When it comes to exercise, we all know about bottom-sculpting squats, leg- strengthening lunges, and arm-toning lifts. And why wouldn’t we? After all, these exercises focus on our “mirror muscles” – you know, the ones we see when we look in the mirror. But what about those quick pelvic floor exercises that strengthen muscles you don’t see? You do those too, right? Well, it’s fair to say that, like ironing bed linen, it doesn’t seem worth the bother. For some reason, it’s always seemed a bit extra to be exercising muscles you can’t see, hoping, somehow, it’ll benefit you in a way you’re unsure about.
But the truth is that we need to look after all aspects of our fitness – and this includes muscles we can’t see but totally and utterly rely on. “Pelvic floors become a hot topic in pregnancy when women are told to do their exercises and later in life when there can be more continence issues, but it appears that often the understanding of the pelvic floor stops here,” says Rochelle Herz, a physiotherapist.
The first thing you need to know? That, essentially, these muscles are the foundations of your body, forming a hammock that supports your uterus, bladder and bowel, and in their most basic form, stop these organs from falling out, something that’s known as prolapse. But they do other magic behind the scenes, too, such as preventing urinary stress incontinence that can happen when you laugh, sneeze or exercise. Heck, they’re even important for your sex life because an orgasm is actually a series of muscle contractions. This means the stronger your pelvic floor, the stronger your pelvic floor convulsions, and therefore the more powerful your orgasm. Who knew?
Inner fitness
The trouble is that few of us appreciate how important our pelvic floor is – until it stops working properly, that is. An estimated one in three women will suffer from urinary stress incontinence, which happens when muscles become weak and the neck of your bladder doesn’t always stay closed under stress, which leads to urine leaks. This can happen when you sneeze, have a fit of giggles, or when you’re coughing, running or jumping. What’s more, you might be problem-free now, but that can change – even if you haven’t, or aren’t planning on, giving birth. Because although it’s true that problems most commonly occur after childbirth when the pelvic floor weakens, and in menopause when low oestrogen levels can lead to thinning of the tissues in the pelvis, they aren’t the only troublemakers.
“Problems can happen at any time in our life,” says Prof Dharani Hapangama, consultant gynaecological surgeon at the University of Liverpool and researcher at women’s health research charity Wellbeing of Women. “Constipation from low fibre or a poor diet can cause problems with our pelvic floor, as can chronic coughing or sneezing, which you might experience as a result of conditions such as hay fever or as a result of smoking. Being overweight can increase your risk of problems, too.”
But the other big obstacle when it comes to keeping our pelvic floors healthy is that we don’t talk about them. While we’ve reached a point where we can talk more openly about sex, periods and the menopause, there still seems to be a secrecy surrounding our pelvic floors. “Most women don’t give their pelvic floor any thought unless they have incontinence or prolapse, but that needs to change,” says Tania Adib, a consultant gynaecologist at the Medical Chambers Kensington in London.
“We need to break down barriers and create more open conversations about the role of our pelvic floor so that women can not only recognise problems and get the help they need, but know what can prevent problems in the future. There needs to be more awareness of gynaecological issues from a younger age, with school-age children being made aware that we use our pelvic floor when we go to the loo, to control urine, and to get acquainted with their pelvic floor in general, so that women can talk more freely about their body parts as they age.”
Feel the squeeze
Ultimately, we all need to take a not-seen-nor-forgotten approach to our pelvic floor, and exercise it just like any other muscle in the body. And pelvic floor exercises are proven to work, not only helping to protect you against future problems but also to send nagging symptoms packing. “Pelvic floor exercises should be done throughout your life – men as well – and not just during life stages associated with hormonal changes,” says Herz.
As with so many things in life, a little-but-often approach is the key. To make it a daily habit, identify something you do regularly – whether that’s washing your hands, making a morning coffee, or putting on makeup – and tag your pelvic floor exercises on to them. The app MyPFF is great if you need a reminder – it also includes exercise tutorials.
On top of this, avoid getting constipated. Although it might seem unrelated to bladder health, if you’re blocked up, this will put an added layer of stress on your pelvic floor muscles, which, over time, can cause problems. “Eat a healthy, balanced diet with plenty of fibre and ensure you drink enough liquid so that you avoid constipation and have regular bowel habits,” says Adib. “Exercises such as pilates and yoga can potentially be beneficial, too, as you are often encouraged to engage your pelvic floor in the classes. Being more mindful of your pelvic floor in general, being aware of it working, can only be a good thing.”
Are you having problems with your pelvic floor, or feel as if exercises aren’t working? Talk to your GP, as they can refer you to a women’s health physiotherapist, who can help you learn how to engage and relax your pelvic floor properly. Likewise, if something down there just doesn’t feel right, you’re suffering from pelvic pain, pressure or heaviness, see your GP to get other health issues ruled out and advice that’s tailored to your needs. It’s time to start a pelvic floor revolution.
As incontinence affects one in four women, we should all be having more open conversations about this everyday condition that impacts women of all ages. Find out more at tena.co.uk/ageless
