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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.
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.”
June 5, 2017, Charleston, SC: The National Association For Continence launches new campaign, “Life Without Leaks”, to raise awareness of bladder leakage and urinary incontinence, and to urge people to seek treatment.
Laura’s bladder-leakage problem started early in life, shortly after she had kids. She would leak a little sometimes when she sneezed, ran, coughed or laughed, but just once in a while, and nothing to make her think it was a big deal. But as the years went by, Laura’s problem got worse. It progressed to the point to where she could not leave the house without packing an extra pair of clothes. She scouted out the nearest bathroom wherever she went. And she stopped doing some of the things that had mattered most to her – traveling with her husband, running, socializing with her friends and family. Slowly, her “little problem” had become it’s own prison – limiting Laura’s life and keeping her from doing the things she wanted.
Laura’s story is not uncommon. Millions of Americans live with some form of Bladder Leakage, yet few seek treatment for it. And while the issue may seem trivial to some, for those who struggle with bladder leakage and incontinence, it can be devastating. Apart from the obvious physical effects, bladder leakage can have a huge impact on emotional well-being. Many people are ashamed of the issue, and take great measures to hide it from friends, and even close family members. As the condition worsens, people retreat further into their lives, limiting their social interaction for fear of having an accident. And the things they loved to do take a backseat to protecting their pride and hiding their problem from others. Financial impact of the condition can also be damaging – the cost for supplies, productivity loss, and missed work can add up, causing even more distress.
NAFC’s new campaign, “Life Without Leaks”, is meant to show people that there is a light at the end of the tunnel – that they don’t have to live with bladder leakage and can take their life back again simply by getting educated and seeking treatment. “We wanted to show people the life they may be missing due to bladder leakage – the one they may have even forgotten they once loved,” says Steven Gregg, Executive Director of NAFC. “Urinary Incontinence is often a slow-building condition, getting worse as time goes by if left untreated. Many people who have it have made so many small adjustments over the years to compensate they may not even recognize what they’ve given up in order to hide their shame. We want to remind them of the life they once loved – to show them life is possible without leaks.”
NAFC launched the campaign’s first video in June, with more videos planned to launch through 2017. The campaign is supported through NAFC’s social channels, email, and their website. www.nafc.org. “We’re trying to raise awareness of this under-treated and little talked about condition,” says Gregg. “There are so many treatment options available for incontinence. We just need to get people to take that first step and seek them out.”
“Life Without Leaks”, has been funded through a sponsorship from Astellas.
We’re wrapping up Women’s Health Month this week and we wanted to leave you with just one thought. If you take away anything from this past month, it should be this:
No matter what your age, it’s never too late to seek help for incontinence.
Whether you are a new Mom in your 20’s or 30’s, or have just finished menopause, there are treatments available that can help you. Talk to your doctor and formulate a plan of action. Don’t be embarrassed – you certainly are not the first woman to discuss bladder or bowel health conditions with your doctor and you won’t be the last. They’re there to help you. And if, for some reason, they do brush you off, or attribute your bladder leakage to aging, then we have news for you: it’s time to get a new doctor. Because living with bladder leakage is really no way to live, no matter what age you happen to be. And if you've looked around this site at all, you know that there are many ways to treat leaks.
Take charge of your health and learn how to live a life without leaks!
Need some inspiration from others like you? Head on over to our message boards. You’ll find a supportive and open community to share tips, struggles and personal stories.
Getting older is inevitable. It will happen to us all at one point, but just because we’re all aging doesn’t mean our life has to decline. The power of positivity is a real thing, and research shows that those who are optimistic about getting older, and who follow the mantra “you’re only as old as you feel” actually do fare better than those who are more likely to attribute aches and pain to old age.
In a study from the Journal of American Medical Association, researchers looked at the effects of positive age stereotypes to see what effect it had on helping people recover from certain disabilities. Participants (aged 70 years or older) were asked to relay 5 words or phrases that came to mind when they thought of old people. None of the participants had a disability prior to the initial questioning, but they did experience at least one month of disability during the 11-year follow up. The people who had given more positive age stereotypes were 44% more likely to fully recover from severe disability and were able to perform daily activities better as they aged than those with negative age stereotypes.
Positive thinking does matter. Even as we age, we are still in control of our own life. How we view it, and our health, make a big difference. Nothing could be truer when considering a condition like incontinence. At NAFC, we hear from people all the time who think incontinence is simply a part of getting older. They’ve already resigned themselves to the fact that it will happen and there is nothing that can be done. But that is simply not true. (And if you follow this blog we hope you know that by now!) Lifestyle changes, medication, simple medical procedures, and even surgery can often correct the problem (or at least greatly improve the symptoms). Don’t let your health decline simply because you’re marking another year on the calendar. Take charge of your wellbeing and attack any health concerns head on now, to enjoy a long and happy life.
