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NHS England to launch nationwide pelvic health service

The service aims to work alongside maternity and physiotherapy services to support women during and after pregnancy

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NHS England is to launch a nationwide pelvic health service to support pregnant women and women who have gone through traumatic births.

Roughly one in three women in the UK experience urinary incontinence three months after pregnancy and around one in seven experience anal incontinence six months after birth.

One in 12 women report symptoms of pelvic organ prolapse, a condition that occurs when the muscles and tissues supporting the pelvic organs become weak or loose.

England’s nationwide pelvic health service aims to better support women during and after pregnancy.

Backed by £11m of government funding, the plans include offering women a self-assessment of their pelvic health early in pregnancy, educating women on the risk of pelvic floor dysfunction and birth injuries, providing support to those at higher risk of pelvic health problems, reducing NHS waiting times and allowing women to access physiotherapy assessment and treatment.

“For too many women, the joy of pregnancy and birth is tarnished by trauma and pelvic health problems can have devastating ramifications for women’s lives,” said Women’s Health Minister, Maria Caulfield.

“It’s vital women receive appropriate support, treatment and information. From initial antenatal appointments, right through to mental health care after birth, we are determined to support women throughout their pregnancy and birth journey.”

Kate Brintworth, NHS England’s chief midwifery officer, said: “For any women that have experienced a traumatic birth, timely access to support is crucial to help address any issues that can occur.

“To increase the support available, the NHS is rolling out dedicated pelvic health clinics nationally, bringing together expert clinicians under one roof, so women can seek help quickly and easily – and already thousands of women have been supported through our pilot sites.”

Perinatal pelvic health services (PPHS) – run by specialist midwives and pelvic health physiotherapists – are already being implemented as pilots right across England. All areas in England are on track to implement these services by March 2024.

These services aim to work alongside maternity and physiotherapy services to support the prevention, identification and timely treatment of pelvic health problems around birth.

They also aim to reduce the risk of these injuries happening in the first place through close work with midwives and obstetricians and through support for the implementation of the obstetric anal sphincter injury (OASI) care bundle.

The care bundle is a set of interventions likely to improve outcomes for women. Analysis of the effectiveness of this care bundle based on over 50,000 vaginal births found that women’s risk of obstetric anal sphincter injuries decreased by 20 per cent.

“Too many women currently suffer pelvic injuries during childbirth, which can mean long-term complications including difficulty controlling the bladder and bowel, chronic pain and painful intercourse,” said Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists (RCOG).

“This guidance represents an important milestone in the development of vital perinatal pelvic health services, created to improve access to early intervention and support for women and people experiencing symptoms of pelvic floor dysfunction.

“We are delighted that this service specification sets out how PPHS will work with maternity units to implement the joint RCOG and Royal College of Midwives’ OASI care bundle.”

She added: “As a college we look forward to supporting the implementation of this important guidance, working with our membership and our NHS partners to help ensure all women have access to high-quality pelvic floor health information, education and care.”

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Mental health

Women more likely than men to get health advice from influencers, study finds

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Young women are more likely than young men to get health and wellness information from social media influencers, a US survey has found.

Among adults aged 18 to 29, 57 per cent of women said they received health and wellness information from influencers, compared with 47 per cent of men.

The Pew Research Center study surveyed 5,023 US adults and examined how young people consume health and wellness content online.

Local university students said influencer content frequently appeared in their social media feeds.

Kabija Koroma, a local university student, said: “It’s more exercise stuff, more like protein and like meals and like how to get ready and like the outfits of the day of videos on TikTok or lately. My favourite ones.”

About 51 per cent of women under 30 said they often consumed influencer content focused on beauty and personal appearance, compared with 18 per cent of men.

The study also found that 21 per cent of women often saw content about therapies outside mainstream medicine, compared with 10 per cent of men.

At least one-third of both young women and young men often encountered influencer content about mental health and weight loss. Around half or more of both groups regularly saw fitness-related content.

Another local university student, Ania Davis, said: “I see a lot like how to meal prep and how to get your morning started. Affirmations stuff. But I do also ask the adults around me because sometimes the internet is not right.”

Researchers also looked at why young adults sought health and wellness information from influencers.

About 51 per cent of young women said they watched the content because they wanted to change their health or lifestyle.

Women were also more likely than men to say they enjoyed hearing from people who shared their background or beliefs, at 23 per cent compared with 14 per cent.

Nineteen per cent of young women said they used influencer content to learn about topics they did not want to ask their doctors about, compared with 10 per cent of young men.

Despite regularly using social media, some students said they did not rely solely on influencer content when making decisions about their health and wellness.

Koroma said: “I’m always on TikTok 24/7 and Instagram, but I also like to ask people older than me because I don’t know everything.”

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Menopause

Menopause hormone treatment may ease brain fog, study suggests

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Estriol treatment may ease menopause brain fog and other cognitive symptoms, according to a small observational study of 20 menopausal women.

