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Did you hear the joke about the weak pelvic floor? There’s plenty around. Apparently, it’s funny when women can’t laugh, sneeze or run for the bus without having to change their trousers. With most women experiencing a pelvic floor disorder at some point in their lives, maybe if we don’t laugh, we’ll cry. But the good news is that you don’t have to live with pelvic floor issues. The medical expertise to treat sexual pain, incontinence, vaginal dryness and prolapse is out there. Read on, and let your pelvic floor be the punchline to your jokes no more!

What exactly is the pelvic floor?

The pelvic floor is a group of muscles that sit like a hammock at the bottom of the pelvis, running from the pubic bone at the front, to the coccyx (tailbone) at the back.

We use our pelvic floor muscles to open and close our bladder and bowel when we need to go to the loo. They play a role in supporting our pelvic organs; the bladder, bowel and uterus, and they work with the abdominal muscles to support our spine and core, especially when we’re lifting something heavy.

Not only that, but strong pelvic floor muscles can improve our sexual pleasure by improving sensitivity and grip inside the vagina.

What are the most common symptoms of pelvic floor dysfunction?

If you’ve suffered from chronic constipation or had a baby, if you smoke or are overweight, if you do a lot of heavy lifting or high impact exercise, or if you’re going through the menopause, your pelvic floor muscles may not function at full capacity.

Pelvic floor dysfunction can cause the following symptoms:

  • Leakage of the bladder or bowel during impact exercises or when coughing, laughing, and sneezing.
  • Urge incontinence: when you feel the sudden and urgent need to pass urine or stools, and may or may not be able to ‘hold on’.
  • Needing to go to the toilet more often than what’s normal for you.
  • Vaginal dryness.
  • A dragging or heavy feeling in the vagina.
  • Reduced sensation or pleasure from sex.
  • Painful sex. 

How does the pelvic floor impact our overall health?

As you can imagine, any of the symptoms above can have a significant impact on your quality of life. Pelvic floor dysfunction can limit what you do or what you feel confident doing, including exercise, intimacy with a partner, even wearing certain clothes.

It can suck a lot of joy out of your life. I’ve seen that the long-term impact on your confidence, mental and physical health can be immense, and yet there’s a lot you can do to either cure, improve or manage the problem.

What are simple preventive measures or practices that women can implement into their daily lives?

There is doing your pelvic floor exercises and then doing your pelvic floor exercises.

You need to know how to properly contract and fully relax your pelvic floor muscles. The first step is to find these muscles! I tell patients at the LETO clinic to squeeze their back passage as if trying not to pass wind. Following this, try to pull up the front passage as if stopping the flow of urine. To relax these muscles, imagine a lengthening between your two sit bones and let your back passage relax in the process.

Once you have that technique right, try building in time every day to complete some pelvic floor exercises, such as in bed when you wake up or before you go to sleep.

Ultimately, reducing stress on the pelvic floor and maintaining good bladder and bowel health is also key to protecting the pelvic floor. Here are some general recommendations from the LETO clinic on how to achieve this:

  • Avoid holding in your stomach, and be aware to let go of any tension in your buttocks throughout the day.
  • Drink enough fluid so that you are emptying your bladder completely 5-6 times a day. On average, you will need 1.5 to 2L per day. The best way to know if you are hydrated is to check the colour of your urine – it should be light straw-coloured and no darker.
  • Try to limit or avoid sugar, and carbonated or acidic drinks such as juice, squash and alcohol. If you must drink coffee, avoid it after 1pm.
  • Do not go to the loo ‘just in case’.
  • If you’ve just had a baby, try not to be carrying your baby all day, and mix it up with using a pram. Rest as much as you can to give your pelvic floor and tissues time to heal. Find 10 minutes a day to lie down on a mat with your knees up (pillow underneath your knees) as this helps relax your pelvic floor – and you!
  • Avoid constipation to help reduce unnecessary strain on your pelvic floor which can lead to weakness. You can do this by optimising your fluid and fibre intake (we love a teaspoon of linseed every morning) and resting your feet on a small stool or stack of books every time you empty your bowel.
  • If you are experiencing IBS-type symptoms, increased flatulence or faecal incontinence, try reducing spicy, fatty and greasy foods, caffeine, artificial sweeteners and alcohol
  • Lube, lube and then lube again. Whether it’s for intimate touching, penetration or masturbation, lubricant can reduce friction and pain, and increase pleasure if you’re experiencing any vaginal dryness.
  • Stay active and maintain a healthy bodyweight.

When should I see a pelvic floor specialist?

If you are experiencing any of the following symptoms, you should seek the help of a specialist pelvic health physiotherapist:

  • Leakage when coughing, sneezing running or exercising
  • Having to wake up throughout the night to use the bathroom
  • Difficulty retaining tampons or having a dragging or heavy feeling in the vagina
  • Vaginal dryness or a feeling of ‘looseness’
  • Pain during sexual intercourse
  • Endometriosis
  • Recurrent urinary tract infections
  • Sexual difficulties in breast care patients
  • Persistent back, hip or groin pain

Discussing pelvic health problems can be difficult. If you are reluctant about seeing a pelvic health physiotherapist, remember we have a special interest and training in pelvic health, we’ve seen and heard it all before, and there really is so much we can do to help.


How we can help:

The first consultation with a practitioner at LETO will start with a discussion regarding your concerns, a review of your short and long-term goals, obstetric and medical history, and current exercise program.  Typically, this will be followed by a vaginal examination to assess past and present trauma, how your pelvic floor muscles are functioning, their strength and overall pelvic health that may include scars, c-section recovery, tummy gap, healing, aesthetic and their overall function.

We may also use functional tests to assess your pelvic alignment, biomechanics and abdominal muscle recruitment.

Following the initial consultation, each client receives a clinical findings summary, educational material, a clear pathway to achieve their pelvic health and fitness goals and, where appropriate, lifestyle recommendations, a pelvic floor strengthening programme and an app-based exercise program to achieve their goals.

We strive to be a centre of excellence in the field of pelvic health. We achieve this with an unfeathering commitment to ongoing learning and offering the best available care for their clients.