The Impact of Obesity on the Pelvic Floor

Obesity levels have risen over 20% in men and over 25% in women during the past 40 years. It is no secret that carrying excess body weight is detrimental to your health. But did you know the impact it has on your pelvic floor? Studies show the likelihood of developing urinary incontinence increases by 7-12% for each 1kg/m2 unit increase in BMI.

"The skeleton is perfectly designed to cope with a healthy weight. But if you're excessively heavy or obese, hips, knees and ankles may all suffer. Excess weight can be particularly damaging to your pelvic floor, which supports all of your crucial internal organs." Tam Fry, chairman of the National Obesity Forum.

Tam Fry, head spokesperson for the National Obesity Forum



Weight Gain During Menopause

Its extremely common to gain weight during your midlife. Nearly three-quarters of women aged 60 and over are overweight. For many women, this is caused, or enhanced, by the menopause. The average age for the menopause to begin is 51, however, 6% of women experience the menopause much earlier as a result of medical conditions and pelvic surgeries (such as hysterectomy's).

Hormone Replacement Therapy (HRT)

Oestrogen receptors play a major role in the regulation and distribution of body fat. As a result, menopausal women who undergo hormone replacement therapy (HRT) tend to have less fat tissue, especially in the stomach area, compared to other postmenopausal women.

When the usage of HRT is stopped, women quickly begin to gain stomach fat. During this process, women store majority of their weight gain as visceral adipose tissue (abdominal fat). This is not the type of fat that you are able to pinch under your skin; instead, this fat is behind the abdominal wall and around some of the vital organs.

The Relationship Between Oestrogen Levels and Visceral Adipose Tissue (Abdominal Fat)

During the menopause, visceral fat mass increases by an average of 44%. A complete loss of the oestrogen hormone can cause visceral fat to increase by 10% in just 5 months. Without the presence of oestrogen, your resting metabolic rate decreases by around 50 calories per day, causing a huge disruption in energy balance.

Over the course of 3 months, this metabolic decrease could add up to a pound of weight gained. Within a year you could have put on almost half a stone! Without reducing your calorie intake or increasing your physical activity, postmenopausal women can naturally gain dozens of pounds over the years through a lowered metabolic rate alone.


Can I Reduce My Risk or Reverse the Damage to My Pelvic Floor?

There is conclusive evidence linking obesity and urinary incontinence. For a lasting improvement in the health of your pelvic floor, you need to maintain a healthy BMI of under 30.

To reverse any damage that you have already experienced, you need to pay close attention to your pelvic floor as you lose weight. For a quick improvement in the condition of your pelvic floor, use an electronic pelvic toner.

  • Exercise your pelvic floor daily - Do your Kegels! Like any muscle, you need to exercise your pelvic floor regularly to keep it strong.
  • Maintain a healthy weight - The National Institute for Heath and Care Excellence (NICE) recommend keeping your BMI under 30 to avoid putting excess weight on your pelvic floor. Studies show that women that lose 10% of their body weight can reduce their leakage by 50%.
  • Avoid high impact exercise - To lose weight you may begin running or join an exercise class. However, these high impact exercises are incredibly damaging to your pelvic floor. When you land heavily on your feet, pressure shoots up your legs to your pelvis. Swap out running for swimming and cross fit for yoga. Yoga and pilates are very good at helping you break a sweat whilst reducing the pressure on your pelvic floor. They can also be modified to balance your weight more evenly.
  • Avoid carrying large weights - Any weight impacts your pelvic floor; regardless of whether it is body weight or cardboard boxes. When you cannot avoid carrying large weights, learn how to lift safely through the National Health Service (NHS). Hold the load close to your waist and avoid bending your back.
  • Avoid constipation and straining - Eat a high fibre diet and improve your toilet posture for easy bowel movements. The best position to go to the toilet is to have your knees high. You can use a toilet stool to get this position just right.


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