Here’s a quick exercise to try each day.
Close your eyes and think of a time when you were at your optimal health. Think of your vibrancy at that age, your energy, how you felt. Now think of yourself as that age – not just in this exercise, but throughout your day. Associate yourself with that vibrant, younger version in everything you do. And, if research is correct, you may just start noticing the difference!
Have some tips to share on how you “think yourself young”? Share them in the comments 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.
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.
Menopause will affect every woman at some point in her life. Menopause occurs when hormonal changes cause the menstrual cycle to stop. Whether you are on the verge of this life change or right in the middle of it, there are things you can do to manage the side-effects. But first, it helps to know what is and isn’t true.
Here are some common myths about menopause and the reality behind them
MYTH #1: MENOPAUSE BEGINS AT A CERTAIN AGE.
Fact: While the average age for menopause to start is 52, this is not a steadfast rule.
Women can begin menopause as early as their 30s and as late as their 60s! Technically, menopause begins when you have stopped having a menstrual cycle for 12 months. But symptoms can start even before this begins – perimenopausal symptoms can last anywhere from a few months to several years before actual menopause starts.
MYTH #2: HOT FLASHES ARE THE BIGGEST SYMPTOM I NEED TO WORRY ABOUT.
Fact: While hot flashes are a commonly talked about symptom of perimenopause and menopause, there are many symptoms that can occur (although not all women experience all symptoms). Irritability, fatigue, anxiety, mood swings, low libido, forgetfulness, weight gain and vaginal dryness are just a few of the symptoms that women may experience during this stage of life.
MYTH #3: INCONTINENCE THAT COMES AS WE AGE IS JUST A RESULT OF GETTING OLDER AND THERE’S NOTHING I CAN DO ABOUT IT.
Fact: It’s true that menopause can increase the risk of urinary incontinence. During menopause, estrogen levels decline, causing a number of changes to the body. Without proper care, pelvic floor muscles can become weaker, increasing the possibility of leakage, or even pelvic organ prolapse. Vaginal dryness can occur as the lining of the vagina produces less mucus. And a decline in bladder elasticity can increase bladder irritation and impact bladder function, which can cause overactive bladder (OAB). But while hormonal changes that come with age can influence symptoms, there are many things that can be done to prevent or manage incontinence, starting with taking proper care of your pelvic floor. If you are experiencing any of the above symptoms, talk with a licensed physical therapist who specializes in women’s health as soon as possible so that they can evaluate your symptoms and set you up on a proper treatment plan.
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.
A Guest Blog By Sally Connor
I am a 38-year old woman, and I am angry. Angry that my body has changed so much since I’ve had children, angry that I developed a prolapsed bladder after the birth of my first son, angry that I can no longer run the way I used to without making several trips to the bathroom, or worse, wetting myself. I am angry with my doctors for not telling me that this may be a side effect of pregnancy and that there were steps I could have taken to prevent it. I’m angry with other women for not telling me that it has happened to them. I am angry for my sheer ignorance of the situation until it happened to me. But more than anything, I am angry that no one knows any of this because in our society, it feels too embarrassing to really talk about.
When we are young, we don’t think about these things. Before I had children, I don’t think that I ever even gave the pelvic floor much thought. Quite frankly, I didn’t even know what it was. Here is what I didn’t know: That the pelvic floor muscles act as a basket, supporting your bladder, uterus, and rectum. It is also connected to and supported by your deepest core muscles – your transverse abdominus (below the ‘six pack’ abs) and your multifidus (the tiny muscles that support the spine), and is affected by almost every movement you make. The pelvic floor, what I now refer to as the epicenter of my body, is called upon every time you sit, stand, squat, walk, and even breathe.
So I ask, why is it that we don’t hear more about this vital web of muscles? Why are we kept in the dark until it is too late? Because, really, much of this can usually be prevented. The pelvic floor, just like any other muscle in the body, can be strengthened and trained. With regular exercise, the pelvic floor and the supporting muscles around it can provide a strong foundation for continence for your entire life. But, like any other muscle, if it is already in a weakened state, and then becomes traumatized by something like childbirth, well, the damage is done.
That is the case with prolapse. You can try to repair it, and may see marked improvement through physical therapy, or even surgery, but once the damage is done, it is done.
