Contributed by our friend Heba Shaheed, co-founder of The Pelvic Expert
Pelvic floor health is crucial for women at all life stages, however these issues can be dismissed or normalized, causing women to put up with them for longer than they should. After working in pelvic floor physiotherapy for close to a decade, I’ve heard the struggles of thousands of women, and helped them to discover tools to restore their bladder, bowel and sexual health, giving them back control of their pelvic floors.
Let’s begin by exploring what the pelvic floor is, the common pelvic floor problems, and strategies to fix these problems from the comfort of your own home.
The Pelvic Floor
The pelvic floor is made up of a group of muscles and connective tissue that provide support for your spine and pelvis, and for your pelvic organs – the bladder, the uterus and the bowel. The pelvic floor muscles are one of the most important muscles in a woman’s body and are one of the four core muscles.
Common Pelvic Floor Problems
After birth and in the lead up to and during menopause, there are a number of common problems that occur in the pelvic floor. It doesn’t matter if a woman has had a vaginal birth or a c-section birth, the pressures and hormones of pregnancy and menopause can put a woman at risk.
Women may experience bladder or bowel leaks, back pain, pelvic pain, sexual pain, pelvic organ prolapse, perineal tears and/or abdominal separation. These are all signs of a dysfunctional pelvic floor and core.
Bladder & Bowel Leaks
1 in 3 women suffer from urinary incontinence. This could be bladder accidents due to urgency known as urge incontinence, or it could be stress incontinence which is leaking with coughing, sneezing, laughing, jumping, running, lifting, and even during sex.
The connective tissue that surrounds the urethra can become overstretched, causing it to flop around when a large pressure comes down on the bladder, such as during a sneeze, resulting in bladder leakage.
Faecal incontinence affects 1 in 8 moms, and is directly related to third or fourth degree perineal tearing during birth, or hormonal changes in menopause. Women may have difficulty controlling their wind and their bowel motions, and can be a very distressing issue.
Pelvic Organ Prolapse
1 in 3 women will experience some degree of pelvic organ prolapse, which is when one or more of the pelvic organs sags down lower in the pelvis. This is due to an overstretch of the connective tissue holding the organ up, which can occur after birth or during menopause.
After vaginal birth, bladder prolapse is quite common, and could be the root cause of urinary incontinence. Caesarean births can also result in prolapse, but usually of the uterus. Once a woman enters menopause, her risk of prolapse increases regardless of whether she has given birth or not.
Other symptoms of prolapse include:
• Incomplete emptying
• Slow stream
• Start-stop stream
• Dragging or heaviness sensations in the pelvis
• Lower back pain
• Lower abdominal pain
• A bulge vaginally
• Sexual pain
During pregnancy, all women will develop some degree of diastasis rectus abdominis (DRA) by the end of their pregnancy, and 40% of women still have this abdominal separation at 6 months postpartum. This can persist for years or even life if it isn’t addressed. DRA is the stretch of the connective tissue, known as the linea alba, between the two sides of the abdominal muscles.
The presence of DRA can give the appearance of a pooching belly, and 66% of women with DRA will also have at least one related pelvic floor dysfunction, such as urinary incontinence, fecal incontinence or pelvic organ prolapse. Fixing the DRA can sometimes fix the pelvic floor issues, as it is the root cause.
At least 50% (and up to 90%) of women will experience some type of pain during pregnancy, after birth, or as they age, whether it’s back pain, pelvic pain or sexual pain. Back and pelvic pain are often related to poor posture, prolonged periods of sitting, standing, feeding and carrying, as well as weakness in the core muscles.
Sexual pain can be linked to perineal tearing and scar tissue, thin or dry vaginal walls, as well as to pelvic floor muscles that are tense and non-relaxing.
Pelvic Floor Exercises
To find your pelvic floor muscles, imagine you are sitting on the toilet weeing, then imagine stopping the flow of the wee. The muscles that squeeze to stop the flow are your pelvic floor muscles. These are the same muscles we squeeze to stop us from passing wind.
During pregnancy, after birth, and during menopause, women are encouraged to do regular pelvic floor exercises, because pressures of these times and hormonal changes creates pressure down on the pelvic floor.
Keeping it healthy
It is really important for women to do their pelvic floor exercises to prevent and stop leaking and pain, and to provide support for any prolapsed organs. A healthy pelvic floor is important for overall women’s health and wellbeing.
They key to a healthy pelvic floor is ensuring appropriate bladder and bowel habits, optimizing posture and alignment and ensuring the pelvic floor and core muscles are activating in day-to-day activities as well as during exercise.
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About the author: Heba Shaheed is the co-founder of The Pelvic Expert, where she provides online exercise, nutrition and pelvic floor physiotherapy programs for mothers, pregnant women, and women with pelvic pain and endometriosis. Heba has over 8 years experience in women’s health physiotherapy, nutrition and exercise.
Learn more at The Pelvic Expert!