How to reduce the risk of pelvic floor dysfunction

It’s important to address pelvic floor dysfunction as it can have a significant impact on your quality of life. Symptoms can be embarrassing and uncomfortable, leading to social isolation, depression and anxiety. In addition, if left untreated, pelvic floor dysfunction can worsen over time and may even result in prolapse.

Fortunately, there are many strategies for preventing and treating pelvic floor dysfunction, including lifestyle modifications, pelvic floor exercises and medical interventions. By addressing pelvic floor dysfunction early and taking steps to prevent it from worsening, individuals can improve their overall health and well-being.

This article covers a wide range of topics, but focuses on reducing the risk of pelvic floor dysfunction.

Jump to the following sections:
⦁ Risk factors
⦁ Symptoms
⦁ Prevention
⦁ Pelvic floor exercises
⦁ Lifestyle modifications
⦁ Treatment options
⦁ Pelvic Floor Mythbusting

Pelvic Floor Mythbusting

Risk factors

There are several factors that can increase the likelihood of developing pelvic floor dysfunction.

Pregnancy and childbirth
During pregnancy, the weight of the growing foetus puts pressure on the pelvic floor muscles, which can weaken or stretch them over time.

Additionally, the hormones released during pregnancy can cause the muscles and ligaments to relax, making them more susceptible to damage during delivery. During childbirth, the pelvic floor may also experience trauma due to tearing or the use of forceps or vacuum extraction. This trauma can cause long-term damage to the muscles and tissues of the pelvic floor, leading to pelvic floor dysfunction.

Aging
As we age, the muscles and tissues throughout our bodies can naturally weaken and the pelvic floor is no exception. Over time, the pelvic floor muscles may lose their strength and tone, leading to a higher risk of pelvic floor dysfunction. Find out more about Pelvic Health in your forties and beyond.

Chronic constipation
Straining during bowel movements can put pressure on the pelvic floor muscles and tissues, leading to damage over time. Additionally, chronic constipation can cause a buildup of faecal matter in the rectum, which can further stretch the pelvic floor muscles and weaken them.

Certain medical conditions
Medical conditions such as obesity, chronic coughing and neurological disorders can all increase the risk of pelvic floor dysfunction. Obesity puts pressure on the pelvic floor muscles, while chronic coughing can cause repetitive stress to the muscles and tissues. Neurological disorders, such as multiple sclerosis or Parkinson’s disease, can interfere with the nerves that control the pelvic floor, leading to dysfunction.

Symptoms

Pelvic floor dysfunction can cause a range of symptoms that can be uncomfortable, embarrassing and impact daily life. Common symptoms include:

Urinary incontinence
Pelvic floor dysfunction can lead to a weakening of the muscles that control the bladder, resulting in urine leakage. This can happen during physical activities such as coughing, laughing and exercising, as well as during normal daily activities such as walking or standing.

The severity of urinary incontinence can vary from person to person, ranging from occasional leaks to a complete loss of bladder control.

Faecal incontinence
Pelvic floor dysfunction can also cause a weakening of the muscles that control the bowel, leading to leakage or loss of stool. It can range from occasional leaks to a complete loss of bowel control and can be particularly distressing and can significantly impact a person’s quality of life.

Pelvic pain or pressure
The condition can cause pain or discomfort in the pelvic area, as well as a feeling of pressure or heaviness and can be constant or intermittent and may worsen during physical activity or after prolonged periods of sitting or standing.

Sexual dysfunction
It can also cause sexual dysfunction, including pain during intercourse or difficulty achieving orgasm. This can be particularly distressing as it can impact relationships and overall quality of life.

Difficulty with bowel movements
Dysfunction can cause difficulty with bowel movements, including straining, incomplete evacuation, or the need for manual assistance to empty the bowels and this can be due to a weakening of the muscles that control the bowel or due to damage to the nerves that control the muscles.

Prolapse
In severe cases, the pelvic organs may begin to protrude into the vaginal canal or rectum, causing a condition called prolapse which can cause a feeling of heaviness or pressure in the pelvis, as well as difficulty with bowel movements and intercourse.

It’s important to note that not everyone with pelvic floor dysfunction will experience all of these symptoms and some people may experience additional symptoms not listed here. Additionally, the severity of symptoms can vary widely, ranging from mild discomfort to significant impairment of daily activities.

If you are experiencing any of these symptoms, it’s important to talk to your doctor to determine the best course of treatment for your individual needs. Find out about our Pelvic Floor Clinic.

Prevention Strategies

Preventing pelvic floor dysfunction completely is a challenge, but there are practical steps that you can take to reduce your risk of developing the condition or to manage the symptoms if you are already experiencing them. Here are some practical tips for reducing the risk of pelvic floor dysfunction and improving your overall pelvic health.

