Pelvic floor physiotherapist Jess Fishburn has been going into schools to talk about menstrual health and pelvic pain since 2019.
Based in Hamilton in western Victoria, she said she had often had women arriving in her clinical room and asking why no-one had ever told them about the issue.
And students in regional Australia are more likely to miss school or work because of pelvic pain than their metropolitan counterparts.
Starting next year, the Victorian government plans to fund 400 pelvic pain and menstrual health education sessions for students across the state, with regional and rural schools prioritised for delivery.
But can education really make a difference?
What is pelvic pain?
Pelvic pain is an umbrella term for a variety of conditions with different causes and management plans.
“It can be menstrual pain, it can be pain with intercourse … endometriosis or bladder pain,” Ms Fishburn said.
She said more often than not, these conditions did not occur in isolation and could be lifelong, but if people got the right treatment it was usually easily managed.
“We don’t have cures … but we can manage the symptoms so that it doesn’t cause ongoing issues,” Ms Fishburn said.
According to the latest Australian Study of Health and Relationships, the highest rates of sexual pain are among 16-19-year-olds.
“Education is 100 per cent a first line treatment. Learning why your body is hurting helps,” Ms Fishburn said.
“We can get that information to them sooner, but then it becomes a really nuanced topic about age appropriateness, what the school wants, what parents want, and what is actually best practice.”
The regional pelvic pain disparity
Almost half of all Australian women experience pelvic pain, which amounts to more than 6 million people.
About 21 per cent of young people aged 15 to 19 years old experience severe pelvic pain during their periods.
In March 2023, the federal government announced funding for 20 specialist endometriosis and pelvic pain clinics in “priority populations” across Australia, but regional and rural access remains a challenge.
In February, a spokesperson for Lyndoch Medical Hub in Warrnambool told the ABC their funding had been redirected.
Research from the Pelvic Pain Foundation of Australia shows rural and regional students assigned female at birth endure higher levels of period and pelvic pain, with 26 per cent regularly missing school or work as a result, compared to 20 per cent of metro students.
A Department of Education spokesperson said the new program would educate young people about pelvic pain.
“The program also aims to destigmatise and remove the shame associated with periods so that nobody suffers in silence,” the spokesperson said.
“We want to ensure that more young Victorians can identify the signs of when to seek help to minimise the impact on their overall health and wellbeing.”
Education an effective therapy
Pelvic Pain Foundation of Australia chairperson Susan Evans is a gynaecologist and specialist pain medicine physician.
She said the foundation had spoken to more than 90,000 students across the country, with about half their sessions taught in regional areas.
“It has to be medically accurate, it has to be valuable for the student, so it has to be consistent and it has to be followed up,” Dr Evans said.
“Pain education … has been shown to be one of the most effective therapies, and you need to develop it early.
“So many women with endometriosis recognise … their symptoms began when they started their periods in that time at school.
“And they just wish they knew so much more at that time because it would have helped them to lead a life that was less impacted by pain.”