Dr Nikki Stamp writes: You have almost certainly heard people talk about their pelvic floor. Whether it be strengthening it or managing problems with it, the pelvic floor is something that a lot of people kind of know exists but beyond that, can be a bit of an unknown. What is for certain though is that understanding your pelvic floor and helping to keep it healthy is important for everyone.
What is the pelvic floor?
The pelvic floor refers to a group of muscles that extend from your tailbone (coccyx) behind to your pelvic bone in front. They form kinds of slings and sphincters around your pelvic organs; bowel and bladder, plus the uterus in women.
Like all muscles, the pelvic floor muscles contract and relax. When you need to use the toilet for example, the muscles relax. When you contract the muscles of the pelvic floor, it keeps urine, stool or wind from passing at the wrong time. Your pelvic floor health is also important for pleasurable and comfortable sex.
Signs you could have some pelvic floor issues
Since your pelvic floor muscles are designed to support your pelvic organs, problems that you might notice can include issues with your bladder, bowels or reproductive organs. Issues include:
- Leaking urine when you cough, laugh, sneeze or exercise
- Not making it to the toilet in time
- Passing wind when you bend over or strain to lift something
- A bulge at the opening of the vagina (this may be a prolapse)
- Tampons that fall out
- A feeling of heaviness in the pelvis
- Recurrent urinary tract infections
- Pain, discomfort or lack of sensation during sex
It’s a common misconception that these symptoms are only seen in women who have given birth or in older women. It can also be seen as ‘normal’ to have some of these issues. Whilst these symptoms can be very common, they can affect anyone of any age, and not just those who have given birth. They are also not something that you have to live with.
Causes of pelvic floor dysfunction
Although pelvic floor dysfunction can affect anyone, pregnancy and childbirth are big causes of pelvic floor dysfunction. Even pregnancy itself can cause pelvic floor issues since the pelvic floor supports the weight of the baby and uterus. Vaginal delivery can also cause pelvic floor dysfunction, owing to stretching and sometimes damage to the pelvic floor during delivery.
Other causes of pelvic floor dysfunction include chronic constipation, chronic coughing or obesity, which puts strain on the pelvic floor over long periods of time. Other conditions that affect the pelvic organs, - including endometriosis, menopause or prostate cancer (and its treatments) - can also adversely affect pelvic floor function.
For those who are active, some exercises can overload the ability of the pelvic floor to keep everything inside, especially in women, who can find that they leak a little urine when they exercise. While exercise is great for overall health, learning to strengthen and use your pelvic floor properly when you work out is vitally important.
Keeping a healthy pelvic floor
There are some very simple things we can all do to keep our pelvic floor healthy and working well. These include treating any underlying medical conditions, like a chronic cough or constipation that might impact your pelvic floor health.
After events that can disrupt your pelvic floor, such as pregnancy, childbirth or surgery and other treatments for pelvic conditions, it’s wise to seek help for a specific plan to rehabilitate your pelvic floor.
Pelvic floor exercises can be useful for everyone. You you may have heard them referred to as ‘Kegel’ exercises. They involve contracting, holding and then relaxing your pelvic floor to strengthen the muscles. Imagine that you’re trying to stop yourself mid-pee or prevent wind passing. Aim to do this 10-15 times, three times a day. If you are having trouble doing these exercises, you can speak to your doctor or see a pelvic floor physiotherapist.
Where to get more help
Whether you are experiencing issues with your pelvic floor or you just want to improve your pelvic floor health, speak to your GP or see a specialist physiotherapist. While pelvic floor issues are common, they don’t need to be tolerated and often can be improved.
Dr Nikki Stamp is an Australian-trained cardiothoracic surgeon and PhD candidate. She has a strong desire to change the way we think about health and is a passionate supporter of the Heart Foundation and women's heart disease advocacy. Nikki is a previous member of the healthylife Advisory Board.
Reviewed by the healthyife Advisory Board August 2022.
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