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You’ve seen the claims. A stronger pelvic floor! Fewer Leaks! Better Sex! The kegel craze is hot right now and for good reason. Kegels can do all of these things and we’re a big proponent of doing them for maintaining good bladder health and a healthy pelvic floor. But before you jump on the kegel bandwagon, read this post. Because while kegels can be super effective for all the reasons listed above, they can sometimes cause problems in women who have certain conditions.
Many women suffer from a weakened pelvic floor, the series of muscles and tissues that form a hammock at the bottom of your pelvis, and are responsible for holding many of your organs (including your bladder) in place. A weakened pelvic floor can be caused by many factors, but pregnancy, childbirth, and aging are all high on the list. This laxity in the pelvic floor can lead to things like incontinence, or even pelvic organ prolapse if not treated properly. And a great way to treat it (most of the time) is with kegels.
But not everyone has a weak pelvic floor – some women experience pelvic floor tension, which prevents the pelvic floor muscles from contracting or relaxing at a normal rate, again making them weak, but in a different way. This can lead to things like constipation, painful intercourse, or the inability to empty your bladder completely.
People with pelvic floor tension are advised NOT to do kegels, and if you think about it, it makes sense. Trying to tighten something that is already too tight can make your problems worse.
So, how do you know if you should be doing kegels or not? Our best advice is to see a physical therapist specialized in women’s health. A trained PT can give you a thorough evaluation and can determine if you have a pelvic floor that’s too tight or too loose.
An added bonus is that if your PT finds you’re a good candidate for kegels, they’ll be able to show you exactly how to do one – something that is actually somewhat difficult for many women. And, if you’re advised NOT to do a kegel, they’ll be able to help you learn how to relax your pelvic floor and will show you exercises to help with that as well.
It’s also worth noting that while kegels are great for many people, they also aren’t the end all be all move for your pelvic floor. Your muscles are all connected, after all, so concentrating just on kegels won’t be as effective as if you worked your entire core, glutes and thighs.
Want to find a PT in your area? Try our Specialist Locator!
We often talk about incontinence as if it has already happened. In most cases, if you’re visiting this website, it probably has. But there are many things that you can do that can prevent incontinence from starting in the first place. Most of these things may also help you manage, or even eliminate symptoms of incontinence once you’ve already gotten it. Read below for some tips to stop incontinence in its tracks.
5 Tips To Prevent Incontinence
Tip #1: Maintain A Healthy Weight
Carrying around extra weight puts a lot of strain on the pelvic floor, causing the muscles to weaken and lead to leaks. In addition, folks who are overweight generally put extra pressure on their bladder, which can lead to leakage. Maintain a healthy weight by following a healthy diet and making exercise a part of your daily routine. Bonus: incorporating exercise into your day can strengthen your core and pelvic floor muscles, leading to even greater protection from leaks.
Tip #2: Don’t Smoke
Smoking on its own is an ugly habit and harmful to your health in more ways than one. People who smoke can eventually develop a chronic “smokers cough”. This chronic coughing can put a lot of strain on the pelvic floor, causing it to weaken and lead to incontinence. Smoking also irritates the bladder, causing you to need more frequent trips to the bathroom. And, smoking can lead to bladder cancer. Need help kicking the habit? Read these tips.
Tip #3: Keep Your Pelvic Floor In Shape
The pelvic floor is a basket of muscles that supports the bladder, rectum and the uterus in women, and the bladder, rectum and prostate in men. These muscles are essential in maintaining control over your bladder and bowel. Keeping the pelvic floor healthy can go a long way in preventing or treating incontinence. Learn more about the pelvic floor and how you can protect it here.
Tip #4: See A PT After Childbirth
We just talked about how important the pelvic floor is in maintaining continence. But certain things, like childbirth, can really wreak havoc on the pelvic floor and cause it to weaken. Many women don’t understand the impact that a weakened pelvic floor can have on them, even long after the baby is born. Seeing a physical therapist specially trained in women’s health soon after childbirth can be very helpful, as they can ensure that you are healing properly and learning how to correctly (and safely) get your pelvic floor back into shape. If left untreated, a weakened pelvic floor can lead to things like incontinence and even pelvic organ prolapse later in life, so this simple step can go a long way in protecting yourself for the future. Learn more about how a physical therapist can help you here.
Tip #5: Watch Your Diet
This may seem to echo Tip #1, but even if you are at an ideal weight, if you’re eating foods that irritate your bladder (and if you’re susceptible to incontinence) then you may be setting yourself up for leaks. There are many common bladder irritants (see a list of some of them here) but they can vary from person to person: what irritates one person may not bother another. If you do experience leaks, pay close attention to your diet and take note of foods that may be triggering leaks.
You're expecting and you couldn't be happier! There's literally a mini-you baking in the oven and you feel proud, excited, and even nervous about it. However, now the phrase, "you're expecting", has taken on a new meaning. Sure, you're expecting a baby, but you also may begin to throw up at random times, crave things you've never desired before, and even leak a little after a sneeze. Nobody told you that you should be expecting all of that!
You're able to get past the sleepless nights and aches and pains, but these leaks, they're not your thing. However, this too shall pass. In the meantime, you can implement a few techniques and products to make it a little more bearable.
What's Up With These Leaks?
A woman's body goes through A LOT while carrying a baby! The uncomfortable experiences are the body's way of adapting for the baby and preparing for childbirth. I mean, we've got to expect a little discomfort with a baby growing and organs shifting to make room for it, right?
Stressed Out Sphincter
You can thank your expanding uterus for putting pressure on the bladder and making you spritz when you walk, talk, laugh and sneeze. This extra pressure on your bladder is known as stress incontinence and this happens when the bladder sphincter doesn't function well enough to hold in urine.
Hormones Going Haywire
Hormones play a big part too. Relaxin is a hormone that relaxes your muscles in preparation for labor. Progesterone is also released to soften your ligaments. The result? A pelvic floor that's looser and softer, which leads to less control of your bladder.
Bladder Spazzes and Spritz
Are you frequenting the ladies room more often than usual? Then you might have an overactive bladder. This happens when the bladder starts uncontrollably spazzing out and it's a common condition for pregnant women.
