Chances are, we’re only paying attention to our pelvic floor when something goes wrong, but there are three stages of life that can have a big impact on this important part of our body. We speak to a pelvic health physiotherapist about why too many people have accepted some form of pelvic floor discomfort or leakage, warning signs to look for and the Kiwi company who is bringing out new tools to improve pelvic floor health.
When it comes to our pelvic health, all too often it’s “out of sight, out of mind,” says pelvic health physiotherapist Liz Childs.
“Most people – if they haven’t had a problem – don’t know much about the pelvic floor muscles; they’re some of the only muscles in the body, that you can actively contract, that you can’t see.”
There are three big events that can have an impact on the pelvic floor: having a baby, menopause, and getting older. In any given week at Pelvic Health Physiotherapy Wellington, where Liz works, they see more than 100 people seeking help with their pelvic floor health. Of those clients, she estimates 95% are women, and half of that entire group are living with overactive muscles.
“Because of the personal nature of what the problems are, people don’t talk about it. They may not tell their doctor, they may not tell their partner, they put up with leaking, or pain every time they have sex, and they think it’s normal.”
In New Zealand, 46 per cent of women will experience a pelvic health issue in their lives. Additionally, one in three women will experience urinary incontinence and one in five will experience pain during sex. Far, far too many women, she believes, have accepted a level of discomfort as something they have to live with – whether it be leakage, or pain.
Pelvic Floor Symptoms To Pay Attention To
– Any kind of leakage
– Increased frequency or urgency to go to the toilet
– Constipation
– Pain, associated with bladder or bowel function
– Being unable to empty the bladder or bowel properly
– Pain with sex, pain or burning around the vulva area.
– A dragging, heavy sensation (a sign of prolapse)
– Back, hip or groin pain that doesn’t go away with standard treatment
The health of our pelvic floor can be something of a signal of other issues we might be experiencing, that we’re not aware of. For instance, Liz says that anxiety can be a cause of overactive pelvic floor muscles. “A lot of the people we see are anxious – well, a lot of people are anxious, full stop,” she says.
It’s a bit of a chicken and egg scenario, because people can be anxious because they are experiencing pelvic floor dysfunction – but they can also experience the actual dysfunction because of existing anxiety. “For many people, their pelvic floor muscles, and the muscles around their shoulders and neck, tighten when they’re anxious – those are two of the biggest areas to be affected by anxiety,” she says.
Fear plays a huge part in the muscle memory of the pelvic floor as well. “Maybe when they first tried a tampon, it was really painful – and then the next time they try to put anything in there, it hurts,” Liz says. “So they might have years and years of not being able to use tampons, or not being able to have pain-free sex.”
If you’ve ever had a baby, you’ll know that a lot of the rhetoric around the pelvic floor is tighten, tighten, tighten. But, as Liz says, many people actually need help in releasing the muscles – and pelvic floor muscles that are shortened due to being overactive can be just as much of an issue as muscles that are weaker. It’s why, as part of the assessment and treatment sessions they do with their clients, they use tools that can help release, as well as tools that can help tighten.
Share Satisfaction, a New Zealand owned and operated sexual wellness brand, has just released the Eyden collection, a range of pelvic floor products to help those who struggle with either over or under-active muscles.
“Currently, we often use plastic dilators that look very clinical and can be intimidating. It will be great to offer patients silicone products that can be more comfortable to use. Small dilators are also very hard to come by in New Zealand, so the size range Eyden dilators offer is fantastic to ease patients into their treatment,” says Liz.
Having a company associated with sexual wellness tackle something like overall pelvic health also helps reinforce the idea that pain-free isn’t the only thing we should be aiming for, when it comes to our pelvic floor.
“It can really affect your libido – if you do something that hurts, the next time you go to do it, you won’t really want to,” Liz says. “You may not get aroused, and there can be a whole fear response around this as well. Pelvic floor muscles tighten up as a protective response. Your brain is protecting you from pain – because pain is a warning that you might be in danger. People should not only be able to enjoy pain-free sex, they should be able to look forward to it too.”
It is slowly becoming a more normalised conversation, aided by the work from companies like Share Satisfaction and also thanks to a move from ACC, who now partially fund pelvic health appointments for those who had a baby after October 1st last year and experienced a birth injury. Liz hopes this is just the start of bigger, more inclusive things to come.
“I would love it if everyone had access to a pelvic health physio during their pregnancy, and after having a baby, for an assessment.” She and another pelvic physio have also just completed a book, on behalf of Continence NZ, to help improve education about the pelvic floor. This will be available free of charge to all pregnant and postnatal women later this year.
At the clinic, Liz says, they have a saying, “’It might be common, but it’s not normal.’ It’s important for people to know that – and that they can do something about it.”