If you’re not exactly sure what your pelvic floor is, you’re not alone. “It was never talked about during my generation at all,” said Robyn Faye, M.D., an OB-GYN and member of HealthyWomen’s Women’s Health Advisory Council. “That’s why women my age are coming in and having problems and all they know about is Kegel exercises — they don’t know about anything else.”
This is a problem for a few reasons. Think of your pelvic floor as a superhero cape inside your pelvis. It stretches from your front pubic bone to your tailbone, and out to both sides of your pelvis. It protects organs like your bladder. And every time you hold your pee long enough to get to the bathroom — that’s your pelvic floor flexing for you.
But if you don’t know much about your pelvic floor — where do you even start? “You need to be introduced to it just like it’s a normal part of your body,” Faye said. “Everyone needs to know about the pelvis and everyone needs to take an interest in taking care of it.”
Here’s what you need to know and how to keep your pelvic floor strong and healthy as you age.
What are pelvic floor muscles?
Your pelvic floor is a hammock-like collection of muscles that support your pelvic organs, including your urethra, bladder, small intestine and bowels. These muscles also support your vagina and uterus.
You’ve probably heard of your core muscles, and your pelvic floor makes up the base of this muscle group that attaches to your spine and pelvis and gives your body stability.
What does your pelvic floor do?
In addition to supporting and protecting your pelvic organs, the pelvic floor is responsible for key bodily functions, including control over when you pee, poop and fart.
The muscles also tighten and relax during sex, when you have an orgasm, and during childbirth.
Pelvic floor muscles can become weak over time because of age, health conditions or injury, which can lead to problems such as bladder leakage and prolapse. Pelvic organ prolapse (POP) is when pelvic organs drop and can bulge in the vagina because of a weak pelvic floor.
Read: Prolapse Changed My Life for the Better >>
To make things even more complicated, your pelvic floor muscles can be weak because they are too loose or too tight. A hypertonic pelvic floor is when your muscles are in a constant state of contraction and they can’t relax. This can cause frequent peeing, pain during sex, pain using a tampon and POP, among other problems. If prolapse happens, you may need pelvic floor therapy, an insertable device called a pessary and/or surgery, and/or depending on your symptoms.
For people going through menopause, a lack of estrogen can cause the vagina to be dry, which can lead to painful sex and affect the pelvic floor. Faye said topical estrogen creams can help, and there are also new innovations people can try. Research has found that red light therapy can stimulate blood flow in the vagina and help create a stronger pelvic floor.
Read: Menopause Can Be a Real Pain in the Vagina >>
How can you strengthen your pelvic floor muscles?
Many different factors can affect your pelvic floor. These can include:
- Pregnancy
- Having a vaginal birth
- Aging
- Straining when you poop
- Living with overweight or obesity
- Trauma and/or stress
You may need pelvic floor training if you notice changes in what’s going on down there. Symptoms can include:
- Leaking urine when you laugh, cough or sneeze
- Having a strong urge to pee
- Leaking poop
The good news is that you can strengthen your pelvic floor with Kegel exercises, a simple squeeze and release muscle training technique.
First, to feel your pelvic floor muscles, stop yourself from peeing while midstream (only do this once or twice to help identify the muscles — it’s not good for your bladder to do it on the regular). You can feel your pelvic floor muscles tighten during this time. Once you’ve identified the muscles, try this pelvic floor exercise:
- Start with an empty bladder
- Tighten your pelvic floor muscles and count to 10
- Relax for 10
- Do 10 sets, 3 to 5 times a day
People often perform these exercises incorrectly, so you may want to consider seeing a pelvic floor therapist for training to make sure you do the exercises the right way. If you do them incorrectly, they can actually do more harm than good.
There are also ways to strengthen beyond Kegel exercises. You can also focus on just strengthening your core with exercises and breathing techniques.
Faye recommended talking to your OB-GYN about methods that can help, including vaginal wands to help relax pelvic floor muscles or vaginal suppositories, and to work with a pelvic physical therapist to find what works best for your pelvic floor. She also noted that working with a therapist before and after pregnancy can help people maintain a healthy pelvic floor and possibly avoid complications that can happen during childbirth.
What is pelvic floor therapy?
Pelvic floor therapy involves seeing a pelvic physical therapist to help strengthen, rehab and/or relax muscles depending on the condition. Therapy can include using weighted belts and breathing exercises.
Faye said many women don’t even know that pelvic floor therapy is an option, but it’s becoming more popular. If you think you may have pelvic floor dysfunction, talk to your OB-GYN to help find a therapist. But keep in mind, your insurance may not cover it. “Insurance companies will cover physical therapy if you break a bone, but I’ve found pelvic floor therapy is rarely covered,” Faye said. “So many women can benefit from pelvic floor therapy.”
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