What is the pelvic floor and what is meant by pelvic floor damage?
The pelvic floor is a group of muscles located in your pelvic area which support the organs in your pelvis (such as your bladder, uterus, and rectum) like a sling would and which control your bladder and bowel movements. Pelvic floor damage encompasses a range of conditions which include:
- Urinary incontinence
- Bowel incontinence
- Prolapse of pelvic organs
- Several chronic pain syndromes
- Reduced sexual function or painful sexual intercourse
- Overactive bladder
What typically causes pelvic floor damage?
Pelvic floor damage can be due to many different factors, including:
- Older age
- Multiparity (giving birth to more than 1 child) with risk of pelvic floor damage increasing with each additional child
- Being female
- Being obese
Other major causes of pelvic floor damage are pregnancy and vaginal birth. In pregnancy, pelvic floor damage can becaused by:
- Increase in the volume of the uterus resulting in overload of perineal muscles
- Changes in levels of certain hormones
During labor and birth, pelvic floor damage can becaused by:
- Prolonged second stage of labor
- A baby with a larger-than-normal head
- A larger-than-normal baby
- Anal sphincter trauma
- Perineal tears
You are also more at risk of pelvic floor damage during birth if you are of advanced maternal age (over the age of 35 years).
How can I avoid pelvic floor damage due to pregnancy or birth?
Unfortunately there is no known method that can completely eliminate the risk of pelvic floor damage during pregnancy or birth but there are pelvic floor exercises you can do which can minimize it. These include:
- Pelvic floor muscle exercises which involve clenching your anus muscles and pulling in your vaginal muscles, as if stopping a bowel movement or the passage of urine
- First do these exercises quickly, clenching and releasing immediately
- Then try to hold the clenches for around 10 seconds
- Try and do around 3 sets of 8 clenches per day
- Use of vaginal cones (which look similar to a tampon) has been found to be just as effective as traditional pelvic floor exercises
- These are cones that are inserted into the vagina and held there for around 15 minutes once or twice a day
- There are 2 types: a set of several cones with different weights or a cone that has an adjustable weight
- Give up smoking and lose weight, as both of these are associated with an increased risk of pelvic floor dysfunction during pregnancy
Cesarean section is another somewhat controversial method of preventing pelvic floor damage. Although this is a procedure many women usually like to avoid if possible, it may be worth undergoing if your doctor is recommending it for your particular situation.