Practise good bowel habits
One of the most effective ways to prevent pelvic floor dysfunction is to maintain good bowel habits. This includes avoiding straining during bowel movements, staying hydrated and eating a diet high in fibre. Straining can put undue pressure on the pelvic floor muscles and tissues, leading to damage over time.

Staying hydrated and eating a diet high in fibre can help keep bowel movements soft and easy to pass, reducing the need to strain. In fact, a study published in the Journal of Urology found that individuals who ate a high-fibre diet were less likely to experience symptoms of pelvic floor dysfunction, including urinary incontinence and pelvic pain.

To practise good bowel habits, aim to drink at least eight glasses of water per day and eat a diet high in fibre, including fruits, vegetables, whole grains and legumes.

Engage in regular pelvic floor exercises
Pelvic floor exercises, also known as Kegels, are a type of exercise that involves contracting and relaxing the muscles of the pelvic floor. These exercises can help strengthen the muscles and improve overall pelvic health, reducing the risk of pelvic floor dysfunction. Pelvic floor exercises are also a helpful way to manage the symptoms of pelvic floor dysfunction, such as urinary incontinence and pelvic pain.

Avoid heavy lifting
Heavy lifting can put undue pressure on the pelvic floor muscles and tissues, leading to damage over time. This is particularly true for individuals who lift heavy objects on a regular basis, such as construction workers and weightlifters. To reduce the risk of pelvic floor dysfunction, it’s important to avoid heavy lifting or to lift heavy objects properly to reduce the strain on the pelvic floor.

If you do need to lift a heavy object, begin by squatting down and bending at the knees, rather than at the waist. Keep your back straight and your feet shoulder-width apart. Use your leg muscles to lift the object, rather than putting pressure on your pelvic floor muscles. If possible, ask for help or use equipment to lift the object instead.

Manage chronic health conditions
Chronic health conditions such as diabetes, heart disease and respiratory problems can increase the risk of pelvic floor dysfunction. These conditions can put additional strain on the pelvic floor muscles and tissues, leading to damage over time.

To reduce your risk of developing pelvic floor dysfunction, it’s important to manage these conditions effectively which may involve working closely with your doctor to monitor your condition and adjust your treatment plan as needed.

Practise good posture
Poor posture can put undue pressure on the pelvic floor muscles and tissues, leading to damage over time. To reduce your risk of pelvic floor dysfunction, it’s important to practise good posture.

• Stand up straight with your shoulders back
• Keep your feet shoulder-width apart
• Avoid slouching and hunching
• Try to avoid crossing your legs when sitting, as this can put pressure on the pelvic floor muscles.

Stay active
Regular physical activity can improve overall pelvic health and reduce the risk of pelvic floor dysfunction. Exercise can help maintain a healthy weight, reduce stress and improve muscle tone and flexibility.

Aim to engage in at least 30 minutes of moderate-intensity physical activity per day, such as brisk walking, cycling or swimming.

Seek treatment for pelvic floor dysfunction
If you are already experiencing symptoms of pelvic floor dysfunction, it’s important to seek treatment as soon as possible. Read more about treatment at the bottom of this article.

Pelvic Floor Exercises

Pelvic floor exercises, also known as Kegels, can help strengthen the muscles that support the bladder, uterus and rectum, and may reduce the risk of pelvic floor dysfunction. In addition, pelvic floor exercises can improve urinary and bowel control, reduce urinary leakage and improve sexual function.

Here’s how to perform pelvic floor exercises correctly:

Identify the pelvic floor muscles
To perform Kegels correctly, you first need to identify the pelvic floor muscles. These are the muscles that you use to stop the flow of urine midstream or to prevent passing gas. You can also identify these muscles by imagining that you are trying to stop yourself from passing wind or trying to stop the flow of urine.

Start with a warm-up
Before you begin your Kegels, it’s important to do a warm-up exercise.

• Try tightening and then relaxing your pelvic floor muscles several times.
• Try to hold each contraction for three to five seconds and then release for the same amount of time.
• Do this exercise for five to ten repetitions.

Perform the Kegel exercise
To perform the Kegel exercise, contract your pelvic floor muscles and hold for five seconds, then release for five seconds. Repeat this exercise ten times in a row. As you become more comfortable with this exercise, you can increase the length of time that you hold the contraction to ten seconds.

Do a cool-down
After you’ve completed your Kegels, it’s important to do a cool-down exercise to help your muscles relax. You can do this by gently contracting and releasing your pelvic floor muscles several times, holding each contraction for three to five seconds and then releasing for the same amount of time.

Repeat the exercise regularly
For best results, you should aim to do Kegels regularly. Try to perform three sets of ten repetitions each day. It may take several weeks or even months before you start to notice an improvement in your symptoms.

