What is a pelvic floor?
A group of muscles that run between your legs, in a sling shape, supporting your uterus, bladder, vagina and bowels. The pelvic floor muscles relax when you’re going to the toilet, but if they are weakened, they sometimes don’t hold everything in when they should, leading to problems such as urinary incontinence.
I’m having problems with my pelvic floor, but I don’t want to talk to anyone about it, as urinary incontinence isn’t that common is it?
Don’t be afraid to talk about issues you may be having with your pelvic floor as you are most definitely not alone!
- In 1998 the World Health Organization (WHO) reported that bladder control problems affect more than 200m people worldwide.
- The NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence.
- A study in 2002 found that 32% of women in the UK, had symptoms of urinary incontinence in the previous 30 days.
You see? It’s not just you!
I had a c-section, so I don’t have to worry right?
Ah, if only that were true! Unfortunately there are a lot of factors that can weaken your pelvic floor, not just the delivery. The weight of your baby during pregnancy for example puts strain on your pelvic floor, and if you begin childbirth naturally, your birth canal is still going to have to take the strain. Pregnancy hormones also loosen the pelvic floor.
Aha, but I’ve not had children at all, so my pelvic floor is safe isn’t it?
No, sorry. Pelvic floor health is determined by all kinds of things, not just childbirth. Pregnancy and childbirth are important factors, but a lot of women also notice significant changes around the menopause. A general weakening of muscles, hormonal changes, a reduction in bladder elasticity and weight gain are all ways in which the menopause can lead to bladder weakness problems.
Other factors include ageing generally, weight gain, inactivity, a history of back pain, heavy lifting, injuries, or conditions that involve chronic coughing or sneezing.
I didn’t do my pelvic exercises during pregnancy, is it too late?
No, fear not, it’s never too late to take action to strengthen your pelvic floor. Read on for more tips!
Can losing weight help with issues?
Yes. Carrying extra weight is one of the key things that impacts on stress incontinence – the sort that causes your bladder to leak under pressure. The extra weight puts your bladder and pelvic floor under constant pressure, but the good news is that even just losing a small amount of weight can have a noticeable impact. An incentive to stay away from the biscuit tin if ever there was one.
Should I just cut back on fluids, so urinary leaks are less likely?
No. Drinking less won’t solve a problem with urinary leaks. Don’t go crazy and drink litres and litres of water a day or anything, but the standard 6-8 glasses is fine. In fact, if you do drink significantly less, your bladder can shrink, meaning it’s less able to hold large volumes when you do have a drink.
Can what you drink impact pelvic floor issues?
Yes, what you drink can increase your risk of suffering from urinary incontinence. Caffeine and alcohol should be avoided as much as possible as they diuretics. This means they cause your kidneys to create more urine, which in turn irritates the bladder. If you really can’t manage without that cup of coffee first thing in the morning then don’t beat yourself about it, but do think about cutting back or switching to decaf where possible.
How will a weak pelvic floor impact my sex life?
Yes, your pelvic muscles are integral to all the fun bits down there, so any weakness is going to have a knock on impact. Studies have shown that strengthening your pelvic floor can often increase sexual pleasure and satisfaction, leading to more intense orgasms. (Squeeze ladies, squeeze!)
I’m a smoker, surely this doesn’t have an effect?
Yes, smoking can weaken your pelvic floor. It’s not so instinctive, but when you think about it, it makes sense- smokers are more likely to have persistent coughs, and chronic coughs are a big risk factor for stress incontinence.
Is sport good for my pelvic floor?
Yes and no. Exercises that support the pelvic floor by strengthening core muscles, like pilates, are really good, but be careful – not all sport is good sport. High impact sports like running can contribute to a weak pelvic floor. If you regularly take part in high impact sports, you’ll need to make sure, especially as you get older, that you take care of your pelvic floor. There’s a great list of pelvic floor friendly exercises here.
What’s a Kegel exercise?
Don’t worry, you’re not the only person who has listened to a friend talk about ‘doing her Kegels’ and wondered what the hell she was on about. Kegel exercises are just another name for pelvic floor exercises, so called because they were first described in 1948 by Arnold Kegel. So now you know.
How exactly do you do a exercises?
This one is tricky, but essentially it’s about clenching the muscles repeatedly, just as you might do arm curls to strengthen your biceps. The easiest way to get a sense of your pelvic floor muscles is to try stopping the flow of urine next time you’re having a wee. The muscles you use for this are the ones you want to be exercising. (Note – don’t do this regularly as it’s not that good for you!). When you’re doing pelvic floor exercises, you shouldn’t be clenching your buttocks or thighs or any other muscles. Have a look at this NHS guidance for more detailed instructions.
Problems arise if you don’t get the technique right, as you can end up doing more harm than good, pushing down instead of pulling muscles up, or just not making a difference at all.
Are there any tools available then to help me strengthen my pelvic floor or to help me get the technique right?
Yes, there are a lot of gadgets on the market now to help you do your pelvic exercises effectively. Elvie for example is an app, that you use in conjunction with a little gadget that slips inside, which tells you whether you’re doing the exercises properly and sets up a little workout regime for you. A bit like playing Tetris with your vagina. You could also have a look at something like the Pelvix, which strengthens your pelvic floor with weights.
Cool, so a weak pelvic floor and a leaky bladder isn’t something that I just have to get used to?
Definitely not. The more we talk about it, the more we can raise awareness about the issue and make sure women are doing everything they can to take care of their pelvic floors. A leaky bladder isn’t something you should just ‘learn to live with’. It’s common, but that doesn’t mean you have to just put up with it, so do start a conversation with your doctor.