Guide to improve the quality of life of women
Spanish Society of Gynecology and Obstetrics and Leti Laboratories
The pelvic floor area is made up of the muscles located in the perineum region, which provide support to the entire lower abdomen (bladder, uterus or womb and lower intestine). In women, they usually present a phasic (relaxed) character, which causes problems of urinary incontinence before efforts, of prolapses such as the descent of the womb or some sexual dysfunctions.
The pelvic floor: anatomy and function
The pelvic floor is made up of a set of muscles that supports the entire lower abdomen, such as a protective arch or a flexible hammock to support the urinary bladder, uterus or womb, and lower intestine. Through the pelvic floor some exit conduits pass to the outside of these organs: the urethra, the vagina and the rectum. For the pelvic floor organs to function properly, the pelvic floor muscles must be healthy and strong.
The weakening of the pelvic floor muscles can cause short or long term one or several disorders such as stress urinary incontinence, prolapses and sexual dysfunctions.
– Stress urinary incontinence. Stress incontinence should be consulted with our doctor as it can be avoided. It is a well-known and widespread medical condition . It is characterized by leaking urine from any sudden abdominal effort , which occurs when coughing, sneezing, laughing, jumping, dancing, walking, exercising, etc. It affects 4 out of every 100 women from adolescents to mature women. However, people rarely go to the doctor for help for the following reasons: embarrassment; for believing that it is a “normal” and unavoidable problem after childbirth or due to aging; believing that there is no cure or that treatment is not available; considering thatit is not serious enough, significant or frequent enough to require treatment ; for believing that the only possible alternative is the much dreaded surgery. If incontinence is not acted upon, it gets worse, causing the woman to gradually reduce her activities and social life. The psychological consequences can range from loss of security and self-esteem, to even anxiety and depression.
– Prolapses . They are even more serious disorders that often require surgical intervention . These are descents of the womb (uterine prolapse), the bladder (cystocele) or the rectum (rectocele).
– Sexual dysfunctions . The lack of tone of the pelvic floor muscles reduces the blood supply and the force of the contractions, and causes that the weight of the internal organs is not adequately supported. This can cause: a decrease in the sexual sensitivity of women, making it difficult to stimulate them; a decrease in the intensity of orgasms or that sometimes are not achieved; and / or that the woman experiences painful sensations during intercourse. Ultimately, it can worsen the quality of sexual relations appreciably for both members of the couple and even avoid them.
Causes that weaken the pelvic floor
The causes that weaken the pelvic floor or aggravate its deterioration are varied. They all have in common an increase in intra-abdominal pressure and a lack of toning of their muscles.
– Pregnancy and childbirth . They are the main cause of wasting, although sometimes their effects do not appear until many years after having a child. The increased weight of the uterus during pregnancy greatly forces and weakens the pelvic floor muscles . This distension increases significantly during labor, when the baby passes through these muscles. In addition, in pregnancy a hormone is produced that relaxes these muscles to facilitate delivery, weakening them even more . The deterioration will be greater if there was a tear, if the baby was of great weight or large head circumference, if a lot of weight was gained during pregnancy and with each new delivery.
– Postpartum . After childbirth, abdominal exercises are usually performed to regain the silhouette without considering how the pelvic floor muscles have been , which should not withstand significant increases in abdominal pressure. In the immediate postpartum, the woman should not jump, carry weights, play sports or do early abdominal exercises . These efforts are formally contraindicated until the condition of the pelvic floor has been assessed and recovery has been made.
– Sports practices . The practice of sport is undoubtedly very beneficial for health in general. However, some sports require jumps and impacts (basketball, athletics, tennis, aerobics, jogging, etc.). These increase intra-abdominal pressure , and if appropriate measures are not taken, pelvic muscle tone worsens . For this reason, among young women, even without children, who practice this type of sports with continuous training and competitions, 6 out of 10 are affected by stress incontinence.
– Menopause and aging . The hormonal changes of menopause can cause a loss of flexibility of the pelvic floor muscles . In addition, the simple passage of the years atrophies them, like any other muscle that is not exercised. For this reason, if they have not appeared before, at this stage the effects of the weakness of the pelvic floor muscles are usually manifested , such as stress incontinence.
– Inheritance . Almost 2 out of 10 women have an innate weakness of the pelvic floor muscles . For this reason, it is important to measure its condition even if there are no other causes of weakening, especially if there is a family history.