It doesn’t mean that there is no hope though. I know this. I have seen great improvement in my symptoms and am grateful to have had access to a very skilled physical therapist who was able to show me how to strengthen things up ‘down there’. But, I still do experience some symptoms and I can’t help wonder if things would be the same had I been more aware of this muscle and what I should have been doing to keep it strong prior to and during pregnancy.
With over 25 million Americans experiencing incontinence, I am baffled that the issue is not publically talked about more often. It is estimated that about 40% of women will experience prolapse at some point in their life. When will we decide that these conditions deserve attention? Talking about them would encourage more people to get help, and, maybe even more importantly, take steps to prevent it.
Instead, the silence only encourages the shame, embarrassment, and isolation that many people with incontinence experience. It does nothing to help those who are experiencing the issue to know there are ways to treat it. Nor does it educate those who have not experienced it to know that this is something that should be considered. Until we can all be more open and recognize that this is a problem worth talking about (shouting about!), we will be a society that continues to allow it’s people to ‘quietly manage their symptoms’ instead of really preventing or treating them.
So please, speak up about your incontinence, your prolapse, or any other pelvic floor issue you may have. While it may be common, it’s not normal, and is nothing that anyone should have to suffer with in silence.
About the author: Sally Connor is a mother, wife, entrepreneur, and homemaker who suffered a prolapse after giving birth to her son. She has refused to let this symptom rule her life and strives to increase awareness of pelvic floor issues and what women can do about them by simply talking more about the issue. She hopes that one day pelvic floor issues and incontinence will be a less taboo subject.
Women…the ultimate caregivers. We take care of our spouse, our kids, our parents, our pets and all the nuances that come with keeping a house, a job, a family…a life. We are superheroes! In fact, we are so good at taking care of everyone and everything, we often tend to forget about one of the most important things we should be taking care of - ourselves.
And this is such a shame, really. Because all the people and things that need us…they need us to be the best versions of ourselves. That means getting good sleep, exercising, eating well, getting regular check ups, and maintaining a healthy weight. And those other nagging things we deal with all the time that get pushed to the backburner because we ‘don’t have time’, ‘it’s not that bad’, or ‘it’s just a part of getting older’ (ahem…incontinence)? Those deserve attention too. Because life is just too short to just live with them. And most of the time, they are things that can be treated.
So women, please – think about yourselves this month and think about ways you can put yourself first. Go for that walk, take a little extra time to make a deliciously healthy dinner, call your doctor for a check up. Do something for yourself and you will see that the joy and health it brings you will spill over into all the other wonderful things you care about too.
Want to do something extra nice for yourself? Take the NAFC 8-Week Challenge!
A hysterectomy is a surgical procedure done to remove a woman’s uterus. There are several potential reasons a woman may need a hysterectomy:
Uterine Fibroids that cause bleeding, pain and other problems
Abnormal vaginal bleeding
Chronic pelvic pains
Cancer of uterus, ovaries or cervix
This operation is either done to remove the part or the entire uterus after going through a rigorous and thorough checkup. In United States, 1 out of 3 women have gone through hysterectomy by the age they are 60. It is the second most common surgery in women, followed only by cesarean delivery. The majority of this operation is done to treat noncancerous conditions in women.
Even though a hysterectomy is a fairly safe surgery, there are certain side effects associated with it. Some of these include problems related to anesthesia, infection, bleeding, blood clots, injury to internal organs and loss of ovarian functions, which means no menstruation. Some women also experience less interest in sex, which can be treated with hormone therapy. And, if this surgery is done before a woman reaches menopause, she may experience menopausal type symptoms, such as hot flashes, mood swings, and vaginal dryness.
A common side effect of having a hysterectomy is incontinence. After the surgery, nerves of the bladder may be damaged because of their nearness to uterus. This can cause stress incontinence, the involuntary release of urine during things like exercise, sexual activity, sneezing or coughing – all of which put increased pressure on the abdomen. Fortunately, there are many treatment options available, so if you have incontinence as a result of a hysterectomy, talk to your doctor about what you can do. Physical therapy, medication, and in extreme cases, even surgery can be used to treat the problem.
While many women are happy to be relieved of the symptoms they experienced prior to a hysterectomy, the changes to a woman’s body after surgery can be drastic. A full recovery after hysterectomy generally takes 6-8 weeks, after which it is advised to start doing regular activities with caution. The body may need additional time to adjust to changes in hormone levels.
Even though this is a common surgery, having a hysterectomy is a major decision for most women. There are several procedures commonly used for hysterectomy like abdominal, vaginal or laparoscopic. Your doctor will be able to walk you through the pros and cons of each option, and help you decide on what is best for you. Visit the NAFC Specialist Locator to find a specialist in your area.