Can I Do Anything About It?
The short answer is yes, you can do something about it. However, what you do about it might not actually stop the leaks. It's one of those things that you can't 100 percent control. However, there are things you can do to help manage it during your pregnancy.
Kegel exercises are helpful before, during and after pregnancy. Doing just a few sets of 20-30 Kegel exercises a day can help whip your pelvic floor muscles into shape. Keep in mind, a stronger pelvic floor can better support your uterus and bladder, which could mean fewer leaks. Plus, they'll come in handy when it's time to give birth! However, before you decide to implement anything new, like Kegel exercises, be sure to consult with your doctor first.
You're probably tempted to cut back on your water intake but that's not a good idea. Ensure you're getting the recommended amount of water each day. Otherwise, you could wind up with dehydration or an unpleasant UTI.
Could your diet be irritating your bladder? It's certainly possible. Ditch the soda pops, coffee (sorry!), tomatoes, and citrus stuff.
Products Can Help You, Too
One way to keep your leaks to yourself is by using pads, but not just any kind of pads. If you're tempted to grab one of your menstrual pads that have been stashed away for a while, please don't. They might look like they can get the job done but they won't. Menstrual pads are great for absorbing menstrual flow but not the rapid output of urine. Instead, look into bladder control pads. They're much more comfortable and offer better protection. Bladder control pads are designed to control odor, keep you dry, and let you remain discreet about your leaks.
Using a Product is Okay
A lot of women are embarrassed about bladder leakage and don't discuss options with friends or their doctor. Others feel like a few leaks aren't that big of a deal. No matter how you feel about it, you don't have to just deal with it. Doing a few Kegels and wearing a bladder control pad as a backup is a great strategy for managing leaks.
Growing a human being inside of you is going to cause a lot of physical and hormonal changes that you may or may not expect. However, one thing you can expect is to have options to make those pesky leaks a little more bearable!
What are you currently doing about leaks? Tell us about it in the comments!
This Post was brought to you by Lily Bird
Lily Bird is for all women with leaky laughs and dribble dilemmas. We squeeze when we sneeze and drip when we jump. And we think it's high time we stop saying sorry for the spritz. We provide a hassle-free monthly subscription service for bladder leak products as well as free tips and tricks for women to take control of leaks via The Chirp.
If you’ve never thought much about your pelvic floor, you’re not alone. Most people don’t give this section of the body much consideration until it’s too late – they become incontinent, or worse, suffer a pelvic organ prolapse as a result of pregnancy, obesity or chronic constipation. But the pelvic floor is one of the most important muscles in the body, and ignoring it can have potentially great consequences later in life.
Let’s begin with a little bit of anatomy. The pelvic floor is a basket of muscles that supports some pretty major organs – your bladder, rectum and uterus in women, and your bladder, rectum and prostate in men, to be exact. The muscles stretch across the pubic area from front to back and from side to side. They are typically very firm and thick, but are also flexible and are able to move up and down (kind of like a trampoline).
These muscles are very important in supporting the organs listed above, and are essential in maintaining control over our bladder and bowel. The pelvic floor muscles also play a large role in sexual function for men and women, and provide support for the baby during pregnancy.
Over the course of our life, many things can compromise the stability of the pelvic floor, leading to things like incontinence, or pelvic organ prolapse. Obesity, childbirth, chronic coughing, chronic constipation, or other things that put strain on the pelvic floor can cause it to weaken. And with age there is often a weakening of the connective tissues of the pelvic floor.
What You Can Do To Protect The Pelvic Floor
The good news is that much like the other muscles in the body, the pelvic floor can be trained and strengthened over time. By learning to strengthen the pelvic floor, you may be able to prevent or even eliminate symptoms of incontinence or prolapse.
There are many exercises you can do to strengthen the pelvic floor. Kegels are great at isolating the pelvic floor muscles, but because the pelvic floor connects to many of the muscles that create your “core” (your diaphragm, transversus abdonminis, and multifidus), you also need to incorporate workouts that build strength in those areas as well. And remember – it’s not just about tightening. We need to ensure that our muscles are neither too tight, nor too loose. Learning how to relax the pelvic floor is just as important as learning how to strengthen it, since a pelvic floor that is too tight can create weakness and cause problems too. Like any other muscle in the body, we are looking for our muscles to be strong and flexible.
Symptoms Of Pelvic Floor Tension
Inability to empty your bladder completely
If you experience these symptoms, we recommend that you see a pelvic floor physical therapist prior to starting any strengthening program. Performing strengthening exercises on a pelvic floor that is already too tight can create additional problems, or make any existing issues worse.
Symptoms Of Pelvic Floor Weakness
Stool and gas incontinence
Pelvic organ prolapse, or the dropping of your organs through your vagina
Pelvic girdle pain
Learning how to strengthen, and relax the pelvic muscles can help with pelvic floor weakness.
Want tips on how to improve your pelvic floor strength? Check out these great resources:
Note: If you are experiencing symptoms of either pelvic floor weakness or tension, we strongly advise you to see a physical therapist specialized in pelvic floor therapy. A physical therapist can help provide you with a diagnosis and put you on a custom treatment program specific to your needs.
One of the most challenging things about being a caregiver to someone who has incontinence can be the mornings. Waking up each day to your loved one’s wet bed can be both physically and emotionally draining. No one likes to wash and change sheets each day, and knowing the discomfort (and likely embarrassment) that your loved one feels can be disheartening. In fact, incontinence is often a big reason that older adults are placed into long-term care facilities.
The key to managing this problem is prevention. Having the right tools at your disposal will do wonders to help keep the bed dry and your loved one comfortable. And remember, layers are your friend. They will help keep any leaks to a minimum and make clean up so much easier.
Here are some of our top tricks for keeping the bed dry and making your life a little easier.
- Zippered, Vinyl Waterproof Mattress Cover. This should go on the bed first and will help keep any moisture from getting on the mattress. After all, replacing a mattress is expensive, and getting lingering odors out of them is very hard. If you do nothing else, do this.
