Your pelvic floor muscles do a lot for you; they support all of your pelvic organs, they help stabilise and support your spine, they help guide your baby during childbirth, they even contribute to your relationship by being responsible for intimate sensation for women and erectile function for men. So isn’t it time you gave these muscles a little TLC?
We all know that Kegel (pelvic floor) exercises are essential in maintaining a strong pelvic floor. But did you know there are other things you can introduce into your life to improve the health of your pelvic floor muscles. Here are 5 things you can do, starting right now:
1. Improve Your Posture
There are many reasons why you should improve your posture:
- reduces back and neck pain
- eases digestion
- eases breathing
- improves mood and self confidence.
But did you know that your pelvic muscles are worked harder (and thus kept stronger) when you are sitting tall than when you are slouching or lying down, and harder still when you are standing tall. A slumped posture increases the downward pressure on your pelvic floor which can strain it and cause it to weaken. If you slouch when you complete your pelvic floor exercises, you risk causing more damage than good as everything is not correctly aligned.
When standing it’s important to balance your weight evenly, relax your shoulders back and down, and maintain a normal lower back inward curve. When sitting, remember to put your bum at the back of your chair; lengthen your spine and again, maintain that natural inward curve at your lower spine.
2. Take Vitamin D3 Supplements
Vitamin D is essential for your musculoskeletal health - simply put, it is required for healthy muscle growth and function. As your pelvic floor is a group of muscles, it is easy to see the connection. Vitamin D is also required to maintain a healthy detrusor wall, a part of the bladder and therefore partly responsible for normal bladder function.
Vitamin D deficiency has been described as a global health problem, with over a billion people deficient worldwide. 50-90% of the vitamin D we intake is produced by sunshine in the form of vitamin D3. However with many warnings coming with exposing your skin to harmful UV rays, and so little vitamin D being taken through diet, its no surprise that so many people are deficient. This is why we recommend taking a daily vitamin D3 supplement.
Other benefits of increasing your intake of vitamin D include:
- improved mood
- reduced risk of obesity
- reduced risk of developing a neuro-degenerative diseases such as Alzheimer's
- boosted immune system
- potentially reduces mild and moderate pain.
3. Maintain a Healthy Weight
Losing weight can improve your confidence and quality of life, as well as importantly reducing the risk of developing many well known health conditions. Being overweight is also associated with an increased risk of developing a pelvic floor disorder, with a strong correlation between high BMI's and waist sizes, with pelvic organ prolapses and incontinence. This is due to the increased weight putting pressure on the abdomen and pelvic floor, causing them to weaken through the consistent stress.
The National Institute for Health and Care Excellence recommend maintaining a BMI of 30 or below to reduce the symptoms associated with pelvic floor disorders. Dr Mark Slack, Consultant Gynaecologist and Urogynaecologist, states that a 10% weight loss can result in a 50% improvement in the symptoms associated with urinary incontinence. Weight loss alone cannot reverse all the damage caused to your pelvic floor, but should be part of any lifestyle change to reduce your risk of developing a pelvic floor disorder and reducing the experience of associated symptoms.
Learn more about the impact of obesity on the pelvic floor here.
4. Avoid Constipation
When you are constipated you will find yourself straining to empty your bowels. This pressure on your pelvic floor causes it to weaken, and as a result can lead to many pelvic floor disorders developing. If you suffer with constipation you have probably already tried many treatments. Here are our tips:
- increase your intake of fibre
- drink plenty of water
- eat lots of fruit and vegetables
- occasionally take laxatives
- use a toilet stool - to put your body in the best position to naturally and easy evacuate your bowels.
You may be constipated as a result of being unable to relax your pelvic floor muscles, and involuntarily contracting them when you try and go to the loo. If you have chronic constipation which you have been unable to treat, speak to your doctor about pelvic floor dyssynergia - where you are unable to voluntarily relax your pelvic floor - and the possibility of biofeedback treatments.
5. Stop Smoking
We all know the common risks of smoking; including lung cancer and coronary heart disease. But did you know that there are many side effects of smoking that result in pelvic floor damage. Smoking 20 or more cigarettes a day puts you at the highest risk of suffering from incontinence, however even former smokers are at more than twice higher risk of suffering from incontinence than women that have never smoked. Damage includes:
- Blood vessel damage - Damage caused to your blood vessels starves your pelvic floor muscles of oxygen, preventing them from workign efficiently.
