Everything you need to know about the pelvic floor and how you can strengthen your pelvic floor muscles. Questions answered by our resident pelvic floor physiotherapist.
What is the pelvic floor?
The primary role of the pelvic floor muscles is to support the pelvic organs which are the bladder, uterus and bowel and help with bladder and bowel function. It has to resist all the forces from above, which is called your intra-abdominal pressure. And that’s what happens when you laugh, cough or sneeze. When the pressure pushes down, these wee muscles should push up and that keeps you dry!
The vagina, the urethra and the anus open through the pelvic floor and the resting tension it creates stops incontinence. A well-functioning muscle should contract when you need it to (and prevent leaking) and relax when you want it to. This allows the passing of urine and faeces. The muscles of the pelvic floor also need to be flexible and coordinated to function well.
The whole sexual function is wrapped up in the pelvic floor muscles. If your orgasms are a bit weak, chances are your pelvic floor is too.
Significant life events such as childbirth, menopause and growing older can weaken the pelvic floor and cause trouble. But the good news is that there is plenty that can be done to rehabilitate the pelvic floor to return to its optimal function. You don’t need to put up with leaks, pelvic pain, or weak orgasms!
Where are the pelvic floor muscles located?
The pelvic floor sits like a tensioned hammock between your pubic bone at the front and your tail bone at the back, and also attaches side to side to form the pelvic bowl. As with any muscles if they are functioning well they are firm and bulky and should be able to move up and down as required to adjust to the forces placed upon it.
What are the benefits of strong pelvic floor muscles?
If your muscles are strong and coordinated with your core stability system then you should remain continent. Stress incontinence is when you lose urine during an increase in pressure such as a sneeze, cough, during the pounding forces of a run, or when there is poorly controlled intra-abdominal pressure during lifting activities. If the muscles are not strong or coordinated to resist forces from above, leaking occurs. It is normal to be able to ‘hold on’ until it is a convenient time to pass urine. The muscles help you do that. Urinary urgency is when you have a sudden, compelling desire to pass urine, and can often result in leaking. This can also be a muscle dysfunction amongst other causes.
Apart from being a bit embarrassing, it is very common for women to experience incontinence during their lifetime. One third of women aged between 35 – 55 leak urine and the numbers increase as we get older. But just because it is common, it does not mean it is normal to leak. And just because the majority people put up with it, that does not mean you have to. So much can be done to fix incontinence forever!
Around 1.1 million New Zealanders are incontinent. That's huge! If we can just get this often neglected little muscle working as part of the continence and core team, then imagine how many lives will change!
Stronger pelvic floor muscles usually mean better vaginal lubrication, more intensely pleasurable orgasms, and improved sensation. Why would you not want that!?
What are the functions of the pelvic floor muscles?
Pelvic floor muscles provide support to the pelvic organs (bladder, uterus and bowels). When these muscles are weak it can lead to prolapse of the bladder, uterus and bowel especially when there is a downward pressure during coughing, sneezing, lifting, pushing and pulling activities. Pelvic organs can drop down from their normal position leading to a feeling of fullness or heaviness in the pelvic region, and sometimes the organs drop so low they come outside of the vagina.
The pelvic muscles work with the abdominal muscles to help support and stabilise the back and pelvic joints. Strengthening pelvic floor muscles can often lead to a reduction in back and hip pain and a more stable and supportive system can be restored.
Having strong pelvic floor muscles can help support a baby during pregnancy, and assist vaginal deliveries. Strong muscles going into a birth, will improve circulation which helps the vagina and perineum recover faster after vaginal delivery after.
They also have a very important role to play in sexual function. Weak or absent orgasms is a sign of pelvic floor weakness. Strong pelvic floor muscles will lead to stronger and more pleasurable orgasms and excellent vaginal lubrication. Increasing the strength of your love muscles will lead to increased sensation and improved sexual arousal. No more low libido!
Strong pelvic floor muscles can improve after gynaecological surgery, and lower the rate of surgeries that need to be repeated because they failed.
Weak Pelvic Floor Muscle Risk Factors
- Childbirth (women who have had a large baby or a long pushing stage of labour are particularly at risk)
- Pregnancy. The baby pushing down can weaken the pelvic floor muscles. Amazingly though during a vaginal delivery, the pelvic floor muscles will stretch, as much as 200% before injury!
- Obesity: Being overweight can stress the pelvic floor muscles.
- Constipation. Excessive and chronic straining to pass bowel motions will weaken pelvic floor muscles.
- Frequent heavy lifting (manual jobs when internal pressure is poorly controlled)
- Prolonged heavy coughing – causing repetitive downward pressure on the pelvic floor.
- Hormonal changes such as at menopause and when breastfeeding
- Incorrect abdominal exercises causing too much downward pressure on the pelvic floor.
- High impact exercise, or athletes that have injured their perineum such as in bicycle racing or equestrian sports
- Pelvic surgery, especially those who have had surgery directly through the pelvic floor muscles.
- People who have had pelvic radiation treatment.
Strengthening your pelvic floor muscles with your yoni egg can improve the strength of your love muscles and ensure you regain full pelvic health. Strong pelvic floor muscles can prevent or improve prolapse, reduce back and pelvic pain, reduce incontinence and urgency, lead to better more pleasurable sex, and much more!
Overactive or high tone pelvic floor muscles refer to muscles that are too tense and not flexible, or in spasm.
People risk increasing overactivity patterns when they do pelvic floor muscle training without adequate relaxation in between exercises. Many athletes, gymnasts and those who practice Pilates without adequate focus on relaxation of core and pelvic floor muscles are at risk. Women who are not having vaginal penetration frequently can also have problems sometimes as relaxing to allow penetration can keep the pelvic floor muscles flexible. Stressful lifestyles can cause people to carry tension through the buttock muscles and pelvic muscles and result in pelvic pain and muscle overactivity.
Symptoms of Overactive Pelvic Floor Muscles
- Pain with inserting a tampon
- Painful sex
- Pain as sexual arousal builds
- Pain with or after orgasm
- Pain with internal examinations
- Constipation and / or pain with passing bowel motions
- Increased frequency of urinary or urinary urgency
- Back, hip or pelvic pain
If you suspect you have overactive pelvic floor muscles you should avoid using Jade eggs or Yoni wands until it has resolved. We recommend that you see your Women’s Health practitioner to obtain an accurate diagnosis if you have the above mentioned symptoms. A Pelvic Floor Physiotherapist can do a complete assessment and determine how best to help you regain normal tone, flexibility and co-ordination back to the pelvic floor muscles and core system and resolve associated symptoms.
The lifetime prevalence of pelvic floor dysfunction is similar to back pain at around 60 -70%, yet people do not hesitate to get treatment for back pain. So why do we delay treating pelvic floor problems? Issues can be dramatically improved, start today!