All About Your Pelvic Floor

What is The Pelvic Floor?

The pelvic floor is the sling of muscles and connective tissue in the pelvis (between your tail bone and pubic bone) that hold up the bladder, bowel, and internal reproductive organs (such as the uterus). Refer to the illustration below for a visual of the pelvic floor, as it looks in a female body. 

                 Photo: Shuttershock, ID: 200938979

The pelvic floor helps to support the core and allows the body to do activities, such as lifting, while protecting the pelvic organs. These muscles are strong while still being flexible, as being able to both relax and contract the pelvic floor muscles is critical for proper bladder, bowel, and sexual function. 

Pelvic floor muscles serve slightly different purposes depending whether you are born with male or female sex organs. For those who are assigned male at birth, the pelvic floor muscles support erection and ejaculation, whereas they assist with vaginal childbirth and contractions for sexual pleasure in those born female (Cleveland Clinic). Both sexes need pelvic floor muscle control in order to pass urine, feces, and gas. 

Potential Pelvic Floor Problems:

Damage to the pelvic floor muscles can occur as a result of pregnancy, injury, or even ongoing constipation. Pelvic floor muscles that are too tight or too loose are common, especially among women, and can result in problems such as pain, bladder leaks, prolapse, or discomfort during intercourse. Men can also experience pelvic floor troubles caused from pelvic floor trauma, enlarged prostates, surgery, or a variety of other causes as outlined by Stanford Health. 

While pelvic floor struggles, including incontinence and pain, are often seen as a normal part of aging or an irreversible side effect of pregnancy, they are neither of these things. Dr. Gurland from, Stanford Medical, said, “They are actually very common medical problems that can be treated successfully.”

Pelvic floor dysfunction, prolapse, and incontinence can all be managed through pelvic floor physical therapy or, if needed, surgical intervention, as well as a variety of other methods. Pain with penetration, another common issue for damaged pelvic floors, can also be managed- refer to a longer list of penetration specific pelvic floor treatments here. 

A Healthy Pelvic Floor:

The pelvic floor is an area of the body that is often overlooked, likely because it is mostly internal and it can be confusing to know how to strengthen or relax that part of ourselves. Still, it is critical we take care of our pelvic floor region just as we would any other essential part of our bodies. 

As mentioned above, symptoms of a damaged or "malfunctioning" pelvic floor can cause a variety of issues. According to a study on pelvic floor disorders (2022), "In the United States up to 4.9 million women will be diagnosed with prolapse by 2050, and an estimated 28.4 million are expected to suffer from urinary incontinence" (Caldwell et al). Both men and women can experience problems and both can benefit from healthy pelvic floor practices. It is also important to understand that having too tight of a pelvic floor can result in as many issues as too weak a pelvic floor, so different approaches will be required depending on what is happening with the muscles. Kegels are often misconstrued as the pelvic floor fix-all, but they can be detrimental to those with too tight of muscle, who should focus more on relaxing and releasing tension. 

Ways to Keep Your Pelvic Floor Happy & Healthy: 

1. If pelvic floor muscles are weak, do strengthening exercises to improve tone. Kegels can be practiced daily with or without the assistance of exercise accessories. Simply tighten and release pelvic floor muscles (there are lots of great online guides for both men and women, like this one by Harvard), or employ the assistance of Kegel balls or a smart-tech Kegel trainer like this one. 
   
   
2. If pelvic floor muscles are too tight, try adding a breathing or meditation routine into your daily life. Breathe deeply, allowing the breath to fill your lungs, stomach, and all the way down into your pelvic muscles. You can find a guide to diaphragmatic breathing here. Meditation can also be beneficial and promote general relaxation and health too. 
   
   

3. Employ medical devices as recommended by your doctor. A vaginal pessary, for example, can help to support pelvic organs if pelvic prolapse is an issue. Pessary's can reduce discomfort/sensations of heaviness and even help individuals avoid surgery. They come in a variety of shapes and sizes, as shown in the image below, and therefore require measurement by a doctor. 

4. Check in with your body regularly. Pay attention to when pelvic floor muscles are too tight and take action to relax them by doing things such as taking a bath or practicing yoga. Prioritize eating well and maintaining a healthy lifestyle. Reducing stress and getting the right nutrients can improve pelvic floor health and wellbeing overall. 
   
   
5. Avoid constipation. Being constipated can strain pelvic floor muscles and chronic constipation can result in damage to the area. Drink lots of water, eat fiber rich foods, and avoid straining on the toilet. 
   
   
6. Try pelvic floor physical therapy. There are physical therapists who specialize in pelvic floor health and can teach patients exercises and techniques to strengthen or relax pelvic floor muscles. Physical therapists can also use biofeedback or recommend additional home intervention techniques, like using a dilator kit. 
   
   
7. Finally, don't neglect your pelvic floor health! Many people ignore, or are embarrassed by, pelvic floor problems, and therefore avoid addressing them early on. Remember, pelvic floor struggles are very common, but that doesn't mean they are normal or should be tolerated as just a part of life. Stay in touch with your body and let your doctor know if pelvic floor struggles arise. In the meantime, work on keeping the area strong but still able to relax.

 Additional Pelvic Floor Health Resources:

          Photo: Shuttershock, ID:1926854258

• Pelvic Support Problems (information about prolapse, pessaries, & kegels): https://www.acog.org/womens-health/faqs/pelvic-support-problems
• Pelvic Floor Disorders (what they are- risks and prevention): https://www.voicesforpfd.org/about/what-are-pfds/
• Kegel Exercises (how to do): https://www.health.harvard.edu/bladder-and-bowel/how-to-perform-kegel-exercises
• Diaphragmatic Breathing (how to guide): https://www.theoriginway.com/blog/the-1-pelvic-floor-exercise-everyone-should-do-not-a-kegel

Pessary Image Credit: Shuttershock, ID:1331732192