Millions of Americans experience some form of incontinence. And, while this condition affects both genders, if you are a woman, you are more likely to suffer from incontinence than men due to things like pregnancy, childbirth, and menopause.
There are several different types of incontinence you may experience:
- Stress Urinary Incontinence: SUI occurs when any extra pressure placed on your bladder or abdomen causes you to leak urine. Things like sneezing, laughing, or certain exercise all may trigger SUI.
- Urge Incontinence: Also known as Overactive Bladder, Urge Incontinence is the sudden, frequent feeling that you need to use the restroom.
- Mixed Incontinence: Many people suffer from both Stress Urinary Incontinence and Urge Incontinence combined.
- Urinary Retention: This type of incontinence occurs when you are unable to completely empty your bladder, leading to leaks.
The good news is that all of these conditions are treatable. And now, more than ever, there are countless options for treatment, so if you haven’t yet found something that works for you, try again! Here are some popular treatment options:
- Absorbent products: Probably one of the most widely used treatment options, absorbent products are a good first line treatment for those who experience leaks. There are many different types and fit is very important, so expect to try out a few and see what works best for you. And whatever you do, don’t use sanitary pads in place of absorbent products specifically designed for leaks – the two are made of different materials and sanitary pads are not designed to hold urine, so leaks are likely to occur if you use them for that purpose.
- Behavioral Therapy: Before trying out medication or other procedures, you may want to tweak some of your behaviors to see if they have any effect. Things like altering your diet to eliminate bladder-irritating foods, starting a physical therapy routine, or practicing bladder retraining can all have an effect on managing your symptoms.
- Medications: There are a number of medications that may help you with bladder control. Most medications work by calming the bladder and reducing the spasms that sometimes happen and cause leakage. Talk with your doctor about the different types and learn what may work best for you.
- Non-invasive procedures: If you’ve tried medications and have not seen results, or experienced unwanted side effects, you may want to give a non-invasive procedure a try. InterStim, Botox, and PTNS are all simple procedures that can be administered in a urologist’s office and can have a significant effect on symptoms and quality of life. Talk with your doctor to learn more about these procedures and what you can expect if you choose to go this route.
- Surgery: Several surgical options exist for those experiencing urinary incontinence. Surgery is often a more permanent solution, and is a common approach for many who have failed on other treatment plans. But, it’s not for everyone, and may not always eliminate all your symptoms. Be sure to talk to your doctor (usually a urological surgeon) about what may work for you and what you can expect after surgery.
Finding the best treatment plan for you requires you to play an active role. Know your options and educate yourself about the different treatments available so you are better able to discuss them with your physician and make an informed decision together.
To find a specialist in your area, visit the NAFC Specialist Locator and make an appointment today!
Becoming a mother is one of the most joyful things that can happen to a woman. But it can also be challenging. Not only are you dealing with the demanding task of raising a little one, your own body is undergoing constant change as well. There are a lot of misconceptions out there about how our bodies should perform after we have kids - many of them false. Take a read below and learn some of the most common misconceptions around bladder health and becoming a mother.
Misconceptions around bladder health and becoming a mother
Fact or Myth? After having kids, it’s normal to pee a little when I laugh, sneeze, run, etc.
Myth. While this can happen for a few months after childbirth, it is not something that is “normal.” It should be dealt with. Talk to your doctor or a trained physical therapist about some exercises that may help get you back to normal, and product suggestions that can help you manage incontinence in the meantime.
Myth. It’s true that sometimes incontinence does not rear it’s ugly head until well after you’ve had your children – often in your 40’s or 50’s. But that doesn’t mean that it’s a sure thing you will suffer from incontinence – especially if you are proactive in getting your pelvic floor strong now. It’s never too late to start incorporating your pelvic floor into your workout routine.
Fact or Myth? I might as well get used to being incontinent – now that I’ve had a baby there is nothing I can really do about it anyway.
Myth. As we mentioned above, incontinence is certainly not normal, and there are a host of things that you can do to manage, and even fix it for good. For starters, adult absorbent products can help you manage immediate leaks that you may be suffering from post childbirth until you are able to build up your strength again. When you schedule your 6-week postpartum check up with your doctor, schedule a visit with your physical therapist as well – it’s a great time for an initial evaluation and you can learn some good postpartum exercises to start right away. And if you are still feeling like things are not quite right after a couple of months, talk with your doctor about what you can do.
Fact or Myth: I don’t have to worry about working on my pelvic floor until after I’ve had the baby.
Myth. One of the best things you can do to prepare yourself for childbirth is to start working out your pelvic floor today. Not only will it make your delivery easier, but you will be that much stronger and your recovery in the postpartum days ahead will be much faster.
