Pelvic floor dysfunctions do not kill, but seriously compromise the quality of life of women. Like so many other circumstances in female life, and more when they concern areas traditionally considered taboo such as the urogenital area, these situations have been lived in silence for centuries. “Even today it is difficult to calculate its incidence. Partly because of the enormous variety of injuries it entails, but also because many women do not openly consult with the doctor because of shame,” highlight the physiotherapists specialized in urogynecology Esther García Martín and Belén López Mazarías, authors of the book Your pelvic floor in shape (Arcopress) and the blog exercisesofsoil.
Little by little, the pelvic floor is talked about without any hesitation, even the consultation is attended before the problem appears. To prevent, one of the best options are Kegel exercises, which are based on contractions and relaxations of that musculature and that must be done for several minutes a day. They aid recovery when the problem has already arisen. For this reason, Indasec and BUENAVIDA have organized a women’s health workshop in which experts on the subject will share the keys to doing them correctly. To participate in the draw for seven double tickets for the event, you just have to answer a simple question on the magazine’s Facebook account, either through a comment or a private message. You can also send the answer through a form. If you find yourself in any of the following circumstances, spending 20 minutes a day working your pelvic muscles is a wise decision and knowing how to do it is essential.
Urine leakage, the most common signal
The muscles of the pelvic floor have a function of controlling access and exit of all the pelvic holes (also in the case of men). If they relax, there are problems. “Who has not heard their mother or grandmother say ‘don’t make me laugh, my pee escapes’? Until recently, if you had several children or were around menopause, it was the price to pay to continue live and have enjoyed life, “say physical therapists. At first it happens only when there is laughter, or it accompanies a coughing fit, maybe it just happens with an effort. And they are becoming more frequent. Urine loss packs are a necessary patch and surgery can be used. To avoid this extreme, it is best to do Kegel exercises.
When the anatomy weighs and the back hurts
Do you notice a lump in the vagina or a feeling of weight in the perineum? “Muscle weakness makes it easier to open the vagina and lower the viscera,” and training the pelvic floor with Kegel exercises helps at least keep it from going any further. This fall in the anatomy is called prolapse and may require surgical intervention, but even in the event that there is no other option than surgery, the area must be strengthened after the postoperative period. One of the symptoms that the uterus has shifted downward due to lack of pelvic floor tone is pain in the lower back or over the coccyx. Don’t wait to notice the lump and it works so that the pelvic musculature recovers its support function.
Penetration should not hurt, nor should the tampon move
When the penetration is deep and one perceives a throbbing pain, the uterus is where it should not be. It may be a sign that muscle strengthening like Kegel exercises offer. It is also true that the tampon drains, since it is held in the vaginal cavity by the own pressure of its walls. Many women notice that the tampon falls off after delivery or that it strains when straining to defecate. It is a sign of lack of pelvic tone and time to start working that muscle.
When what escapes is not urine
Almost everyone knows that a lack of muscle tone in the pelvic floor causes urine leakage, but fecal leakage is still taboo. This situation can range from inability to retain gas to dread to an involuntary gas leak accompanied by a slight fecal leak. There are also sudden losses or the feeling of always wearing stained underwear. Reasons can range from anal or rectal surgery to complications in childbirth that have damaged the nerves that supply the rectum and the muscles of the pelvic floor. “We will work the Kegel, especially, with fast contractions to inhibit the rectal reflex and to gain a few minutes to the emergency. Also the technique of the blockade (to contract before an effort) to prevent losses, for example, when lifting a weight.”
Chronic constipation is also a reason
Sitting on the toilet and pushing as if there is no tomorrow is not only frustrating, “excessive pushing to defecate is another risk factor for the pelvic floor.” As it is an inevitable process, there is no other way to facilitate it: drink more, increase fiber intake to promote peristaltic movements, try to relax and never inhibit the urge to go to the bathroom. And, as long as the intestinal situation does not improve, it strengthens the area to prevent the degradation of the musculature.
A consequence of chronic cough (and running)
Coughing at all hours “causes uncontrolled pressure on the pelvis, weakening of the pelvic floor and, finally, lowering of the pelvic organs (prolapse). It is normal that, after many years of coughing, there should be a loss of urine”. Something similar happens to women who play wind instruments or sing opera. If you are a trumpeter or soprano, practice Kegel exercises before problems appear. If you go for a run, you should also do this type of exercise. Impact sports don’t just hurt your ankles. “Every time you hit the ground, the pressure on the lower abdomen suddenly increases.” This rattle, in the long run, produces laxity.
Before and after vaginal delivery
Without a doubt, this is the greatest trauma for the pelvic region. “Let us think that in labor this musculature is stretched up to five times its length to allow the baby to come out. It is very important that it be elastic, but also that it regain tension so that the organs remain in place,” say the physiotherapists. Once the puerperium is over and as long as your gynecologist does not say otherwise, start exercising the pelvic floor so that the muscles, as far as possible, recover their tone. It is also a good idea to take advantage of the previous months to tone and flex those muscles: it will facilitate pushing and prevent possible damage due to lack of elasticity, such as an episotomy.
One more effect of menopause
If you have not yet had symptoms of problems, it is likely that when crossing this stage they will appear. Estrogens are responsible for the firmness of tissues and the abrupt drop in this hormone when menopause arrives is not only reflected in increased facial flaccidity. “The pelvic floor tissues are atrophying. They are going to be less flexible and, at the same time, with less muscle tone.” On the other hand, over the years, muscle mass is lost. It happens throughout the body. Doctors recommend increasing force work to compensate, and the pelvic floor is no exception.