Here is a story that felt small in the telling but lingered long after the room had emptied at our Pelvic Partner launch event in Singapore.
A personal trainer invited two friends to our intimate pelvic health panel discussion. She mentioned it would cover things like leaking, urgency, and pain. The stuff nobody talks about. Both friends said no. Not because they didn't have time. Not because they didn't have the symptoms. They said no because they didn't want anyone to know that they did.
"My friends said they didn't want to come because people would know their body has problems. I asked them: do you experience leaks when you sneeze? They said yes. But they think it's normal. And to them, coming to an event like this is shameful." — Apple Ng, Personal Trainer
Both of those women are leaking when they sneeze. Both of them have quietly filed it under 'normal.' And both of them, on some level, felt embarrassed about it. Which is exactly why they haven't done anything about it.
This is not an unusual story. It is, in fact, one of the most common ones in pelvic health.
The shame is doing real medical harm
Let's be specific about what the shame we often feel costs.
When symptoms go undisclosed (to a GP, to a physiotherapist, to a friend who might know a specialist) they go untreated. And pelvic floor conditions, like most physical conditions, tend to respond better to early intervention than to delayed ones. Prolapse caught early is typically manageable with conservative treatment. Incontinence addressed when it first appears is usually more straightforward to resolve than incontinence that has been present for years.
Every year of 'just getting on with it' is a year of unnecessary symptom load, unnecessary limitation on activity, and, for many people, unnecessary impact on sexual wellbeing, confidence, and quality of life. The shame is not a private feeling. It has a physical cost on women's health.
Why the system hasn't helped
The silence is not our fault, this shame didn't come from nowhere. It was shaped.
Medical training in women's health has historically been sparse. GP training in pelvic floor health in some countries is covered in just a few optional hours. Menopause guidelines that should have existed decades ago are still being written. The result is a healthcare system that frequently tells women their symptoms are 'normal', offers minimal follow-up, and creates no particular expectation that pelvic health is something worth discussing openly.
Couple that with a culture that has long treated women's bodies, and specifically vaginas, pelvic floors, and anything adjacent, as either risqué or too graphic for open conversation, and you have a perfect environment for silence to flourish.
What actually shifts things
Events. Conversations. The specific experience of sitting in a room with other people and realizing, sometimes for the first time, that what you've been quietly carrying is not yours alone to carry.
This is why gatherings like the one we co-hosted with Embrace Physiotherapy matter. Twenty women in a room talking honestly about bladder urgency, prolapse, pain with sex, and leaking might sound like a small thing. But for the people in that room, it was frequently the first time they'd ever said those words out loud to anyone who wasn't a medical professional.
The tide doesn't turn because the medical system changes. It turns because the conversation changes first.
That conversation has to happen in places that don't feel clinical. In events. In articles people forward to friends. In podcasts listened to alone on a walk. In product descriptions that treat pelvic health as the everyday wellness concern it actually is, rather than something niche, uncomfortable, or vaguely embarrassing to acknowledge.
On self-advocacy
There's a version of this conversation that becomes entirely about systemic failure, and that version is true and important. But there is also something to be said for the individual act of deciding that your quality of life is worth some discomfort.
"Nobody is responsible for my quality of life. If you are not embarrassed, the one who is embarrassed is the other party you're speaking to." — Apple Ng, Personal Trainer
Apple Ng was lifting 100kg by the time she started working on her pelvic floor. She had been leaking for years and writing it off as normal. She said no to surgery, said yes to physiotherapy, became a certified personal trainer, and now trains her pelvic floor every other day without fail. She even brings her pelvic weights on holiday. Her story is not a universal blueprint. But it is a useful reminder that the decision to take your own health seriously is, in the end, yours to make.
What we can all do
Tell the friend. Forward the article. Mention it to the GP even if it feels awkward. Ask if there's a pelvic health physiotherapist in the area. Use the language out loud (pelvic floor, incontinence, prolapse, pain with sex) until it stops feeling like a confession and starts feeling like a conversation.
Smile Makers exists, in part, to be one of the places that conversation happens. Because intimate wellness deserves to be talked about with the same matter-of-fact warmth we'd bring to any other part of the body.
The two friends who stayed home that night? They're still leaking when they sneeze. The information that could help them is out there. We just have to keep making it easier to find than the shame is to hold onto.
