The muscles every woman needs to strengthen
Rise and shine squeeze!
In the realm of women’s health, the pelvic floor is often overlooked. If you’re asking what the pelvic floor is, it’s likely that you haven’t had a gynaecological check-up (you’re not the only one who is afraid) or haven’t had children.
From hormonal upheavals during pregnancy to menopause and everything in between, our pelvic floor muscles are working hard to keep everything intact. But despite its importance, pelvic floor health is often neglected or misunderstood.
“The pelvic floor is made up of an intense base of muscles, ligaments and tissues that form the foundation of the pelvic region. They stretch like a hammock from the pubic bone in the front to the tailbone at the back, and between both the sitting bones on the sides,” explains Mumbai-based Dr Vanshika Gupta Adukia, founder of Therhappy and a pelvic floor physiotherapist (along with being a pregnancy/childbirth and lactation specialist).
Adukia adds that pelvic floor muscles play a crucial role in holding all the pelvic floor organs, including the bladder, rectum and uterus, in place. They also help control the release of urine and faeces. “Additionally, the pelvic floor assists in sexual functioning. Normally, these muscles are firmly wrapped around the passages of the pelvic organs, keeping the openings shut.”
Neglect, however, can lead to pelvic floor dysfunction. Often, we don’t even know when we are experiencing something related to our pelvic floor. A UTI, perhaps? But this region needs your attention, especially if you have or are planning to have children.
What happens when you have weak pelvic floor muscles?
Weakened pelvic floor muscles can lead to pelvic floor dysfunction. “[This] refers to the weakening of the normally firm and tight pelvic floor muscles,” says Adukia.
She adds that there are several symptoms, including urinary incontinence while coughing, sneezing and laughing, and having trouble making it to the loo in time when you need to urinate (there will be leakage).
“It impacts the body’s ability to hold onto bowel movements, or causes the involuntary release of flatulence, with wind passing from the back at the rectum to the front of the vagina.”
If your pelvic floor muscles are severely weakened, “the organs may descend lower from the original positions in the pelvis, even prolapsing out of the body. It’s also associated with painful intercourse,” says Adukia.
What causes a weak pelvic floor?
The pelvic floor changes with each stage of life. There is a misconception that pelvic floor health is a matter to think about only if you are planning on getting pregnant.
The number of pregnancies can impact your pelvic floor muscles, with the growing baby in the uterus putting pressure on and weakening the pelvic floor. How you deliver is also a factor. “During a vaginal birth, the baby has to push through the vertically placed pelvic floor muscles, stretching them for prolonged hours, causing further weakening.”
Postpartum aside, hormonal imbalances can wreak havoc on our pelvic floor muscles. Major oestrogen fluctuations during the period of perimenopause/menopause and nursing “directly impact its strength, leading to dysfunction.”
How do professionals assess pelvic floor health?
Many Indian women are still apprehensive about visiting a gynaecologist (especially if they’re unmarried) and the thought of getting their nether region checked out can induce fear or embarrassment.
Adukia says assessments can be done depending on the patient’s age and symptoms. “For the comfort of young patients with no history of sexual activity, we generally assess based on the description of symptoms. For those who are comfortable and/or are older, a vaginal examination by therapist can be performed to assess the strength and functioning of the pelvic floor.”
Vaginal examinations are generally avoided for pregnant women to safeguard their comfort and avoid any potential pregnancy complications.
What about treatments?
Treatment for pelvic floor issues depends on symptoms and severity. Initially, pelvic floor exercises like Kegels are recommended to strengthen muscles, says Adukias. Biofeedback provides real-time muscle activity feedback, while Transcutaneous electrical nerve stimulation (TENS) can enhance muscle function. Supportive devices like rings or pessaries may be temporarily used for more severe cases. Surgery is the last resort. The overall goal is to restore function and improve quality of life by addressing the root causes of the dysfunction.
Pelvic floor-strengthening exercises you can do at home
All women should incorporate pelvic floor exercises into their fitness routine, whether they experience pelvic dysfunction or not. Since the risk of a weakened pelvic floor is common at different life stages, regular strengthening exercises are essential to maintain optimal pelvic health.
“These should be done as a preventive measure at least thrice a week, for about five minutes throughout the day,” says Adukia. “A woman will be able to assess her pelvic floor strength progression with time. These exercises can be performed anywhere, on the go, without anyone knowing, as it is all internal.”
Your pelvic floor muscles are the same ones you would contract to hold your urine when there is no possibility of emptying the bladder; or the muscles you use to hold a tampon in place.
- Gently lift your pelvic floor muscles, squeeze and hold, and release. As you gain strength, hold for longer.
- Contract your pelvic floor muscles by squeezing and tightly holding the muscles. With time, hold for longer.