Going from zero to 60mph is great for your new two-seater racing car, but not for your muscles. It’s important to slowly gain speed in your workout routine, making your warm up routine a prime time to work your pelvic floor.
Strengthening your pelvic floor will help restore muscle function and lessen the symptoms of incontinence. Kegels are the primary pelvic floor exercise.
Whether you’re jogging, running, hiking, biking, or playing a contact sport, warming up is crucial to your exercise plan, so why not incorporate kegel training into your daily routine to help strengthen your pelvic floor muscles?
Here are a few suggestions for including kegels in your warm up routine:
Walk for 3-5 minutes at a steady pace. Take a break at a corner on your block or a turn on a trail and do 10 pelvic floor holds.
Do 10 lunges and 10 wall-sits for three reps. Between rotations, practice 5 kegels.
Practice a forward fold to stretch your hamstrings and back. Hold the fold 10-15 seconds, then stand and hold a kegel for 5-10 seconds. Repeat for 2-3 times.
Do jumping jacks or jump rope for 30-second intervals. Between each interval, practice 10 kegels.
Both men and women have pelvic floor muscles and both men and women experience a lack in pelvic floor strength as they age. Learn more about the importance of working your pelvic floor here. And find instructions on how to properly kegel, or lift your pelvic floor, here. It is important to remember to let your muscles relax between contractions and to work all the muscles of your core to ensure optimal pelvic floor strength. If you are unsure of the exercises that would work best for you, finding a physical therapist specialized in pelvic floor strengthening can be very helpful in creating a routine.
If you are looking for more ways to warm up before your work outs, we suggest heading over to workoutlabs.com. You can make your own printable full-body warm up graphic so you always have examples at hand. Print your own sheet out and add kegels wherever you feel most comfortable.
See our favorite full body warm up rotation below. Click here to make your own.
When you first met your spouse years ago, you were enthralled with how they made you feel. Seeing one another and spending time together was really all you needed to feel giddy, happy, and complete.
Life continued its course, your relationship progressed, and with the years came successes and challenges. Honesty, with both with your partner and yourself, likely played a huge factor in how you tackled those challenges.
Tackling your incontinence deserves the same level of honesty you’ve used in other situations. The person you chose to spend the rest of your life with is your best mirror and they will have the most insight into how to keep you accountable with your care and how to help you live a full life. To leave them out of the conversation about your health is taking away one of the best assets you will have in managing your care and moving away from embarrassment and secrecy.
We believe honesty is the best policy and asking for help is a good thing. We also believe that those who are most close to you can be the biggest supporters in your life. Use that insight and commitment to your advantage and ask for help in every day things. Practicing this in other aspects of life will trickle into your health, too!
Here are five ways your spouse can keep you honest:
1. Pick a designated time during the day or the week when you give one another one piece of positive reinforcement and one suggestion for improvement.
Example of positive reinforcement: “You were so helpful this week doing the laundry while I was at coffee with my friend.” OR “I think John really appreciated your phone call to him this weekend—great job reaching out!”
Example of a suggested improvement: “Next time you call me on your way to work, could you please say ‘I love you’?” OR “I felt like you didn’t really want to help me rake the yard this weekend. Next time I ask for help can you be up front if you’re in a bad mood?”
2. Choose a household item that can serve as a reminder to you that you need to check-in with your treatment plan.
This could be a figurine, candle, or paperweight. Decide on a place for this item to be placed and ask your spouse to put this item in that designated place when they think you need to re-evaluate your treatment plan. Maybe you haven’t been taking your medicine as prescribed or you’ve avoided drinking water like your doctor recommended.
Let this object be a check in that your spouse can initiate.
3. Swap household duties (within reason) with your spouse for one week and report back at the end of the swap. Discuss ways you have both made assumptions about the other’s work or how you can display gratitude for their help more often.
Pick a few chores that your significant other typically does and do them for a week instead. Report back to them at the end of the week and discuss the challenges of walking in their shoes for a week.
4. Designate a jar or vase on your dresser or somewhere in your personal space that serves as a compliment jar.
Ask your spouse to use this jar as a way to compliment you on areas of treatment you’re excelling in. Use the jar in the same way for areas of their health and life they’re looking to improve.
Read the compliments before going to bed every week or every month.
5. Give yourself a report card every season and ask your spouse to check your grading.
Sketch a basic grading rubric with boxes for each area of life you’re looking to improve in (i.e. sleep, diet, exercise, downtime, community), fill out your own evaluation, and go over the details with your spouse. Discuss goals you can set to improve in the next season.
Tell us how you keep the lines of communication open with your spouse in the comments below.