Do you wet yourself a little bit when you laugh, cough, or sneeze? If so, you might be among the one in three women who have a weak pelvic floor.
Most people will just “put up” with the problem, often due to embarrassment or thinking it’s an inevitable result of childbirth, menopause, or aging. But continence specialist Jane Simpson is on a mission to break the taboo and help women realize that you don’t have to just accept things like stress incontinence as a result of having a weak pelvic floor – because there are things you can do about it.
“While we’ve almost become comfortable discussing periods, pelvic floor issues are still frequently ignored, despite affecting one in three women. This absolutely has to change,” says Simpson, who explores the topic in her new book, The Pelvic Floor Bible.
Here, she outlines ten things every woman should know about her pelvic floor and how to keep it strong.
Your pelvic floor is easy to find.
If you’re a woman, sit on any hard surface with your feet flat on the floor. Lean slightly forward with your vulval area in contact with the hard surface, and try to lift the area around your vagina and anus away from whatever you’re sitting on. These are your pelvic floor muscles contracting. Squeeze and let go a few times until you’re sure you’ve found the right muscles. Try not to squeeze your buttocks.
Your pelvic floor muscles are the bottom of your core.
Acting like a hammock, pelvic floor muscles provide the main support for your pelvic organs. Without them, your internal abdominal and pelvic organs would simply fall out. Your pelvic floor muscles are wrapped around the urethra, vagina, and anus in women. They are able to contract when you cough or sneeze, to help you stay continent and prevent leaks.
You should be doing pelvic floor exercises daily.
It’s important everyone does pelvic floor exercises, even if they don’t currently have a problem. “It can happen at any time in life, so be prepared to start working on your muscle training straight away,” says Simpson.
Either lying with feet flat on the floor, sitting, or standing, draw up your pelvic floor muscles, squeeze and hold for a count of five if possible. Let go and count to five. Repeat the process five times, and do this three times every day. Keep practicing and hold for a longer time, until you can contract the muscles for ten seconds each time. Once a day, also do a series of ten short, sharp contractions, which will help you maintain control when you sneeze or cough.
High-impact sports can cause pelvic floor problems.
A recent review concluded that sports practice increases the prevalence of urinary incontinence, with high-impact sports causing the most incontinence. Have you stopped running, playing tennis, or any other sport that you really enjoyed because you’re worried you might have an accident? If so, pelvic floor exercises will help.
Pelvic floor dysfunction isn’t just about stress incontinence.
Do you frequently or urgently need to go to the toilet? Does the sight of your front door trigger an urgent need to pee? This is called urge incontinence and it’s thought that 25 to 45 percent of women suffer from this.
Childbirth is a common cause of pelvic floor dysfunction.
Every woman needs to do pelvic floor exercises after having a baby – whether they’ve had a vaginal delivery or a caesarean section. While common, it’s a myth that it’s normal to leak if you sneeze after having a baby.
Half of women over 50 have some degree of prolapse.
A prolapse happens when weakened pelvic floor muscles and a weakened vaginal wall lead to one or more of the pelvic organs, often the bladder, bulging into the vagina. You may have no symptoms and it’s only noticed on a routine smear test, or it may feel like you’re sitting on a ball or have a heavy feeling in your vagina. “It’s not normal or right to just accept a prolapse as a normal part of aging,” says Simpson. “Whether your prolapse is big or small, don’t just ignore it and hope it goes away. Start working on your pelvic floor exercises straight away.”
Pelvic floor exercises are good for your sex life.
Pelvic floor muscles are very important for sex, as they help increase the blood supply to the vagina, improve muscle tone, and help maintain nerve activity, resulting in improved sexual sensation and satisfaction. “I’m sure we’ve all felt boosted by a long walk or a great workout. The same is true for your vagina following pelvic floor exercises,” adds Simpson.
Pelvic floor dysfunction can start at the menopause.
Simpson warns women not to neglect their pelvic floor around the menopause, when estrogen levels start to fall. Estrogen is important for keeping the pelvic floor ligaments strong and elastic, so when levels of the hormone drop, the ligaments become thinner, weaker, and less resilient and pelvic floor problems are more likely to occur.
Men have a pelvic floor too.
In general, the male pelvic floor behaves better than the female one, largely because men don’t have babies. However, about a third of men over the age of 50 have some form of lower urinary symptoms.