- Waterproof Mattress Pad. Use this as a second layer – it’s a softer, but still waterproof cover that will go over your vinyl cover.
- Waterproof Flat Sheet.
- Waterproof Underpad. You can use these both under, and on top of a flat sheet if you wish, and they can be disposable or washable. We recommend putting a large, sturdy, washable pad on the flat sheet, then topping that with a disposable pad that you can simply toss in the trash when needed.
- Use Layers Of Blankets Instead Of A Thick Comforter. These are easier to wash in the event of an accident.
- Disposable Absorbent Products. A good fitting disposable absorbent product is key. Find one for nighttime use (they’re more absorbent) and make sure the fit is good – you don’t want anything too tight or too lose, as it will lead to leaks. For a breakdown on what to look for, see our guide on absorbent products here.
- Skincare Protection. While this won’t protect your bedding, it will protect your loved one. Proper skincare protection can help keep skin from getting irritated or chapped due to accidents that happen during the night.
Try these tips for a drier night, and happier morning.
What tips do you have for a dry night? Share them with us in the comments below!
Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.
Question: I live with incontinence and am often concerned about others noticing a certain “smell” about me. How do I ensure that my incontinence problem lead to an odor problem?
Answer: Many people with incontinence often worry about this issue. But, it’s an easy one to solve as long as you’re diligent in following a few simple steps.
1. Change often.
If you wear absorbent pads, make sure you change them often to avoid smell. Fit and type of product is also important – a close fitting product will hold odors better than something that fits too loosely, and some products have odor-reducing materials built in, which can help prevent smells. In addition, stool or urine get onto your bedding or clothing, wash them right away, or place them in an airtight container until you are able to wash them to prevent odors from making their way throughout your house. If you’re on the go, pack a disposable plastic ziplock bag to store any soiled clothing due to leaks.
2. Drink plenty of fluids.
While many people with incontinence may try to limit their fluids, you should never do so to the limit that you become dehydrated. Drinking too little fluid throughout the day makes your urine more concentrated, and more likely to smell. The general guidance is 6-8 glasses a day. You’ll know if you’re drinking enough water by the color of your urine – clear urine with almost no color (and hardly any smell) is a good sign your staying hydrated – if your urine is a concentrated yellow, it could be a sign you need to drink a bit more.
3. Be diligent about hygiene.
It’s essential that you wash daily and clean yourself well after any accidents and after each pad or application change with a gentle cleanser. If your skin becomes irritated, you can use a moisturizer or a protective ointment. The best line of defense against odor is ensuring that skin is kept clean and absorbent products are frequently changed or washed.
Are you an expert in incontinence care? Would you like to join the NAFC expert panel? Have a question you'd like answered? Contact us!
Barbara Jennings was 6 weeks postpartum when she realized that something wasn’t right. “I had been feeling some pressure in my vagina for a while, but figured it was just a part of the normal healing process after vaginal delivery.” When she finally got the courage to explore a bit, she found something that surprised her. “I felt a smooth lump protruding slightly from the opening of my vagina. I was horrified, and so scared!”
What Barbara was experiencing is called a pelvic organ prolapse, and it’s not uncommon. A prolapse happens when the vaginal walls become too week (due to things like childbirth) and the organs that are supported by them fall into the pelvic floor basket, sometimes protruding from the vagina. It’s not a curable condition, but can be improved by behavioral modifications, or surgery if necessary.
“After doing a lot of research, I learned that physical therapy could be done to help strengthen the muscles of the pelvic floor and improve symptoms of prolapse”, said Barbara. “I had never even heard of physical therapy for that part of the body, but because I knew I didn’t want surgery, I signed right up.”
Women’s Health PTs are a thing, and they treat everything from prolapse, like Barbara experienced, to pelvic pain, incontinence, back pain, diastasis recti, and more. But how do you know if you need one? And at what stage of life do you see them?
The first thing to know is that you can see a Woman’s Health PT at anytime. Whether you’re feeling some back pain during pregnancy, want to get checked out after baby arrives, or have difficulty picking up your grandkids without leaking, physical therapy is an option. Improvements can be seen at any age, and most physical therapists would agree that it should be a first line of defense against leaks and pelvic floor disorders.
Medications and surgery are often thought of first when it comes to treatment, but when you commit to a physical therapy routine, you’re making the effort to strengthen your body yourself, which can alleviate a lot of pain and/or leakage on it’s own. If you’re experiencing any kind of pelvic floor, back or hip pain, or if you have bladder leaks, call a physical therapist and get set up an appointment for an examination.
So, what can you expect when you visit? As with most doctor’s visits, you’re PT will ask you lots of questions about your medical history, and the symptoms you’re currently experiencing. You’ll also likely get a musculoskeletal evaluation, and if you are experiencing any pelvic floor dysfunction, an internal exam.
The internal exam sounds scarier than it actually is – rest assured your PT has performed many internal exams and there is nothing to be embarrassed about. It’s a necessary step for them to determine the state of your pelvic floor muscles, and your treatment plan.
Multiple visits are usually required to assess your improvement over time, and to ensure that you are performing your exercises correctly. Treatment is considered complete when your symptoms have improved, although you may need to continue with your treatment plan even after you stop visiting your PT.
If you experience any type of pelvic floor related dysfunction, including pain, bladder leaks, or even if you experience back pain (those muscles are all connected after all!), don’t hesitate to see a PT. It’s often a good first line of defense for these issues and may resolve them better and more naturally than medications or surgery. “Even though my prolapse will never be completely “cured”, I have seen tremendous improvement in my symptoms since I started physical therapy”, says Barbara. “I’m so glad I looked to this option first.”
You don’t really hear much about incontinence in men. Let’s face it – it’s not something that anyone ever really wants to talk about, but for men, it can be especially hard. Men are supposed to be tough. Caretakers. Leaders. Defenders. Admitting to something like incontinence can feel like a slap in the face. But it’s something that happens to everyone – not just women – and it isn’t something that anyone should have to live with.
Unfortunately though, many do. As many as 15% of men living at home between the ages of 15-64 may have some type of incontinence.
