Pelvic Floor Knowledge Bombs

If you follow the news at all you will be aware of the stories about problems with vaginal mesh implants. It seems to be popping up again and again and for good reason. You can read the BBC’s take on it here 

As many of my patients and followers on social media know, I am a ‘pelvic floor enthusiast’ and it’s a muscle and subject very close to my heart (well approximately 40cm away from my heart if we’re going to get anatomical about it, but you know what I mean!)

Obviously the surgical procedure talked about in the news is something that may not be on the agenda for the majority women. It does however, highlight the fact that surgical solutions to pelvic floor dysfunction such as Pelvic Organ Prolapse (POP) or incontinence issues are less than optimal.

So in terms of preventing or delaying the need for intervention like this it is worth bearing in mind the following information:

What stresses the pelvic floor in the first place?

The pelvic floor muscles and the connective tissue which attach to the underside of your pelvis are complex and essential for many things including maintaining continence, supporting your pelvic organs, sexual function and your overall core function (with other muscles).

Life changes such as pregnancy, the hormonal changes of the peri-menopause and menopause can weaken the connective tissues and muscles. Postural issues can put them under pressure, as can extra weight as the muscles are loaded in different ways.

Able to withstand some pressure, if these muscles are already weakened, the added pressure of ‘explosive’ bodily functions (think sneezing, coughing, laughing – even vomiting) or external explosive action (jumping, running) can strain them further.

Lifting heavy things or straining (even on the loo) can also cause pressure against these muscles that stresses the tissues. (Constipation is also for another blog!)

What are the warning signs?

An obvious warning sign of a weakened pelvic floor is the leaking of urine, sometimes noticeable with the ‘pressure moments’ described above. Given the muscles also support the bowel, passing wind without warning or leaking poo is also a strong warning sign that the muscles need some attention.

A lesser talked about dysfunction are the different types of pelvic organ prolapse (POP). More common than many women realise (current studies suggest that as many as 50% of women who have given birth twice or more will develop POP at some stage) , there are different types and stages. I will save this for another blog but here’s a useful image of the different types from the Holistic Core Restore® programme:

Tell-tale signs of a prolapse can include a heavy, dragging feeling in the vaginal area, low back pain, pelvic pain or just a feeling that ‘something is there’. Some women with POP find it hard to insert or keep a tampon in. Sometimes sex can be painful or difficult and if the prolapse is a stage 3 or 4, there may be tissue protruding from the body.

So who can help?

In the first instance, if you think you have a prolapse, or are very worried about any leaks you are experiencing, make an appointment with your GP or self refer to a Women’s Health Physical Therapist such as an Osteopath or Physiotherapist. Please don’t be embarrassed, it is very common and it’s their job to help.

With regards to physical exercise,  finding someone who is specialist in the area is key. Considering finding a Holistic Core Restore Coach – they really are the gold standard for pelvic floor rehabilitation exercises (so much so I am training to be a coach myself). You can find your local coach here. These coaches are literally changing hundreds of women’s lives.