Your Pelvic Floor and Why it Matters
This past week I went live with Dr. Melissa Thompson, a holistic pelvic floor physical therapist, and we discussed anything and everything related to the pelvic floor. In case you missed it, we are going to dive into some of the details here and you can also always find this on my IG page.
So what exactly is our pelvic floor and why the heck does it matter so much? The pelvic floor is a complex of muscles that are considered part of the core. This group of muscles extends from the pubic to the tailbone. Dr. Mel put it best in my opinion, to think of your core as a 3-dimensional system. You have the pelvic floor at the bottom, the front is the abs, the back is the spine, and the top is the diaphragm and rib cage. If our pelvic floor is weak then some other part of this system will give.
Who is at Higher Risk for Pelvic Floor Issues?
Strengthening the pelvic floor is crucial for everyone as we age, but there are certain populations that are at higher risk for developing an issue. People at higher risk are women who are pregnant or postpartum, women who have had a baby at any point in life, women going through menopause, and women post-gynecological surgery (ex: hysterectomy). Crazy to think that so many of these categories include women throughout different phases of life whether it be starting motherhood or natural aging. That is why pelvic floor health is an essential discussion to have as women.
What Goes Wrong As the Pelvic Floor Weakens?
As discussed earlier, the pelvic floor complements other muscles that all contribute to the core. When one is out of wack, the others tend to overcompensate. This can result in sciatica, disc herniations, etc. Some other common signs that indicate a pelvic floor issue are urine leakage, urinary frequency, prolapse, pelvic pain, and painful intercourse.
How Do Hormones Affect the Pelvic Floor
Estrogen receptors exist throughout the body. Our pelvic floor muscles like to have a rich blood supply and with depleting estrogen levels the muscles tend to atrophy. Once estrogen depletes, urogenital atrophy occurs which is the decline of tissues in the vulva, vagina, and urinary system. With less estrogen, the tissues in this area are less flexible and less lubricated. While all of these vascularization changes and less laxity in the muscles the risk for organ prolapse increase.
In a systematic review with multiple studies, there were findings that topical estrogen application is considered an effective treatment for atrophy. With that said, many more studies are still being conducted comparing varying doses and methods of estrogen therapy.
When is the Right Time to Start Pelvic PT
According to Dr. Mel—the sooner the better. At any point in a woman’s life, a pelvic health assessment can be beneficial. Preventative care is key and can help you get ahead of issues that may develop as women age and postpartum. Pelvic floor exercises can help improve bladder and bowel control, reduce prolapse, improve recovery after childbirth, and increase confidence and quality of life.
Sources
Radzimińska A, Strączyńska A, Weber-Rajek M, Styczyńska H, Strojek K, Piekorz Z. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clin Interv Aging. 2018 May 17;13:957-965. doi: 10.2147/CIA.S160057. PMID: 29844662; PMCID: PMC5962309.
Weber MA, Kleijn MH, Langendam M, Limpens J, Heineman MJ, Roovers JP. Local Oestrogen for Pelvic Floor Disorders: A Systematic Review. PLoS One. 2015 Sep 18;10(9):e0136265. doi: 10.1371/journal.pone.0136265. PMID: 26383760; PMCID: PMC4575150.
https://www.pelvicfloorfirst.org.au/pages/are-you-at-risk.html