Men – if you struggle with bladder leakage, we urge you to speak up about it. This doesn’t mean shouting about it from the rooftops. But a frank discussion with your doctor or a loved one is a good start.
Here are 4 good reasons to talk to Someone about your incontinence:
You’ll get some emotional support.
Have you ever had something on your mind that weighed on you? Keeping your incontinence a secret can have big effects on your emotional well-being. Many people who live with incontinence become more reclusive as time goes on and the condition worsens. They avoid social activities, or don’t do the things they once enjoyed because they’re scared of having an embarrassing accident in public. But this can mean isolating themselves from others, and hurting some of their close relationships.
Lean in to those close to you and let them know what’s going on. You’ll likely find that their support motivates you to take the next step in talking to your doctor, where you can finally find some treatment. Still not ready to talk to someone close? Try our message boards. They're filled with lots of people who struggle with bladder leakage and can be a great resource when you need some tips on how to manage, thoughts on treatment options, or even when you just need a place to vent. Trust us, they know what you’re going through, and are a wonderful and caring community where you can share your concerns without judgment.
You can find out what’s actually causing Your bladder leaks.
In most cases, incontinence is not the real condition – it’s a symptom of something else. Talking to a professional about it may help you uncover the true source of what’s going on, which could be something that’s easily treated, or something that’s far more serious than some light bladder leakage. Either way, finding out is better than living in the dark, and will help you get the treatment you need to be on your way to recovery.
You’ll learn about the incontinence treatments options available to you.
We’ve come a long way from adult diapers being the only treatment option. While absorbent products are still great management tools, there are many things you can do to actually treat the symptoms and avoid leaks all together. Diet and exercise changes, kegels (yes - they're good for men too!), medications, minimally invasive procedures, and even surgical options all exist. Learning more about your options will help you find something that works for you and your lifestyle, and can feel very empowering.
There’s no good reason not to discuss it.
With so many treatment options available to you these days, there’s really not a reason to stay silent. Yes, it will probably be an uncomfortable discussion at first, but it’s not one that your doctor hasn’t had before. They hear from men who have this problem all the time. Talk with them and begin getting treatment so that you can get back to the activities you once enjoyed, instead of worrying about your bladder.
NAFC has some great resources that can help you as you begin getting treatment. Check them out below:
So, you’ve made it through menopause – now what? While many of the symptoms that came along with menopause will go away, because of some of the changes that happened during menopause, you still need to be on your A-game to remain healthy.
Here are some of the common things to watch out for
As your estrogen levels drop during menopause, the vaginal lining becomes very thin and, as a result, may be easily irritated, resulting in bleeding. Polyps (usually non-cancerous growths) can also occur. Bleeding after menopause is not normal, so if you experience this, be sure to see your doctor right away to get checked out to ensure it’s nothing serious.
Risk of Osteoporosis
After menopause, a woman’s bone breakdown overtakes bone buildup, resulting in a loss of bone mass. Overtime, this can develop into osteoporosis. Prevention is key here – be sure to exercise on a regular basis (weight bearing exercises done regularly are great at making bones stronger). Eat high calcium foods, such as low-fat milk and dairy products, canned fish, dark leafy greens, and calcium fortified foods. Vitamin D is also essential, as it helps the body better absorb the calcium you’ll be taking in. You can get Vitamin D naturally by exposing your skin to sun for about 20 minutes daily, but you may also get it from foods like eggs, fatty fish, cereal and milk. If you feel you are at a risk for not getting the calcium or vitamin D you need, talk to your doctor about taking supplements.
Risk of Heart Disease
While menopause doesn’t cause heart disease, women are at an increased risk for heart disease after menopause has occurred. Some believe that lack of estrogen may again be to blame, but other changes are in effect too – increased blood pressure, increased LDL cholesterol (this is the “bad” one) and higher levels of fat in the blood can also increase after menopause. Diet and exercise are as important as ever (to keep your heart healthy and prevent other conditions). Just 30 minutes of physical activity - walking, dancing, and swimming are all great options – 5 days per week can give you a good aerobic workout. And be sure to eat a healthy diet while avoiding too much red meat, or high sugar foods and drinks.
Because of low estrogen levels, you may still experience some vaginal dryness. Over the counter vaginal lubricants and moisturizers can help ease these symptoms, but if that doesn’t work, talk with your doctor about using some type of estrogen treatment – there are many available, and in different forms (tablets, rings, creams).
Life after menopause can be a wonderful time provided you take the time for self care and work to maintain a healthy lifestyle.
A Guest Post By Michelle Herbst, PT
As women age, their birthing history and overall muscle weakness may catch up with them. A healthy pelvic floor can be achieved as we age but often little attention is paid to the pelvic floor until it starts to fail. It can be difficult for women to seek medical attention due to feelings of embarrassment and despair. But, advances in health care and knowledge of the aging process allows today’s women to seek effective treatments.
Let’s step back and take a closer look at the pelvic floor as we age.
The pelvic floor is a sling supporting our abdominal and pelvic organs. It is made up of our muscles and connective tissues which I like to think of as our active and passive pelvic support structures. The pelvic floor muscles, or active pelvic support structures, create a muscular sling whereas our passive pelvic support structures are made of connective tissue called fascia. Fascia is a spider-web like material traveling through and covering the pelvic floor.
The active and passive pelvic support system are one in the same. They are knitted together interlacing creating a dynamic basin of support. Healthy pelvic support system work together controlling our sphincters, limit the downward descent of the pelvic organs and aide in sexual appreciation. Damage or weakness to the pelvic support system may result in symptoms of pelvic floor dysfunctions resulting in leakage and pelvic organ prolapse.
The pelvic floor over time.
Pregnancy, child birth and the post-partum period is a time of great change. The interlacing nature of the active and passive pelvic floor support systems protect the mother and baby as they both grown. Child birth calls on the pelvic support system to push and slide the baby out into the world. The pelvic floor muscles can heal in as quickly as 6 weeks after delivery. But, the physical strain of living and creating new life can be taxing on the pelvic support system leaving it overstretched and weak.
