the earlier and more regularly you practice them throughout pregnancy, the greater the benefits. If you're unsure if you're performing pelvic floor exercises correctly or would like some guidance, we can help!

Incontinence, intimacy pain and initial appointment all start with the letter I and are all related to pelvic health. How can we help?