Pelvic floor facts

 
Bendigo Physiotherapist working with a mother post birth on exercise

What is the pelvic floor?

The pelvic floor is a group of muscles and ligaments that support the bladder, uterus and bowel. The role of the pelvic floor is to provide support to your pelvic organs in day to day life. There are three openings in the pelvic floor, the urethra, the vagina and the anus, which the pelvic floor acts to support. Your pelvic floor muscles attach at your pubic bone and your tail bone and provide the “floor” of your pelvis.

Role of your pelvic floor

Your pelvic floor helps you to control your bladder and bowel function and allows you to “hold on” until you are in an appropriate place.  Some issues that can be cause by issues with your pelvic floor include

  • Incontinence (involuntary loss of urine or faeces)

  • Prolapse of pelvic organs

Cause of pelvic floor dysfunction

There are many of reasons a person may have pelvic floor dysfunction. Some common causes include

  • Pregnancy

  • Childbirth (especially with a large baby or long labour)

  • Constipation

  • Being overweight

  • Excessive coughing

  • Changes in hormones, especially in menopause

  • Heavy lifting

Incontinence

Incontinence is the involuntary loss of urine, faeces or wind. There are 2 main types of incontinence that occur.

1.       Urinary incontinence

  • Poor bladder control can range from anywhere to a small leak when coughing to a complete inability to control your bladder.

  • Urinary incontinence may be caused by many things and a physiotherapist may be able to help you improve or resolve your symptoms through different treatment strategies

  • It is thought that up to 13% of Australian men and 37% of Australian women experience some degree of urinary incontinence, yet 70% of people with urinary leakage don’t seek help

 2.       Faecal incontinence

  • People with faecal incontinence may struggle to control their bowels

  • Symptoms include being unable to control a bowel motion, getting some staining in your underwear and being unable to control passing wind

  • Faecal incontinence may cause by weakness in pelvic floor muscles, constipation or diarrhoea

  • Approximately 20% of Australian men and 13% of Australian women experience faecal incontinence

Do you think you might have an issue with incontinence?

-          Do you find you leak before you make it to the toilet?

-          Do you feel you can’t fully empty your bladder?

-          Do you wake two or more times over night to urinate?

-          Due to leak when you cough, sneeze or run?

-          Do you strain to empty your bowel?

Prolapse

Prolapse occurs when the walls of the pelvic organs sag down into the vagina. You may feel a heaviness in your vagina or a bulging sensation. Other symptoms include pelvic pain, pain with sex and trouble emptying your bladder. It is thought at approximately 50% of women who have given birth will have some degree of prolapse, however not all women will experience symptoms or issues. Pregnancy and childbirth are the greatest risk factor for prolapse. Other causes can be menopause, heavy lifting, chronic cough and being overweight. There are several management and treatment options that can be provided by your physiotherapist or GP.

How can you prevent damage

  • Avoid straining on the toilet

  • Avoid persistent heavy lifting

  • Treatment for persistent coughing

  • Stay in a healthy weight range or lose weight

  • Make pelvic floor exercises part of your day!

Why don’t women seek help?

  • Embarrassment

  • The thought that leaking is “normal”

  • Poor experiences in the past

It’s very important that you feel comfortable discussing these issues in confidence with your physiotherapist. Our aim is to make you feel as safe and comfortable as possible.