The prescription is often kegels and post-partum kegels can be hard to do. The muscles are lengthened, very weak and trying to ‘reconnect’ to their nerve supply. In an attempt to ‘get it all done’, the post-partum mom is often multi-tasking while doing kegels. Their brain is preoccupied, sleep deprived and foggy. Despite good intentions, many new mothers ‘muscle their way through’ relying on other muscle groups to assist or do the job of the pelvic floor. Overtime with due diligence and a sleeping baby – the brain fog lifts, kegels are consistent and pelvic floor muscles recover allowing the new mom to return to and enjoy life’s pleasures and adventures.
Life continues to click at a fast pace. The biological process of aging ticks away. The passage of time can be bittersweet. In the 3rd through 5th decades of a woman’s life, she will begin to experience a gradual loss in overall muscle strength and tensile strength of their connective tissue. In their 4th and 5th decades, peri-menopause ushers in a decrease in circulating estrogen and progesterone. The conclusion of these gradual changes are marked by menopause which is typically complete during the 5th decade. Life starts to catch up with you. The birthing of children, past injuries, the development of chronic health conditions and your family history may predispose the active and passive support system to overall weakening and loss of integrity resulting in leakage, organ prolapse and decline in sexual function.
What Can you do To Strengthen The Pelvic Floor?
1. Protect and strengthen your active pelvic support system by engaging in a strength program and doing your kegels. Peak muscle strength occurs in twenties or thirties. And, unless a woman is engaging in a strength program she will begin lose muscle mass and strength.
2. Protect the passive pelvic support system by avoiding straining during bowel movements and avoid holding your breath while lifting, pushing and pulling. The passive pelvic support system can not ‘fix itself’ and will need to rely strength of the active pelvic support system. So, revisit number 1 again and again and again …
3. Stay healthy and seek out your doctor’s advice when you are sick or notice your first sign of leakage or prolapse. The treatment often times isn’t as bad as you think it will be.
It’s estimated that a whopping 6,000 women reach menopause each day in the US. Menopause happens to every woman, and is the shift in hormonal changes that result in the cessation of menstruation.
While many women know about the common symptoms of menopause (Hot flashes! Insomnia!), there are certain changes that come about in menopause that are often surprising to women. One of these is loss of bladder or bowel control.
A number of things occur during menopause that can contribute to you suddenly experiencing a bit of leakage
Weakening Of Pelvic Floor Muscles
Your pelvic floor muscles play a huge role in controlling your bladder and bowel. As the muscles weaken, it can lead to more urgent needs to use the restroom, and more leaks. Weakened muscles can also lead to an increased risk for pelvic organ prolapse.
A Less Elastic Bladder
Changes that occur during menopause can cause the bladder to lose it’s elasticity and the ability to stretch. This can cause increased irritation in the bladder when it fills with urine, and can impact the nerves that regulate bladder function, which can sometimes cause overactive bladder (OAB).
During and after menopause, the body produces much less estrogen, which results in an increase of vaginal dryness. This dryness has a number of consequences, which can include an increase in the amount of urinary tract infections.
While anal trauma is usually the result of childbirth, many women may not see the results of it until menopause, when that, combined with a weakened pelvic floor can increase the risk of fecal incontinence.
It’s important to know that while these changes can lead to bladder or bowel leakage, the symptoms can also be avoided or eliminated by taking proper care of the pelvic floor. It’s never too late to start strengthening things up.
Here are some ways to increase the strength of your pelvic floor as you go through this period
As simple as it sounds, simply staying active is great to keep your weight, and overall health in check. Gentle exercises, like walking, that don’t place too much pressure on the pelvic floor are best.
Squats are a great way to build up your glute and core muscles. To perform one, stand with feet shoulder with apart. Keeping your knees over your feet (don’t let them move past your toes), lower your bottom down as if you are sitting in a chair, being careful not to lean too far forward. Raise back up to starting position. Aim for 10 reps per day. (Note, if these feel too difficult for you, try wall squats, which use the same movement, but are performed with your back to the wall for extra support.)
When done correctly, kegels can do wonders for helping women with incontinence. They help strengthen the muscles that prevent bladder leakage and also help to avoid or reduce the symptoms of pelvic organ prolapse. Remember that when performing a kegal, learning how to relax the pelvic floor is just as important as learning how to tighten it. In some cases, women have pelvic floors that are too tight and cannot relax, and if this is the case, kegels can end up aggravating your condition. If you’re concerned about your pelvic floor, or just can’t get the hang of how to do a kegel, visit a pelvic floor physical therapist for help.
The relationship between urinary incontinence (UI), pelvic floor disorders, and vaginal birth is a hot topic. Popular magazines and some scientific journals claim that vaginal birth is a cause of urinary incontinence, which has fueled the debate about another equally hot topic: cesarean delivery by maternal request! The presumed logic is this: if vaginal birth leads to UI, then cesarean delivery should be done to prevent it. In fact, questions surrounding causes and prevention of UI, as it relates to vaginal birth, are far more complex. Scientific studies done to date have shown no conclusive evidence that vaginal birth causes UI or pelvic floor disorders. Until we have more answers, cesarean deliveries done to protect the pelvic floor are unwarranted.
What is a “Birth Plan”?
It is never too early to learn what you can do during childbearing years to protect your pelvic floor and bladder health. A Birth Plan is a paper document you develop that serves as a communication tool between you and your healthcare provider. It describes how you would like to be cared for during your pregnancy, labor, and birth. A Birth Plan helps you and your provider focus on practices and procedures you believe are important to include or avoid. Everyone wants a healthy mother and baby – that is a given. However, there are many pathways to achieving a safe, normal vaginal birth, a healthy infant and a healthy, satisfied mother and family. A Birth Plan simply places these thoughts in writing. During the course of your prenatal visits, a Birth Plan encourages conversation with your provider about the processes and procedures that occur in the hospital during labor and birth that may affect your bladder and pelvic floor.
Tips For Determining a Birth Plan
During your pregnancy, ask your provider to teach you the correct method for doing Kegel exercises. When done correctly, Kegels help strengthen your pelvic floor during pregnancy and after birth.