- Drop in collagen synthesis - You may be more concerned about the wrinkles developing on your face, but collagen is required by every cell to keep it firm. Your pelvic floor muscles are no exception, and will loose its strength and stability as your collagen levels fall.
- Drop in oestrogen level - Oestrogen is essential for all mechanisms in the pelvis to be healthy - enhancing urethral resistance and control over the bladder. Smoking results in a drop of oestrogen, in the same way as the drop in oestrogen as a result of menopause, your pelvic floor will weaken.
- Chronic cough - The chronic cough that develops as a result of frequently smoking, puts increased pressure on your abdomen and pelvic floor, causing anatomic damage. Over 50% of women suffering with a chronic cough will also suffer with a degree of urinary incontinence.
How to Protect a Weak Pelvic Floor
Alnaif, B. Drutz, H. P. (2001). Journal of Lower Genital Tract Disease.The Association of Smoking with Vaginal Flora, Urinary Tract Infection, Pelvic Floor Prolapse, and Post-Void Residual Volumes. [online] 5(1), p7-11. [viewed 17/04/18]. Available from: https://journals.lww.com/jlgtd/Citation/2001/01000/The_Association_of_Smoking_with_Vaginal_Flora,.2.aspx
Bassotti, G. Chistolini, F. Sietchiping-Nzepa, F. de Roberto, G. Morelli, A. Chiarioni, G. (2004). BMJ. Biofeedback for pelvic floor dysfunction in constipation. [online] 328(7436), p393-396. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC341393/#!po=68.7500
Briñol, P. Petty, R. E. Wagner, B. (2009). European Journal of Social Psychology. Body posture effects on self-evaluation: A self-validation approach. [online] 39, p1053-1064. [viewed 17/04/18]. Available from: http://www.psy.ohio-state.edu/petty/documents/2009EJSPBrinolPettyWagner.pdf
Bump, R. C. McClish, D. K. (1992). American Journal of Obstetrics & Gynecology. Cigarette smoking and urinary incontinence in women. [online] 167(5), p1213–1218. [viewed 17/04/18]. Available from: http://www.ajog.org/article/S0002-9378(11)91691-3/pdf
Dainese, R. Serra, J. Azpiroz, F. Malagelada, J-R. (2003). Gut. Influence of body posture on intestinal transit of gas. [online] 52(7), p971-974. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773697/
Davis, C. (2012).Don't be caught short: From botox jabs to a plaster on your back, the treatments that can fix a leaky bladder. [online] Mail Online, 2012. [viewed 17/04/18]. Available from: http://www.dailymail.co.uk/health/article-2218230/Incontinence-Dont-caught-short-From-botox-jabs-plaster-treatments-fix-leaky-bladder.html
Dr. Mark Slack. (2017). Biography of Dr Mark Slack: MB BCh, MMed, FCOG (SA), FRCOG. [online] Dr. Mark Slack, 2017 [viewed 17/04/18]. Available from: http://www.markslackgynaecologist.org.uk/Biography.php
Hannestad, Y. S. Rortveit, G. Daltveit, A. K. Hunskaar, S. (2003). BJOG An International Journal of Obstetrics and Gynaecology. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. [online] 110(3), p247-254. [viewed 17/04/18]. Available from: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1046/j.1471-0528.2003.02327.x
Hein, J. T. (2016). Posture: Align yourself for good health. [online]. May Clinic, 2016. [viewed 17/04/18]. Available from: https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/posture-align-yourself-for-good-health/art-20269950
Jain, P. Parsons, M. (2011). The Obstetrician & Gynaecologist. Review, The effects of obesity on the pelvic floor. [online] 13, p133-142. [viewed 17/04/18]. Available from: https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1576/toag.126.96.36.199664
Jundt, K. Peschers, U. Kentenich, H. (2015). Deutsches Ärzteblatt International. The Investigation and Treatment of Female Pelvic Floor Dysfunction. [online] 112(33-34), p564-574. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4570968/#__ffn_sectitle