The study involved menopausal women with an average age of 53.

They underwent an initial assessment of their cognitive symptoms before receiving a customised regimen of estriol and progesterone for 12 months.

Estriol is a natural form of oestrogen that occurs during pregnancy and has been used in Europe and Asia to treat menopausal symptoms including hot flushes and genitourinary symptoms.

It differs from estradiol, the most commonly used oestrogen hormone therapy in the US, by binding primarily to a different oestrogen receptor in the brain.

Previous research has shown that estriol may help protect brain cells and reduce brain atrophy in the hippocampus, the region responsible for learning and memory.

After 12 months of treatment, participants reported significant reductions in brain fog, concentration problems, working memory problems, slower processing speed, verbal memory problems and problem-solving difficulties compared with before treatment.

Senior author Dr Rhonda Voskuhl, a neurologist and member of the Comprehensive Menopause Center at UCLA Health, said: “Oestrogen plays a well-documented role in protecting the brain, yet there are still no approved type and dose of treatment that specifically targets the cognitive symptoms so many women experience during menopause.

“Women are often told to simply live with brain fog, when in fact there is a neuroscience basis for it, and potentially a way to address it. That gap in care is what motivated us to look more closely at estriol.”

Researchers also examined estriol treatment in midlife female mice to investigate how the hormone treatment might work.

Estriol reduced markers of brain pathology in the hippocampus and improved measures of working and spatial memory in the animals.

The findings are preliminary. The study was a small case series with no placebo group or randomisation, meaning the results may not apply to broader populations.

The researchers said larger placebo-controlled clinical trials using brain imaging and standardised cognitive testing are needed to confirm the findings on cognitive symptoms.

The treatment used in the study was invented by Voskuhl and is patented by UCLA. UCLA licenses the patent to CleopatraRX, which sells the treatment as PearlPAK. Voskuhl serves as a medical adviser to CleopatraRX.

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News

Women shouldering hidden burden of navigating healthcare system – study

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Women face a hidden burden navigating healthcare, with many repeatedly retelling their medical history, a national study suggests.

The findings indicate that Canadian women are taking on cognitive, emotional and administrative work alongside managing their health, including coordinating providers and advocating for care.

More than half of women surveyed, 53 per cent, reported a past or current chronic condition, while 64 per cent said there were health topics they struggled to raise with their doctor.

Sarah Hoffman, president and CEO of Pacific Blue Cross, said: “These findings challenge us to think differently about women’s healthcare and highlight the hidden work required to navigate the system.

“For many women, managing their health has also come to mean managing the healthcare system itself.

“They are acting as project managers of their own care, shouldering the invisible labour of coordinating between providers, retelling their medical history and advocating to be heard.

 “The gap between men and women is meaningful and raises important questions about why younger women report lower levels of confidence and support.

“It also challenges us to consider whether we are actually making progress in women’s care, and whether the next generation is being equipped with the confidence and voice to advocate for their health.”

Overall, 71 per cent of Canadians described their doctors as supportive and 88 per cent expected their appointments to go well.

Among women living with chronic conditions, 71 per cent reported having to repeat their complete health history multiple times a year.

Younger women were particularly likely to report difficulties discussing their health. The study found 81 per cent of Gen Z women aged 18 to 30 and 73 per cent of Millennial women aged 31 to 45 had health topics they struggled to raise with their doctor.

Among Gen Z women with chronic illness, 92 per cent reported having to repeat their complete health history.

The study also found differences between young women and men. While 95 per cent of Gen Z men expected a doctor’s appointment to go well, the figure was 82 per cent among Gen Z women.

Similarly, 82 per cent of Gen Z men said they felt supported by their family doctor, compared with 66 per cent of Gen Z women.

Reasons for holding back health concerns varied between generations.

Among Gen Z women, 30 per cent cited fear of dismissal and 29 per cent fear of judgement.

Embarrassment was the most common barrier among Millennial, Gen X and Boomer women, reported by 29 per cent, 27 per cent and 35 per cent respectively.

Women who felt they needed to prove themselves to be taken seriously said they adapted how they approached appointments.

Strategies included researching medical information, repeatedly describing or justifying symptoms, bringing written notes or documentation, tracking symptom timelines, making repeat visits and emphasising how symptoms affected their daily lives.

The study also found an association between feeling supported by a doctor and expecting appointments to go well.

Canadians who described their physician as supportive were nearly four times more likely to expect appointments to go well than those who felt unsupported, at 98 per cent compared with 25 per cent.

Overall, 66 per cent of Canadians said they described their symptoms accurately. This fell to 48 per cent among those who said they felt unsupported by their doctor.

The 2026 Blue Cross Women’s Health Study surveyed 2,045 adult Canadians online in March 2026 through independent research company Research + Knowledge = Insights.

The survey had a reported margin of error of plus or minus 2 per cent, 19 times out of 20.

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