In 1997, physicians and researchers Ambre Olsen, Virginia Smith, John Bergstrom, Joyce Colling, and Amanda Clark published, “Epidemiology of Surgically Managed Pelvic Organ Prolapse and Urinary Incontinence,” in the journal Obstetrics and Gynecology. In their article, the authors retrospectively analyzed data from patients who underwent surgery for pelvic organ prolapse or urinary incontinence two years prior in 1995. Often due to a weakening of or damage to their pelvic muscles, women with pelvic organ prolapse can experience a descent of pelvic organs into the lower pelvis and vagina. People with urinary incontinence can experience bladder control issues and urinary leaks. According to the authors, an estimated fifty percent of women who have previously given birth have had a prolapse. In their article, Olsen and colleagues analyze factors such as race, age, and weight in women who had surgery to treat pelvic organ prolapse and ultimately advocate for a standard assessment for the severity of those conditions.

In 1981, Frank Addiego and colleagues published “Female Ejaculation: A Case Study” in The Journal of Sex Research. In the article, the authors find that female ejaculation, or the expulsion of fluid from a female’s urethra during or before orgasm, is a legitimate phenomenon that can occur when one stimulates an area in the vaginal wall that the team names the Gräfenberg-spot. According to the authors, at the time of publication, many individuals believed that if a female expelled fluid during orgasm, the fluid was urine and, thus, improper bladder control caused the expulsions. However, in “Female Ejaculation: A Case Study,” the researchers explain that they collected samples of one woman’s orgasmic fluid and compared its chemical composition to that of her urine, and they found that the two fluids were different. In their case study, Addiego and colleagues not only provide evidence that female ejaculation is a legitimate physiological response, but they also support the idea that females who experience it are not defective, which helped to shape social views and future research on the female orgasm.

John Chassar Moir lived in Scotland during the twentieth century and helped develop techniques to improve the health of pregnant women. Moir helped to discover compounds that doctors could administer to women after childbirth to prevent life-threatening blood loss. Those compounds included the ergot alkaloid called ergometrine, also called ergonovine, and d-lysergic acid beta-propanolamide. Moir tested ergometrine in postpartum patients and documented that it helped prevent or manage postpartum hemorrhage in women. Moir also developed methods to treat tears between the bladder and the vagina, called vesico-vaginal fistulas, that occur due to complications of childbirth, and that cause urinary incontinence in women who have them.

The Martius flap procedure is a surgical procedure used to treat obstetric fistulas in women. Heinrich Martius developed the procedure in twentieth century Germany to treat women with urinary incontinence caused by stress, and later doctors used it to repair obstetric fistulas. Fistulas occur in pregnant women when a hole is torn between the vagina and the urinary tract (called vesicovaginal) or the vagina and the rectum (called rectovaginal). The hole, or fistula, occurs in the tissue separating two organs and therefore obstetric fistulas result in either urinary or fecal incontinence. Fistulas can occur due to surgery, injury, or chemotherapy, but they most commonly occur in pregnant women who experience prolonged labor and do not have adequate access to obstetric care. As a result of the Martius flap procedure, patients regain functional use of their vaginas without continued urinary or fecal incontinence.

Arnold Henry Kegel worked and carried out research in the medical field of gynecology in the US during the twentieth century. Through his work, Kegel was one of the first to describe what researchers call Kegel exercises, which strengthen the pelvic floor muscles, or the muscles that extend from the pelvis to the tailbone and support the internal reproductive organs, bladder, and bowel. Kegel observed that weakened pelvic floor muscles could cause disorders like urinary incontinence, when a person loses partial or complete bladder control, and organ prolapse, which is when the pelvic floor cannot adequately support organs in the pelvic region, causing them to fall out of place. Kegel was also one of the first to find that females could strengthen their pelvic floors through exercises, which provided an alternative to invasive surgeries to repair those muscles. Kegel helped discern the role that the pelvic floor plays in reproductive health, and he developed simple methods to strengthen the pelvic floor that could, in turn, improve sexual and reproductive health in females and males of all ages.