Miller, J. Perucchini, D. Carchidi, L. T. Delancey, J. O. L. Ashton-Miller, J. (2001). Obstetrics and gynecology. Pelvic Floor Muscle Contraction During a Cough and Decreased Vesical Neck Mobility. [online] 97(2), p255-260. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1226460/#!po=78.5714
Naeem, Z. (2010). International Journal of Health Sciences. Vitamin D Deficiency- An Ignored Epidemic. [online] 4(1), pV-VI. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068797/
Navaneethan, P. R. Kekre, A. Jacob, K. S. Varghese, L. (2015). Journal of Mid-Life Health. Vitamin D deficiency in postmenopausal women with pelvic floor disorders. [online] 6(2), p66-69. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481742/#__ffn_sectitle
NHS. (2016). Laxatives, Overview. [online] NHS Trust, 2016. [viewed 17/04/18]. Available from: https://www.nhs.uk/conditions/laxatives/
NICE. (2015). Urinary incontinence in women: management, 1 Recommendations [online] National Institute for Health and Care Excellence, 2015 [viewed 17/04/2018]. Available from: https://www.nice.org.uk/guidance/cg171/chapter/1-Recommendations#physical-therapies
Pomian, A. Lisik, W. Kosieradzki, M. Barcz, E. (2016). Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. Obesity and Pelvic Floor Disorders: A Review of the Literature. [online] 22, p1880-1886. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4907402/#__ffn_sectitle
Powell, J. T. (1998). Vascular Medicine. Vascular damage from smoking: disease mechanisms at the arterial wall. [online] 3, p21-28. [viewed 17/04/18]. Available from: http://journals.sagepub.com/doi/pdf/10.1177/1358836X9800300105
Sapsford, R. R. Richardson, C. A. Stanton, W. R. (2006). Australian Journal of Physiotherapy. Sitting posture affects pelvic floor muscle activity in parous women: An observational study. [online] 52(3), p219-222. [viewed 17/04/18]. Available from: https://www.sciencedirect.com/science/article/pii/S0004951406700319?via%3Dihub
Sharma, S. Aggarwal, N. (2017). Journal of Mid-Life Health. Vitamin D and Pelvic Floor Disorders. [online] 8(3), p101-102. [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625572/
Tampakoudis, P. Tantanassis, T. Grimbizis, G. Papaletsos, M. Mantalenakis, S. (1995). European Journal of Obstetrics & Gynecology and Reproductive Biology. Cigarette smoking and urinary incontinence in women--a new calculative method of estimating the exposure to smoke.[online] 63(1), p27-30. [viewed 17/04/18]. Available from: http://www.ejog.org/article/0301-2115(95)02212-P/pdf
The Pennine Acute Hospitals NHS Trust. (2015). Obesity and its effects on the pelvic floor. An information guide. [online] The Pennine Acute Hospitals NHS Trust, 2015 [viewed 17/04/18]. Available from: http://www.pat.nhs.uk/downloads/patient-information-leaflets/gynae/911%20Obestity%20and%20pelvic%20floor%20repair.pdf
Townsend, M. K. Curhan, G. C. Resnick, N. M. Grodstein, F. (2012). Obesity, A Research Journal. BMI, Waist Circumference, and Incident Urinary Incontinence in Older Women. [online] 16(4), p881-886. [viewed 17/04/18]. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1038/oby.2008.14
Weber, M. A. Kleijn, M. H. Langendam, M. Limpens, J. Heineman, M. J. Roovers, J. P. (2015). PLOS One. Local Oestrogen for Pelvic Floor Disorders: A Systematic Review. [online] 10(9), e0136265 [viewed 17/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4575150/#__ffn_sectitle
Wilson, V. E. Peper, E. (2004). Applied Psychophysiology and Biofeedback. The effects of upright and slumped postures on the recall of positive and negative thoughts. [online] 29(3), p189-195. [viewed 17/04/18]. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=15497618.ui
Zoglmann, R. Nguyen, T. Engberts, M. Vaessen, D. Patberg, N. Van den Berg, J. (2015). European Respiratory Journal. Do patients with stress incontinence cough or do cough patients suffer from urinary incontinence? [online] 46(59). [viewed 17/04/18]. Available from: http://erj.ersjournals.com/content/46/suppl_59/PA713