Destigmatizing Pelvic Floor Dysfunction with Digital Health

Musculoskeletal (MSK) care may be a core focus of the healthcare industry, but pelvic floor health remains an overlooked and under-treated corner of the MSK space. The lack of appropriate and easily accessible care in this field leaves countless individuals alone to face chronic, debilitating—yet highly treatable—pelvic pain.

As a first step to driving change, employers and payers alike must understand the scope and severity of the issue to bring the right care to individuals who have waited decades for relief.

Characterizing pelvic floor dysfunction

The pelvic floor describes a group of muscles that work together to promote proper function in a number of pelvic organs and help stabilize the trunk. When this intricate network fails to work properly, overactive and/or under-active muscle activity can lead to a variety of bowel, urinary, and reproductive issues–as well as pain. 

Although pelvic floor dysfunction is not often discussed, its burden is felt: An estimated 32 percent of women and 16 percent of men suffer from at least one pelvic floor disorder (Kenne, 2022; Smith, 2016). Among these disorders, the most common are bowel dysfunction, urinary incontinence, and pelvic organ prolapse (Kenne, 2022). The causes of pelvic floor dysfunction are not fully understood, but certain factors have been shown to increase an individual’s risk of developing one of these disorders, including older age, childbirth, physical and emotional trauma, surgery, and higher body mass index (BMI) (Grimes, 2023).

Despite the large number of individuals already impacted by pelvic floor dysfunction, the prevalence rate is only expected to grow as the population trends toward higher BMI and older age (Kenne, 2022). In light of the coming surge of pelvic health disorders, critical changes must be made to knock down barriers to care and provide patients with appropriate treatment.

Understanding the deep impact of stigmatization

Given the inherent sensitivity of pelvic floor health, many patients report feeling too embarrassed to share their concerns with their clinician (Kenne, 2022). Some view their symptoms as a natural part of aging, while others aren’t aware that pelvic floor dysfunction is a possible diagnosis with effective treatment (Minassian, 2012). On the whole, at least 50 percent of women do not seek treatment for urinary incontinence—one of the most common pelvic floor disorders—and even fewer receive specialized care (Brown, 2021; Minassian, 2012).

Moreover, embarrassment and poor communication with clinicians aren’t the only factors that block access to care. Pelvic floor dysfunction is also a health equity issue, as women are less likely to seek care if they don’t have access to regular pelvic exams from their primary care clinician or OB/GYN. The same racial, socioeconomic, and geographical barriers that impact the healthcare system as a whole obstruct access to this area of medicine as well (Brown, 2021). 

On the whole, at least 50 percent of women do not seek treatment for urinary incontinence—one of the most common pelvic floor disorders—and even fewer receive specialized care.

How inappropriate care skyrockets costs  

If patients with pelvic pain make it past the hurdles of stigmatization and access, they’re often met with another challenge: inappropriate care. Like countless other MSK conditions, pelvic floor dysfunction frequently jumpstarts a cycle of unnecessary and expensive treatment that drives minimal improvement at best. 

One electronic health record analysis quantified the financial burden of chronic pelvic pain in both men and women and found that, for in-network services alone, the average cost per patient reached $30,000 (Hutton, 2023). In hindsight, the authors of the report noted that many of the diagnostic tests, imaging scans, treatments, and surgeries employed to address chronic pelvic pain were highly inappropriate and only served to further multiply the cost of care (Hutton, 2023). 

Like countless other MSK conditions, pelvic floor dysfunction frequently jumpstarts a cycle of unnecessary and expensive treatment that drives minimal improvement at best.   

How digital health unlocks access to the right care

From a dual health equity and value-based care lens, digital health reduces much of the friction felt by patients struggling with pelvic pain. As a virtual-first medical practice with multidisciplinary doctor-led teams available to anyone anywhere in the country, Vori Health is committed to providing better access and better care for pelvic pain.

Vori Health physician and pelvic floor specialist Carolyn Chudy, MD, plays a lead role in this effort. “Pelvic health is not usually something people want to discuss with their friends, family or even their doctor, so it feels taboo to many patients,” shares Dr. Chudy. “At Vori Health, our convenient video visits help relieve those feelings. From the privacy of their own homes, patients can speak to clinicians, get their questions answered, and get their pain addressed by pelvic health experts.” 

Dr. Chudy and the Vori Health team’s approach to pelvic floor dysfunction is unique from other physical therapy-only solutions. Dr. Chudy explains that, “Because a specialty medical doctor is leading the care team, the medical history and examination is viewed through a lens of restoring function in addition to relieving pain or other symptoms.” This includes a comprehensive look at each individual’s:

• Gynecological factors (pregnancy, childbirth/complications, fibroids, infertility)
• Sexual history (pain with intercourse)
• Bladder symptoms (frequency, urgency, leaking)
• Other MSK factors (hip or back pain)
• Exercise and activities
• Diet

After a thorough medical evaluation, Vori patients are then connected with a personalized care plan that gets to the root causes of pain without unnecessary testing or procedures. “Once a patient is feeling better, they may be more likely to share their experience,” explains Dr. Chudy. “This ends up helping others in need get the care they deserve.”

By destigmatizing pelvic floor dysfunction and connecting individuals with the care they truly need, Vori Health is leading the charge in driving value for pelvic floor care. 

Learn more about how Vori Health can help you provide high-value care for your members and employees suffering from pelvic floor dysfunction.

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REFERENCES

• Kenne, 2022: Kenne KA, Wendt L, Jackson JB. Prevalence of pelvic floor disorders in adult women being seen in a primary care setting and associated risk factors. Sci Rep. 2022;12(1):9878.
• Smith, 2016: Smith CP. Male chronic pelvic pain: An update. Indian J Urol. 2016;32(1):34-39.
• Grimes, 2023: Grimes WR, Stratton M. Pelvic Floor Dysfunction. StatPearls Publishing; 2023. Accessed June 16, 2023.
• Minassian, 2012: Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012;23(8):1087-1093. 

• Brown, 2021: Brown O, Simon MA. Applying a Health Equity Lens to Urinary Incontinence. Clin Obstet Gynecol. 2021;64(2):266-275. 
• Hutton, 2023: Hutton D, Mustafa A, Patil S, et al. The burden of Chronic Pelvic Pain (CPP): Costs and quality of life of women and men with CPP treated in outpatient referral centers. PLoS One. 2023;18(2):e0269828.