How To Take Better Care of Your Pelvic Floor
Last month, I wrote a blog post about pelvic floor dysfunction. As a woman over 40, a current perimenopause coach–and a former birth educator and perinatal yoga teacher–I talk with women about their pelvic floor ALL. THE. TIME. There is nothing embarrassing about it–its an essential and important area of our bodies and is responsible for proper urinary and bowel function as well as an area dedicated to sexual health and function. In the aforementioned post, I quickly mentioned things that you can do to help with pelvic floor dysfunction–and in this article, I would like to expand upon those action items and share tools, resources and tips that will help you regain health and function in your pelvic floor in your 40’s, 50’s and beyond.
Here is the short list again for you to review about things we can do to help relieve any stress incontinence that you may be suffering from–and keep scrolling for my expanded tips for each of these items
Do pelvic floor strengthening exercises
Learn how to relax your pelvic floor
Avoid alcohol and caffeine
Drink Plenty of Water
Eat more fiber
Decrease High Impact exercises and increase strengthening exercises
Be cautious about lifting weights
Lose excess weight
Do pelvic floor strengthening exercises.
One of the most well known ways to strengthen the pelvic floor is the kegel exercise. To find the pelvic floor muscles–you would tighten the muscles that you would use if you were stopping the flow of urine. If your muscles are weak–it will be difficult to feel this engagement of the muscles.
Let me first describe the kegel, and then share some alternatives for strengthening if these don't work for you. The classic kegel focuses on what we would call the “fast muscle twitch fibers'', where you can pulse the muscles, quickly engaging and releasing the muscles of the pelvic floor. Another really effective version is the "elevator" kegel, by imaging there are 4 floors in your vagina, and the idea is that you slowly engage and lift the pelvic floor up all 4 floors, one at a time, hold for a couple of breaths at the top floor, and then slowly release the muscles floor by floor to the “bottom” floor. Or you can visualize the pelvic floor closing in like a fist sqeezing and slowly getting tighter and tighter to close all the way–and then after holding this tension, you can slowly release and open it back up again, bit by bit.
If you are struggling with feeling the engagement of the pelvic floor from more extreme laxity–you may want to consider a couple of items that you could use to insert into the vagina to have something to work against. These Kegel balls from Earth and Salt Shop, a local Adult Pleasure shop here in Burlington, VT–are a great first step to seeing if you can begin to feel more engagement by inserting something small and weighted. There are also larger weights that you can try searching for here or on any other site. If you are going to insert anything into the vagina please make sure it is high quality silicone–not plastic–or glass. You want to be able to clean it fully.
Kegel balls from Earth and Salt Shop
If these are still not helpful, you should connect with a local pelvic floor PT that can help stimulate muscles that have atrophy by using gentle manual or electrotherapy stimulation. See a specialist for this.
Learn how to relax your pelvic floor.
Your pelvic floor can also suffer from vaginal atrophy (as I mention above), dyspareunia-which is difficult penetration & painful intercourse, vaginismus & vaginal tightness–and in these cases you would want to learn how to relax your pelvic floor. One way to teach yourself to relax the pelvic floor is to focus on the "letting go" of the pelvic floor during kegel exercises. For example, if you were practicing the "elevator" kegel,you would really focus all of your attention on slowly releasing the muscles floor by floor. Typically, most women say they cannot control the descent of the muscles. They drop from the 4th floor straight down to the bottom.
This type of exercise–the elevator kegel– uses the slow muscle twitch fibers, which make up 70% of the muscles of the pelvic floor, and can help you to become more aware of what it is like to consciously relax the pelvic floor muscles.
Now, this also may be too difficult for you and you would want to think about using a vaginal dialator to help to encourage the muscles to relax and release. Earth and Salt again has a great set of dialators for sale here– and there are plenty of other sites to explore vaginal dilators online. I would use one of these kits under the guidance of your pelvic floor PT.
Dilators from Earth and Salt Shop
Avoid alcohol and caffeine
What does your glass of wine or your coffee habit have to do with your pelvic floor? Alcohol is a diuretic and bladder irritant, essentially making you have to urinate more frequently and with increased urgency. If you are struggling with less than optimal pelvic floor health or strength–alcohol quite simply just makes it worse. Same with caffeine–the increased frequency and stronger urges to urinate can exacerbate an already weak pelvic floor.
Drink Plenty of Water
I know this seems counterintuitive, but this is a really important one!! Staying properly hydrated is a key for proper pelvic floor function–and not holding your urine in are both really important. If you are properly hydrated–all of your systems will function more optimally.
Eat more fiber
This goes along with the water drinking above–eating plenty of fiber from veggies and fruits will help keep you regular. Chronic constipation actually damages the pelvic floor–so it is super important to pay attention to your bowel movements and their regularity for optimal health in the pelvic floor.
Decrease High Impact exercises and increase strengthening exercises
This is not a forever recommendation–but while you are experiencing urinary incontinence–try to reduce the amount of high impact exercise you do and see if it helps–but be sure you pair the reduction of high impact with the strengthening exercises I mention above. Other areas to strengthen are the hip and leg through adduction and abduction exercises as well as incorporating transverse abdominal exercises into your routine. These are exercises that strengthen the deepest layer of the abdominals–responsible for postural alignment and integrity.
Be cautious about lifting weights
Anything that puts intra-abdominal pressure on the core and pelvic floor should be avoided while working to repair urinary incontinence. Swinging kettlebells or dumbbells that are heavy are areas where you need to be very aware of your alignment and the amount of pressure you are feeling in your pelvic floor and abdomen. Do weighted exercises with the help of a private trainer or PT until you are strong enough or aware enough to know when you need to dial back on the intensity.
Lose excess weight
Last but not least, carrying around a lot of extra weight can increase your pelvic floor dysfunction–so as you are able, reduce excess weight through healthy lifestyle choices to bring your weight into balance. I loved testing out Noom last year for learning about how to adopt healthier habits, learn about some of the psychology behind your eating habits and a way to track your progress. There are about a million and one ways to lose weight–ask your doctor for a recommendation that would work best for you.
There you have it! An expanded explanation of the ways that you can address your pelvic floor dysfunction. I hated leaving you with all of the reasons why you are experiencing pelvic floor dysfunction and so I am thrilled to be able to share my recommendations for reclaiming the health of your pelvic floor. Share with your loved ones, and please feel free to reach out to me and ask any questions!!