The obesity epidemic in the United States has led to changes in recommendations about weight gain in pregnancy. Ask your provider about the optimal weight gain for you. The old adage, “eating for two” no longer applies. Obese mothers who give birth to excessively large infants are more likely to experience postpartum bladder troubles whether having a vaginal or operative birth.
Pregnancy provides the ideal time for women to quit smoking. Cigarette smoking is a risk factor for urinary incontinence. Your healthcare provider has many suggestions to help you quit once and for all.
Once in labor, being upright allows gravity to assist with your baby’s descent instead of working against it while lying on your back.
New evidence shows that “gentle pushing” or delayed, non-directed pushing techniques can minimize pelvic trauma and are more protective than “forced pushing.”
To protect pelvic floor muscles, nerves, and connective tissue, express your desire to avoid the use of episiotomy, forceps and/or vacuum extraction. There is more than a decade of research that an episiotomy need not be performed unless there are indications for such intervention (e.g., fetal distress). Episiotomy, especially midline, has been shown to increase a woman’s risk of anal sphincter injury and not to reduce the risk of other pelvic floor disorders. Patients should discuss whether or not to have an episiotomy and be certain that their doctor will not use one, other than in extreme situations. Sometimes however, these maneuvers may be necessary for you or your baby’s health.
For help in writing a Birth Plan that works for you, consult your library, pregnancy resources, your healthcare provider, and the Internet. Your healthcare provider can guide you about trusted web sites.
You’re young, healthy and probably think you’re invincible. However there are some infections that are common in young women. Read below to learn about three you are likely to experience at some point, and what to do about them.
Urinary Tract Infections
Urinary tract infections can occur in men and women of any age. They can be very uncomfortable and most symptoms include a burning feeling when urinating, urinating frequently, feeling tired or shaky, or feeling a pain or pressure in your back or lower stomach. They occur when foreign bacteria enter into the urethra and travel up to the bladder where they can cause an infection. The most common causes of UTIs are improper wiping after using the toilet (always wipe from front to back to avoid spreading bacteria from the anus to the urethra) and sexual intercourse, which can present larger numbers of bacteria into the bladder. (Tip: Always urinate after having sex – it helps to flush away any bacteria that may be present). UTIs typically clear up quickly with antibiotics, but drinking plenty of water, removing any bladder irritants from your diet (caffeine, alcohol, spicy foods), and emptying your bladder regularly can help treat UTIs too.
Yeast infections are caused by the presence of extra yeast in the vagina. When the normal ratio of yeast to healthy bacteria is off, yeast can grow too much and cause an infection. This imbalance can be caused by fluctuating hormones, certain antibiotics, or other conditions like diabetes. Many women experience itching in the vagina, in addition to painful urination and a thick white discharge. Yeast infections are typically diagnosed by a physician, and can be treated with OTC anti-fungal cream, suppositories, or anti-fungal tablets.
Younger women tend to have more sexual partners than older women. Great for your sex life – not so great when trying to prevent STDs. The human papilloma virus is the most common sexually transmitted disease, and one that you should be regularly checked for. Be sure to ask your doctor to check for HPV at each Pap smear. It’s a good idea to also get tested for chlamydia and gonorrhea while you’re at it.
Learn more about women’s conditions here.
Thinking of trying for a baby soon? Now is the perfect time to start strengthening your body in preparation for pregnancy and childbirth. And even if you’re not quite at that stage yet, the moves listed here are great for anyone to improve pelvic floor and core strength.
The pelvic floor acts as a basket of muscles that help support the pelvic organs (your uterus, bladder and bowels). Keeping them toned can not only help ease pregnancy discomforts (like urine leakage and hemorrhoids), but it can also help you later on in life as your body naturally changes due to hormones, and age. The moves below work not only the pelvic floor, but also other important muscles connected to it to ensure overall core strength.
Four Moves To Firm Up Your Pelvic Floor Before Pregnancy
There’s a reason that you’ve heard again and again that kegels are important. This exercise has long been touted by professionals as one of the most vital exercises in increasing your pelvic floor strength. Follow the instructions below to be sure you’re performing them correctly.
Identify your pelvic floor muscles by attempting to stop your urine flow mid-stream. If you can do this, you’ve found the muscles! (Note – don’t practice your kegels in this way on a regular basis – it should only be done to identify the correct muscles.)
Performing with an empty bladder, your first goal should be to tighten your pelvic floor muscles for 5 seconds. Then relax them for 5 seconds. Try to do 5 reps on your first day. As you gain confidence from your new routine, aim for 10 seconds at a time, relaxing for 10 seconds between contractions.
Be careful not to flex the muscles in your abdomen, thighs, or buttocks. Also, avoid holding your breath. Breathe freely during the exercises to keep from stressing the rest of your body.
Aim for at least 3 sets of 10 repetitions per day. The beauty of kegels is that they can be done anywhere, anytime. Try performing them during your downtime, such as waiting in line, or sitting at a stoplight.
Give yourself encouragement. These exercises will feel foreign in the beginning. But the longer you stay with this, the better your bladder health will become. As a bonus, Kegels have been reported to increase sexual pleasure as well.
Strong glutes and hamstrings are very important to the overall health of your pelvic floor. And one of the best exercises to develop these muscles is the deep squat. Squatting is actually one of the most natural forms of movement there is, however our modern-day lifestyle, characterized by long hours of sitting at a desk or on a couch, has made the squat virtually extinct. By strengthening your glutes and hamstrings, you’ll be adding additional support to your pelvic floor. Follow the instructions below to make sure you are performing squats safely and correctly.
Stand with feet slightly wider than your hips, toes pointed slightly outward.
Keep your spine in a neutral position – don’t round your back, and don’t over accentuate the natural arch of your back.
Extend your arms out straight so they are parallel with the ground, palms facing down.
Balance your weight on the heels and the balls of your feet.
Taking a deep breath, begin sending your hips backwards as your knees begin to bend.
Keep your back straight, and your chest and shoulders up.
