What is the Pelvic Floor, and Why Should We Care About It?
Pelvic health has become a hot topic in the past decade, and for good reason. Women experience significant changes to their pelvic floors throughout their lifespans, and we have historically received minimal education about this part of our bodies. Perhaps you have birthed children vaginally and forever sworn off trampolines with your kids. Perhaps you leak urine when you sneeze, but you cross your legs and hope for the best. Perhaps you hit menopause, and have just accepted that you have symptoms of prolapse at the end of each day. These examples are extremely common, but far from normal. There are treatment options available and even ways to prevent many of these issues before they start. They are not something that women have to live with due to childbirth or aging as was believed by previous generations.
The pelvic floor is a critical group of muscles at the bottom of the pelvis. They play important roles in sexual health, bowel and bladder function, organ support, core stability, circulation and posture. These muscles are small but mighty, and deserve more awareness and education. In females, the pelvic floor undergoes significant changes across the lifespan with injuries, exercise, pregnancy, childbirth (even Cesarean section), and menopause. Understanding what signs or symptoms to look for, and how to go about addressing or preventing them, can help avoid long-term issues and improve your quality of life.
During childbearing years, the pelvic floor is a key player. It is quite literally responsible for supporting the growing uterus during pregnancy, which may lead to weakness or spasming of the muscles trying to support these changes in posture. Following childbirth, weakness, tearing, stitches, muscle spasm or trigger points can cause persisting issues with postpartum pelvic floor function. The pelvic floor also works closely with your abdominal muscles and breathing diaphragm, and the coordination between these structures can be altered after delivery. Women who have c-section births often still have changes to the pelvic floor from pregnancy, and scar tissue from c-sections can also directly affect how the pelvic floor works.
The pelvic floor undergoes significant changes at menopause when hormone levels shift drastically. This group of muscles and the tissue at the perineum is particularly susceptible to the drop in estrogen in the body. These changes can lead to increased muscle atrophy, tissue laxity and tissue sensitivity. This often presents as symptoms such as organ prolapse, pain with sexual activity, or urinary urgency or incontinence, to name a few. Sometimes, these pelvic floor changes may be present (though asymptomatic) prior to menopause, but the hormonal shift can bring symptoms to the forefront and impact function.
While the pelvic floor is a small group of muscles, it is an important puzzle piece that works closely with the rest of the body. Other factors that may affect your pelvic floor health include back and hip injuries, chronic pain, diastasis recti, core weakness, abdominal pain or surgeries, gynecological conditions or procedures, constipation, PCOS, endometriosis, stress/anxiety, or poor postural habits. Some types of exercise can also contribute to pelvic floor stress if not done properly or if you have underlying pelvic floor dysfunction.
The pelvic floor is susceptible to many changes, stressors, and challenges throughout the female lifespan, which is really no different than any other group of muscles in the body. The difference, however, is that this small group of muscles is responsible for such critical roles, that when they are not functioning optimally, significant inconveniences can result. The great news is that there are treatment options available, and you do not have to live with these concerns indefinitely. Finding an excellent pelvic floor therapist as part of your women’s health team can be life-changing from reproductive years to post-menopause. After many years in this profession, I can tell you that it is almost never as simple as the blanket recommendation to “Do Kegels,” but a skilled physical therapist will assess your concerns and get you back on track to improve your pelvic health.
You can find more information from Dr. Kaitlyn Labberton and ReclaimHER Physical Therapy at https://www.reclaimherpt.com.