– Daily habits and other factors . There are some daily habits and other causes that also damage these muscles : holding urine for a long time; push hard to empty the bladder; dress with girdles or very tight garments; the obesity; the constipation; play wind instruments; the singing; chronic cough from smoking or other causes; and in general, any repetitive increase in intra-abdominal pressure.
How to prevent pelvic floor disorders?
Knowing yourself and taking care of yourself is the basis for preventing pelvic floor disorders and their consequences. Know your own genital anatomy and become aware of your pelvic floor muscles . Take care of and strengthen the pelvic floor muscles since adolescence. Perform a pelvic floor muscle recovery postpartum. Be alert to any symptoms of weakness in these muscles , especially if you have children, play sports or want to increase your sexual response capacity.
Every woman should worry about maintaining internal muscle tone , essential for her quality of life and health. This is valid whether the muscles are healthy or just recovered. Once the recovery therapy is finished, it is recommended to do a self-assessment or review , for example, with the vaginal cones, twice a year, and to resume the exercises if a decrease in muscle strength is observed . In the same way that women take care of their diet, the state of their skin and their general health, they must also take care of this very important aspect of their health.
Pelvic floor recovery
Fortunately, all these problems derived from lack of pelvic muscle tone can be prevented, treated and cured. This is done by working these muscles through specific exercises to strengthen them . Although it is best to prevent, after childbirth or in the case of impact sports, if any symptoms have appeared, recovery should begin, even years later.
The recovery (or physiotherapy , as specialists call it) of the pelvic floor has been known for years for its important effect in preventing all disorders derived from this weakening. Therefore, the ideal is to recover the pelvic floor already in the postpartum , as is routinely recommended in many countries. If it was not done after delivery, it is still equally useful and important to do it years later. It will continue to provide enormous benefits to the patient who has faithfully followed it, a significant improvement in her quality of life and, for the vast majority, it can lead to a total cure of her problem.
Not only does it prevent the onset of these disorders, but even if, for example, moderate or advanced stress incontinence or moderate prolapse has already appeared, you can avoid surgical intervention .
What exercises to do to strengthen the pelvic floor
The exercises of the pelvic floor consist in active and regular contractions the muscles of the pelvic floor. It is a well-known and widely verified technique known to specialists as “Kegel exercises . ” Try the following exercises to control these muscles:
– Urethral sphincter: imagine that you are urinating, squeeze hard as if you wanted to stop the urine. Later relax.
– Anal sphincter: think that gases are going to escape, contract the muscles around the anus feeling how it rises.
Once you are able to identify the different muscles of each sphincter, alternately contract and relax them all at once. Ideally, you should associate these exercises with some daily task such as drinking coffee, driving, watching the news, no one will notice that you are doing pelvic floor exercises .
A big help: vaginal cone therapy
It was developed by leading gynecologists to address the difficulty some women found in performing pelvic floor exercises correctly and the lack of a means of evaluating their progress, which led to them abandoning the exercises before achieving the ideal tone.
Vaginal cone therapy represents an important advance: it allows you to automate exercises and learn to perform the correct contraction easily , it requires much less dedication and it strengthens the pelvic floor muscles more effectively and in less time. It has been clinically tested in prestigious hospitals, both in Europe and the United States , and is widely prescribed in many countries. It is a simple, effective and inexpensive measure for the conservative treatment of the consequences of the weakness of the pelvic floor muscles that can avoid a surgical intervention.
Each cone has a different gradual weight (although they are the same size), and they are used by holding them in the vagina like a small tampon for a few minutes a day, standing or walking. When the cone is inserted into the vagina, it tends to fall under its own weight. The sensation of loss of the cone causes a soft contraction reflex in the pelvic floor muscles that makes the cone retain. This simple contraction and gradual advance toward heavier cones very effectively strengthen the pelvic floor muscles . An improvement in the tone of the muscles begins to be noticed in about 2 or 3 weeks, and a complete treatment usually lasts between 2 and 3 months.
Answer these questions and you will quickly know the state of health of your pelvic floor: Have you ever had a sensation of weight in the genital area ? Have you had a urine leak on any of these occasions: going up or down stairs, laughing, sneezing, coughing or jumping? Take the “pee stop” test: try to completely stop the flow of urine, do you ever leak any droplets? After a bath, have you had a loss of water from the vagina? Have you had any painful sensations during intercourse lately ? Take the test with vaginal cones: Do you drop the number 3? If you answer “yes” to two or more of these questions, you should begin a pelvic floor recovery as soon as possible.
Do not forget to go to your doctor to start a pelvic floor recovery or physiotherapy program