Ask Me Anything: "Why Do I Pee When I Laugh?"
(What is Pelvic Floor Laxity/Hyperactivity?)
Good question. A simple answer is this: your pelvic floor is either too relaxed or it's too stressed out.
What is the pelvic floor? I hope you have a general idea, but I am going to spell it out even more clearly than your high school health teacher. This is where my 15 year career in Childbirth Education comes into very excellent use. I nerd out on things like the pelvic floor. I can’t help it.
The pelvic floor is a hammock-like structure made up of muscles and ligaments that runs from front to back and both sides of the pelvis. This elastic, stretchy, incredibly strong, and flexible group of muscles is responsible for holding in our internal organs, the bladder, uterus, vagina, small bowel, and rectum. From it we have three openings that allow the passage of urine, from the urethra, (the urethral sphincter), the passage of stool from the anus, (anal spincter), and the passage of blood or a baby from the vagina (vaginal sphincter). These three openings and in turn the sphincters or muscles that help keep them closed, or allow them to release– also have the double duty of housing our pleasure centers.
There is a lot going on “down there”, to say the least.
Peeing when you laugh or cough is usually pretty common among circles of women who have just had a baby. It’s even joked about within many “mommy communities” as though it’s something everyone who has a child experiences. It is also very common for women who are over 40 and experiencing symptoms of perimenopause to have frequent and uncontrollable urges to urinate, and to have some leakage when laughing, or sneezing, or coughing! And while some pelvic floor laxity or hypertension is common for many women who have recently had a baby or are perimenopausal– I want to make sure you know that it is not normal and that you do not have to simply accept it as part of aging. Pelvic floor dysfunction is something that you can and should work on repairing to improve the function of your area “down there”.
Having a baby, (or two or three) does certainly increase your chances of pelvic floor dysfunction. Not repairing some dysfunction completely in your 20’s or 30’s can lead to increased likelihood of worsening symptoms in your 40’s and 50’s. The reason for this is the decrease in estrogen that is common in our 40’s, 50’s and beyond. The pelvic floor is receptive to the hormone estrogen, this we know for sure–and when our body makes less and less of it–our pelvic floor muscles are likely to suffer from the lack.
Two important takeaways from this post:
One quarter of women in the United States over the age of 40 have some form of pelvic floor dysfunction, and the statistics increase with age.
Many women do not seek help for their dysfunction because they are embarrassed, are not able to talk about it, or think that it’s just something they have to live with.
It does not have to be this way!!
Let’s recognize what dysfunction is. Symptoms of pelvic floor dysfunction include:
pelvic pressure or fullness.
the frequent urge to urinate or painful urination.
urinary leakage.
urinary incontinence.
lower back pain.
constipation, difficulties with bowel movements, or bowel leakage.
difficulty emptying the bladder.
pain with sexual intercourse.
Your pelvic floor should be a place that holds in what you want to hold in (not for hours and hours and hours–which is really not good for your pelvic floor muscles), and releases easily that which you would like to let go of. It’s also a place where if you choose to insert something into the vaginal opening– it should not hurt. The vagina is able to stretch to accomodate a 9, 10, or 11 pound baby –so it should certainly be able to stretch to accommodate comfortably a tampon, penis, dildo, or other safe insertable device.
There are ways to repair (even though you are perfectly imperfect and none of us need fixing) your pelvic floor. We can and should work to regain function and take control over our most basic, primal, and elemental functions in the body. A happy, healthy and functional pelvic floor is essential for a happy healthy and functional life. They go together like peanut butter and jelly, like summer and rosé, like ebony and ivory–you catch my drift?
Here are some things you can do to help with incontinence:
Do pelvic floor strengthening exercises
Learn how to relax your pelvic floor
Avoid alcohol
Avoid caffeine
Drink Plenty of Water
Eat more fiber
Decrease High Impact exercises and increase strengthening exercises
Be cautious about lifting weights without proper training
Lose excess weight
If you are suffering with pelvic floor issues/dysfunction you are not alone. You can and must get help with it. If you need a pep talk, reach out to me via email here–or send me a voice memo on IG or FB–I will urge you to see a pelvic floor PT–I may even refer you to one. I am also available currently in a one on one setting if you are looking to work with me privately. I can help you assess what your most pressing needs are, how to find the right PT for your needs, how to integrate the care into your daily life once you get a plan of action, and I can even keep you accountable, do the exercises with you online. I can also develop a set of exercises that are complimentary to your treatment and do them with you each week.