Be sure to keep your knees directly in line with your feet as you squat.
Continue lowering your hips until they are slightly lower than your knees to perform a deep squat.
Use your core to push yourself back up, keeping your bodyweight in your heels.
Congratulations! You have just completed 1 rep!
It may help to watch yourself in a mirror as you first perform this exercise, as it is easy to perform squats incorrectly. Some things to watch for are not dropping low enough, leaning your body too far forward, allowing your knees to drift inward, and performing the exercise too quickly. Aim to complete about 2-3 sets of 10 reps daily.
Finding Your TA
Your transverse abdominus, also known as the TA muscle, is the muscle that is located deep within your core, below the six-pack muscles. This muscle is often overlooked, but it serves a vital role. The TA muscle helps to stabilize the core, pelvis and lower back, and is recruited almost anytime a movement is made. Strengthening your TA muscle will ensure that you are protecting your back and spine from extra force or pressure when you move, and will help aid in pelvic floor stabilization.
The following steps provide a very basic way to locate your TA muscle and give it a workout:
Lie on your back, with your knees bent.
Place your hand on your stomach, just over your belly button.
While you exhale, tighten your stomach muscles and pull your belly button inward. You should imagine that you are tightening a corset and flattening your stomach.
Repeat 3 sets of 10 reps each.
Once you have a good feeling for where your TA muscle is and how to activate it, you can begin incorporating the action into your everyday life - while sitting at work, standing in line, etc. Also try to practice tightening your TA muscle, like a brace, every time you perform a movement such as lifting, sneezing, squatting, etc. With practice, this action can become automatic and will aid in your core stability.
The multifidus is one of the most important muscles in aiding spinal support. The muscles are attached to the spinal column and are called upon when bending backwards, turning, and bending side to side. These muscles work with the rest of your pelvic floor muscles and TA muscle to help you hold good posture, and to stabilize your lower back and pelvis during movement. Try the exercise below to strengthen the multifidus muscle:
Lie on your stomach, with your forehead on your hands, or a towel, looking straight down. (Not to the side)
Very slowly, rotate your pelvis back slightly so that your tailbone lifts toward the ceiling. This should be a very subtle movement.
Hold for one second, then rotate your pelvis back to the floor.
Complete 3 sets of 10 reps each.
Practice activating your multifidus muscle throughout your day by keeping good posture.
Note: Even before you’ve had children, there may be times when certain pelvic floor exercises are not appropriate. And, it’s important to know that there is no “one” exercise alone that will strengthen your pelvic floor as it is supported by many muscles. Always check with your doctor before beginning any exercise program. And, if you have concerns about your pelvic floor, no matter what life-stage you are in, consult a trained physical therapist specialized in women’s health. Your Physical Therapist will also be able to ensure that you are performing the moves correctly so that you are getting the most out of your workout. Use the NAFC Doctor Finder to find a doctor in your area.
If you’ve never been pregnant, it’s likely you’ve spent little time thinking about your pelvic floor. And yet, now is exactly the time that you should be focused on it. A healthy pelvic floor can prepare you for a great pregnancy and a safe delivery, and it can prevent a host of problems that may occur after childbirth. The pelvic floor works as a basket of muscles, holding your uterus, bladder, and rectum in place. When you’re young, and your pelvic floor has not suffered the effects of age or childbirth, you usually see few complications. But sometimes, strain on the pelvic floor (like carrying a growing baby for nine month, giving birth, and the natural effects of gravity over time) can cause problems like bladder leakage. The good news? These effects can be lessened, or even eliminated, if proper care is given to the pelvic floor now. Here are the steps you need to take to ensure that you’re taking proper care of your pelvic floor, and yourself, prior to becoming pregnant.
How To Prepare Your Pelvic Floor For Pregnancy
Assemble your squad.
Finding the right team of professionals is key to keeping your health in check. If you haven’t already, do your due diligence and start seeing these health care professionals on a regular basis.
- Primary Care physician
Need help finding a health care professional? Use our Doctor Finder!
Keep a healthy weight and develop a workout routine.
If you’re planning to get pregnant, don’t fall into the trap of thinking that weight doesn’t matter pre-pregnancy – the healthier you are now, the healthier you will be during your pregnancy, and the easier it may be to shed those extra pounds after baby arrives. Not only that, but keeping your core and pelvic floor strong now will help better prepare you for pregnancy and childbirth.
Maintain a healthy diet.
Eating right is always a good idea, and it can really help you maintain your weight. In addition, keeping your diet in check can help you prevent diabetes (a condition that is on the rise in the US, and that, in some cases lead to neurogenic bladder.)
Get a well-woman exam every year – be sure to talk with your physician about general health metrics like blood pressure levels, diet, weight, and any stress that you may be experiencing. Have a regular Pap smear every 3 years if you’re between 21 and 30. While you’re at it, be sure to have a yearly breast exam to check for any unusual changes. Do your own monthly exams as well and become familiar with how your breasts normally look and feel.
Quit those bad habits
If you haven’t heard, smoking is really not cool anymore and even if you don’t believe that, consider this – aside from a host of other health problems, smoking can contribute to a leaky bladder.
Uncover any risk factors that you may have by learning your health history
Talk with your family to learn about any risks that you may have health-wise. Knowing these now can help you prevent possible health threats down the road.
Even if you only choose to follow a couple of these steps prior to pregnancy, know this: this time is all about prevention – the steps you take now to take care of your body will pay off in folds down the road. Don’t wait to start taking control of your health.
Check in with us all month to learn how to stay healthy at every stage of life.
Being constipated is a very uncomfortable situation, leaving many people stressed and impatient. For some, constipation further aggravates bladder control issues and for others, the problem is merely uncomfortable. Regardless of how your bladder is affected, the impatience and stress caused by constipation only makes the whole situation worse.
Thankfully, constipation is usually a situation fixed by better eating habits and/or a change in medication. Talk to your doctor about your constipation and consider bringing in a bowel diary of how often you pass a bowel movement.
If medication is the sole catalyst, your doctor should be able to advise a healthy alternative. And if eating a more fibrous diet is in the cards for you, consider trying these ten constipation-fighting foods.
