We've all heard of them, especially after childbirth, but what actually are they, what do they do and how do we keep them strong?
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What are they?
Your Pelvic Floor is a sling of muscles between your legs that attach from the front to the back of your pelvis and is important in holding the pelvic organs in place against gravity. So to put it bluntly the Pelvic Floor stops your uterus, vagina, bladder or bowels from falling towards the floor! We aren’t very aware of our pelvic floor muscles until they become weak and this is more common as we get older and especially during and after pregnancy. Other risk factors include multiple births, large babies and traumatic births.
What are the signs of a weak Pelvic Floor?
- Leaking of urine – some women notice they leak a small amount of urine when coughing, laughing or sneezing. This is called stress incontinence.
- Urgency to pass urine – women may feel they have little time between feeling the need to pass urine and actually passing it. This can lead to incontinence of urine.
- Faecal incontinence – this is less common than leaking of urine but it is when you are unable to control your bowels
- Prolapse – this is when the pelvic floor is so weak that a lump hangs down from the vagina or labia. This is due to weakness of the pelvic floor and may be the vaginal wall protruding or the uterus in more severe cases. This lump is more obvious after periods of standing and seems to improve when lying down. My advice would be to see your GP for an examination if you notice any lumps in vagina/labia or if you have any concerns.
How do I treat a weak Pelvic Floor?
Pelvic Floor Exercises are the simplest, quickest and cheapest way to prevent and treat weakness. You can do them anytime and any place as no one else will know you are doing them. The hardest thing about them is remembering to do them! It is important that you do them during pregnancy and after birth, but also to continue them through life as our pelvic floor continues to get weaker as we get older. Another benefit from doing pelvic floor exercises is that they can improve sensitivity when having Sex.
How do I do Pelvic Floor exercises?
The movement is very subtle and is almost just a feeling. You need to try to lift your vagina up towards your bellybutton, a similar feeling as when you try to stop yourself from passing urine. Try to do 3 different types of exercise
- Lifting and holding for 10 seconds.
- Pulsing for 10 beats
- Lifting up a little bit each time for 10 seconds, imagining a lift going up 10 floors in a building, then down again.
Data from a Cochrane Review of 43 Randomised Controlled Trials has shown that pelvic floor muscle training is significantly better than no treatment at all.
How do I remember to do Pelvic Floor exercises?
I advise my patients to buy some brightly coloured stickers and stick them in an obvious place that you spend time each day. For example if you put your sticker on the mirror above the bathroom sink then when you brush your teeth twice a day you can also be training your pelvic floor.
What if I can’t do them or, if they don’t work for me?
If you have tried Pelvic Floor Exercises and feel your symptoms are no better then I would advise seeing your GP for a chat and examination. Your GP may also need to dip a sample of your urine to make sure that nothing else is going on. Your GP may refer you to see a Physiotherapist who is trained in Pelvic Floor management and they may recommend some further exercises, vaginal weights or Electrical Stimulators to try to stimulate the pelvic floor.
Take Home Message:
It is important not to neglect your pelvic floor. Try to do a few pelvic floor exercises every day. If you notice any new symptoms or are concerned at all then visit your GP. Websites that may be helpful are NHS and Patient