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Pelvic healthJun 29, 2021

Nice draft guideline recommends pelvic floor muscle training courses for thousands of women

Physiotherapists and other appropriate clinicians should be offering three-month pelvic floor muscle training courses to as many as 140,000 women a year, according to a draft guideline.

The National Institute for Health and Care Excellence (Nice) released a draft guideline on the prevention and non-surgical management of pelvic floor dysfunction yesterday (28 June).

Photo Credit: Shutterstock
A group of pregnant women tones up their pelvic floor muscles

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Deadline for responses

It has set a deadline of 9 August for stakeholders to respond to its draft recommendations, which cover topics such as the prevention, assessment, and the non-surgical management of pelvic floor dysfunction in women – and also in girls aged 12 and upwards.

According to the draft guideline, three-month programmes of supervised pelvic floor muscle training that help prevent pelvic floor dysfunction should be available to pregnant women who have reached the twentieth week of their pregnancy – if they have a mother or sister with pelvic floor dysfunction.

Women who have experienced certain risk factors while giving birth should also be offered the programme during their postnatal care.

The programmes should be supervised by physiotherapists or other healthcare professionals who can tailor exercises to address the needs of individual women and monitor their progress. Up to 140,000 women annually year could benefit from this preventive strategy, Nice claims.

Nice wants a response from the 'wider community'

Gillian Leng, Nice’s chief executive, said: ‘This draft guideline aims to raise awareness of non-surgical management options so that women are better informed about effective options to address pelvic floor dysfunction. Improving women’s awareness of pelvic floor health and encouraging them to practise pelvic floor muscle exercises throughout their lives is the most effective way to prevent pelvic floor dysfunction.

‘We are keen to hear views from stakeholders and the wider community on these draft recommendations and would encourage as many organisations and people as possible to contribute to the consultation.’

The draft guideline points out that educating women about pelvic floor health will increase the likelihood that they will act to prevent pelvic floor dysfunction. It also outlines risk factors relating to pregnancy, such as an assisted vaginal birth. 

The symptoms of pelvic floor dysfunction include:

  • urinary and faecal incontinence
  • emptying disorders of the bladder or bowel
  • pelvic organ prolapse
  • sexual dysfunction
  • chronic pelvic pain


The following response from the Pelvic Obstetric and Gynaecological Physiotherapy (POGP) professional network was added on 30 June 2021


POGP chair Kate Lough said the network was 'delighted' to see the Nice draft document released for wider consultation and would contribute in detail as a registered stakeholder in due course.

'This guideline is a very welcome step towards a strategy for lifelong pelvic floor care for all women,  helping to reduce the normalisation of pelvic floor dysfunction at key life stages such as childbearing and older age,' she said.

'Broader involvement of all the agencies included in delivering healthcare and lifestyle advice and activities is to be welcomed. A wider provision of information for women will help increase the national dialogue about the impact of pelvic floor dysfunction for so many women.  

'Implementation of the recommendations will clearly impact on current practice and POGP will support any plans to increase the required workforce of specialist physiotherapists to achieve this goal.  

Dr Lough added: ''The uptake of the research recommendations are key to improving the knowledge and certainty about optimal interventions for different populations of women and for understanding more about areas of greater uncertainty such as beneficial exercise for women with pelvic floor dysfunction.

'It is to be hoped that the impact of this guideline will be considerable.'


To see the Nice draft guidance, visit: https://www.nice.org.uk/guidance/indevelopment/gid-ng10123

Amendment: this article was amended on 30 June 2021 to remove a response from the Pelvic Obstetric and Gynaecological Physiotherapy network that was included in error in the original article.  The headline was also changed. Later on the same day a new POGP response was added.

 The POGP professional network is affiliated to the Chartered Society of Physiotherapy. For more information, visit: https://pogp.csp.org.uk

Author: Ian A McMillan
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