In addition to Kegels, there are other pelvic floor exercises that can help improve pelvic floor strength and reduce the risk of pelvic floor dysfunction.

These exercises include:

Bridge exercise

• Lie on your back with your knees bent and your feet flat on the floor.
• Tighten your pelvic floor muscles and lift your hips off the floor until your body forms a straight line from your shoulders to your knees.
• Hold this position for five seconds and then lower back down.
• Repeat ten times.

Squats

• Stand with your feet hip-width apart and your toes pointing forward.
• Tighten your pelvic floor muscles and squat down as if you were sitting in a chair.
• Keep your knees behind your toes and your weight in your heels.
• Hold this position for five seconds and then stand back up.
• Repeat ten times.

Lunges

• Stand with your feet hip-width apart and take a step forward with your right foot.
• Bend both knees until your right thigh is parallel to the floor and your left knee is hovering just above the ground.
• Tighten your pelvic floor muscles and hold this position for five seconds.
• Then, push off your right foot and return to the starting position.
• Repeat on the other side.

Lifestyle Modifications

In addition to pelvic floor exercises and good bowel habits, there are several lifestyle modifications that can help reduce the risk of pelvic floor dysfunction.

Avoid smoking
Smoking is a risk factor for a variety of health conditions, including pelvic floor dysfunction. Smoking can damage blood vessels, decrease blood flow to the pelvic region and increase the risk of chronic coughing, which can put pressure on the pelvic floor muscles. Quitting smoking can help reduce the risk of pelvic floor dysfunction and improve overall health.

Limit caffeine intake
Caffeine is a diuretic, which means that it can increase urine production and irritate the bladder. This can lead to an increased risk of urinary incontinence, which is a common symptom of pelvic floor dysfunction. Limiting caffeine intake, particularly in the form of coffee, tea and fizzy drinks, can help reduce the risk of urinary incontinence and other symptoms of pelvic floor dysfunction.

Maintain a healthy weight
Carrying excess weight can put additional pressure on the pelvic floor muscles and increase the risk of pelvic floor dysfunction. Maintaining a healthy weight through a balanced diet and regular exercise can help reduce this pressure and improve pelvic floor health.

Stay hydrated
Drinking plenty of water can help keep the urinary system healthy and reduce the risk of urinary tract infections, which can contribute to pelvic floor dysfunction. Aim to drink at least eight glasses of water per day.

By incorporating these lifestyle modifications into your routine, you can help reduce the risk of pelvic floor dysfunction and improve overall pelvic health. While some risk factors for pelvic floor dysfunction, such as pregnancy and ageing, are not within your control, making these simple changes can help reduce your risk and improve your quality of life.

Treatment Options

The treatment options for pelvic floor dysfunction depend on the specific symptoms and underlying causes of the condition. Some of the most common treatments include pelvic floor physical therapy, medication, biofeedback, electrical stimulation and, in severe cases, surgery.

It’s important to note that treatment plans for pelvic floor dysfunction are highly individualised and may involve a combination of different approaches. It’s important to work with a doctor to develop a personalised treatment plan that addresses your specific symptoms and needs.

Click here for more information on our Pelvic Floor Clinic.

Pelvic floor mythbusting

Pelvic floor dysfunction is a common condition, but there are many myths and misconceptions about it.

Myth
⦁ Pelvic floor dysfunction only affects women.
Fact
⦁ While pelvic floor dysfunction is more common in women, it can also affect men. Men may experience symptoms such as urinary incontinence or erectile dysfunction.

Myth
⦁ Pelvic floor dysfunction only affects older people.
Fact
⦁ While age is a risk factor for pelvic floor dysfunction, it can also affect younger people, particularly women who have given birth.

Myth
⦁ Pelvic floor dysfunction is just a normal part of ageing.
Fact
⦁ While age is a risk factor for pelvic floor dysfunction, it is not a normal or inevitable part of ageing. Symptoms of pelvic floor dysfunction can often be managed or improved with the right treatment.

Myth
⦁ Doing Kegels is the only way to prevent or treat pelvic floor dysfunction.
Fact
⦁ While Kegels can be helpful in improving pelvic floor muscle strength, they are not the only way to prevent or treat pelvic floor dysfunction. Other lifestyle modifications, such as maintaining a healthy weight and practising good bowel habits, can also be effective.

By understanding the truth about pelvic floor dysfunction and dispelling these common myths, individuals can better manage their symptoms and seek appropriate treatment.

• If you’re worried about your symptoms, speak to your GP about possible treatments. (Don’t have a GP?)
• If you’re suffering from any pelvic floor symptoms or want more information, why not come to a Pelvic Floor Clinic at King Edward VII’s Hospital