Foods To Prevent Constipation
- Beans and Legumes
- Flax Seeds
- Pineapple Juice
What foods or drinks do you use to combat constipation?
Diabetes is a growing epidemic in our nation. More than 29 million Americans currently suffer from diabetes, and the Centers for Disease Control and Prevention estimates that by 2050, as many as 1 out of every 3 adults in the US could have the condition.
Many of us have heard the common complications associated with diabetes: heart disease and stroke, eye problems, including blindness, kidney disease and amputations due to damaged blood vessels and nerves. But did you know that diabetes can also lead to neurogenic bladder?
Neurogenic bladder is a condition that occurs when nerve damage has occurred, preventing the bladder from emptying properly. Symptoms can include a frequent and strong urge to urinate (but in small amounts), difficulty emptying the bladder, incontinence, and urinary retention. Many people associate neurogenic bladder with conditions such as spinal cord injuries, MS, Alzheimer’s Disease, or Parkinson’s Disease. But neurogenic bladder can happen in people with diabetes too, as a result of diabetic neuropathy, which causes the bladder to lose the ability to sense when it is full.
The good news is that there are treatment options available for neurogenic bladder. Lifestyle changes, such as scheduled voiding, dietary changes, and keeping a bladder diary are a helpful start and can make a big difference. Several drugs and procedures can help with symptoms of overactive bladder, and for those who have difficulty urinating, catheters can be a big help as well. Finally, surgery options are available.
Of course, if you are pre-diabetic, the best course of treatment is prevention. Keeping your A1C levels in check with proper diet and exercise is essential in ensuring that you maintain a healthy weight. Eating healthy foods at moderate portions, and getting in 30 minutes of physical activity can delay and in some cases prevent the disease.
If you are concerned about diabetes, talk with your doctor. He or she will help you assess your risk factors, and start you on a plan to combat this very prevalent disease.
Question: What’s the best way to prevent UTI’s when you have a neurogenic bladder?
Answer: Unfortunately, Urinary Tract Infections are common in patients with neurogenic bladder. Patients with neurogenic bladder often have a harder time completely emptying their bladder. They also are often unable to sense that the bladder is full, resulting in them holding urine for too long. Some patients also self catheterize, or use indwelling catheters, which can present complications leading to a UTI.
Of course, the best treatment of a UTI is prevention.
Below are 2 simple steps that patients living with neurogenic bladders can take to avoid bladder infections.
1. Keep things clean.
It stands to reason that keeping yourself, and any equipment used to assist with voiding, hygienic can help keep bacteria at bay. Be sure to properly clean your body, and any external catheters after each use. Always wash hands before and after self-catheterizing. During a short-term infection, change indwelling catheters and be sure that the bladder fully empties to prevent urine from remaining in the bladder for too long.
2. Develop a voiding schedule.
While many things are considered when deciding when to catheterize, including patient and caregiver schedules and urine production, steps should be taken to ensure that the bladder is emptied frequently to prevent infections. Develop a schedule that works for you and stick to it.
UTI’s can cause many complications for people with Neurogenic Bladder, including decreased quality of life and other serious health concerns. If you are experiencing any common signs of a UTI, call your doctor.
Common signs of a UTI:
- Urinary incontinence/leaking around the catheter
- Cloudy urine
- Back pain
- Bladder pain
- Painful or difficult urination
- Sudden, high blood pressure
Simply stated - the pelvic floor isn’t just a female thing - it is a muscular sling supporting the pelvic and abdominal organs of men and women. The pelvic floor helps keep us dry. More than 50 percent of men over the age of 60 experience bladder control issues due to an enlarged prostate.
Before I share my best pelvic floor tips for both sexes, we need to agree on the following three truths: strengthening a weak pelvic floor may improve bladder control and confidence, utilizing my tips in conjunction with seeing your healthcare provider will create the most optimal effect, and it’s important to allow yourself to have a bad day here and there.
Here are my best pelvic floor tips.
For a week, keep track of your trips to the bathroom, your leaks and how much and what you are drinking. Note any trends with fluid intake, time of day and activity level in relation to using the bathroom and your leaks. Your documentation may help your health care provider order tests, make a more accurate diagnosis or prompt a referral to a specialist.But, please consider what you can do with the information. Are there any trends you are seeing? Do you have more problems in the morning, afternoon or evening? Do you need to space out your fluid intake? ou may be able to cue into changes that may positively impact your bladder control and confidence.
Drink more water and consider cutting down on alcohol and caffeine
Many newly incontinent persons incorrectly assume if there is less water in the system there will be less water to pass. Cutting out water, or significantly decreasing water consumption, while continuing to consume alcohol and caffeine at normal previous levels may aggravate the bladder and make the leakage problems worse. Hydration with plain, old water is one of the keys to improved bladder function. And, revisit your diary – it may be possible that alcohol or caffeine may be a trigger to your leakage pattern. Do you need notice you have more problems with bladder control after a glass or two of coffee or your favorite cocktail?
Yes – we need to talk about this. Men can do Kegels and should do Kegels to improve bladder control. Kegels are not just meant for women. Repetitively performing Kegels will improve pelvic floor muscle function, strength and endurance. Kegels should be a habit like brushing your teeth. The truth of the matter is - if your pelvic floor muscles are in better space they will be better able to support you and keep you dry. Here are some cues that may help you or your loved one perform a Kegel.
Return to the idea that pelvic floor is a muscular sling. It supports your abdominal and pelvic organs kind of like a hammock running along the base of pelvis – front to back and side to side.
Gently pull the pelvic floor up and in towards your navel as if trying to protect yourself from a blow to the belly. When you do this – you may feel a gentle tightening of the muscles underneath your navel. Your tailbone may gently rises up and in. Continue your normal breath. Keep in mind, the Kegel, I am recommending is not 100% effort but a gentle tightening of the muscular sling.
Continue breathing and hold the Kegel for a few seconds. Then gradually relax. Repeat until you’re fatigued or have completed your goal.
That concludes my list of my best pelvic floor tips. What are your best practices?