Peeing Yourself: What you should know about pelvic floor disorders

Once you’ve been potty trained no one ever goes back and asks how things are going. And that is why Dr. Lisa Rogo-Gupta says too many people are suffering in silence from pelvic floor disorders.

Pelvic floor disorders (PFDs), such as urinary incontinence (a.k.a. loss of bladder control) and pelvic organ prolapse can have a major impact on people’s daily lives. Conditions like these affect the pelvic floor. What is the pelvic floor you might ask?

Well let’s just say for ladies there’s more happening in the pelvis area than having a period. Now, the pelvic floor is made up of several layers of muscles, ligaments and connective tissue in the lowest part of the pelvis. It supports your organs, including the bowel, bladder, uterus, vagina and rectum, allowing them to function properly.

Pelvic health plays an important role in complete physical, mental, social and sexual well-being. So for this week’s Ask a Lady Doc episode we sat down with urogynecologist, Dr. Lisa Rogo-Gupta to find out what you should know about pelvic health.

1. Be aware of symptoms

PFD symptoms may affect your job, school, relationships, sexual health and self-image. All of which are not something you should just deal with.

Symptoms include urinary issues, such as the urge to urinate or leakage when sneezing or laughing, constipation, discomfort during sexual intercourse, and/or pain or pressure in the pelvic region or rectum.

Consider how often you feel the  urge to urinate and whether or not it’s impacting your daily life? Does it come too often? Do you sit at the edge of the aisle in the movie theater just in case you need to run to the restroom? Do you skip trips or parties to places where you don’t know where the bathroom might be? Or do you wake up in the middle of the night to urinate? Is it disturbing your sleep? Track your symptoms and share them with your doctor.

2. Consider the cause

Many factors can weaken your pelvic floor muscles, including pregnancy, childbirth, surgery, aging and excessive straining from constipation or chronic coughing.

Discussion of the pelvic floor usually occurs around the time of pregnancy or childbirth, which makes sense because those are big changes for the body. However, PFDs affect women and men of all ages and can be triggered by many factors. And just because you haven’t had a baby doesn’t mean these issues can’t happen and can’t be treated.

Aging may play a role in your pelvic health. For example, menopause is a stage of many changes for female bodies. But, pelvic floor disorders are not a normal part of aging that you just have to live with. They are medical conditions and can be treated.

Other lifestyle risks include: obesity, diet, smoking, heavy lifting and exertion. Dr. Rogo-Gupta says she often treats professional weightlifters and even professional dog walkers, who’ve put a lot of stress on those muscles.

Constipation or chronic straining, pelvic injury and emotional stress are health problems, which may also impact your pelvic health.

3. Kegels… do your research

You know how to strengthen your core but what about your pelvic floor? Now you may have heard of a little thing called kegels. The term gets thrown around a lot, but it might just become a part of your regular exercise routine.

Kegel exercises strengthen pelvic floor muscles by contracting and relaxing them. Talk to your doctor if you’re having trouble figuring out how to do kegels.

And in the words of Bubba Sparxxx, get it right, get it tight. Yes, there is a right and wrong way to do kegels.  In fact, Dr. Rogo-Gupta mentioned only 40% of women can actually do kegels correctly. And it makes sense… you’ve never had to engage those muscles before and perhaps have no idea what you’re doing. Done correctly, kegels are very beneficial. So talk to your doctor or see a urogynecologist. Urogynecologists are physicians with special training in treating pelvic floor disorders in women.

Your urogyn might refer you to pelvic floor physical therapist. Yes, like a personal trainer for your pelvic floor, these therapists are certified to help you strengthen your pelvic floor.

4. Don’t just deal with it… treat it

Kegels and pelvic floor physical therapy are one form of treatment used to cure or relieve symptoms of PFDs. Urogynecologists can offer a variety of treatment options, depending on the severity of your condition. There may even be simple changes and interventions which could significantly affect daily quality of life.

As mentioned above, there are many lifestyle and behavior changes to improve pelvic health, including diet and fitness, pelvic floor muscle exercises, bladder retraining, pantiliners, pads, briefs, diapers and physical therapy. Vaginal devices may also be recommended.

For women who have urinary leakage and are comfortable using a tampon, there’s an over the counter tampon to help keep you dry. It puts a little bit of pressure on the bladder door to help it stay shut.

Procedures and or surgery, like nerve stimulation and bulking agents, are also options. Discuss the best treatment option for you with your healthcare provider.

5. Remember: You’re not alone

Women who suffer from pelvic floor disorders tend not to report their condition, due to embarrassment. Don’t be embarrassed.These issues are widespread and affect women and men of all ages. According to Voices for PFD, one out of four women 20 years or older suffer with PFDs

6. Comunicate

It can be difficult to talk about problems such as urinary leakage, even with a healthcare provider. However, doctors, especially urogynecologists, are used to talking about these issues.

Find someone you feel comfortable with and talk about it. Or if you think your loved one is suffering from a PFD, here are some tips to help start the dialogue: https://www.voicesforpfd.org/about/talk-about-it/

Resources:

ACOG – https://www.acog.org/Patients/FAQs/Pelvic-Support-Problems?IsMobileSet=false

Voices for PFD – https://www.voicesforpfd.org/