What is Pelvic Health?

Maintaining good pelvic health is essential to the quality of life and can aid in the prevention of bladder problems and reproductive issues.

Pelvic health is the study and treatment of disorders that impact the pelvic floor which are the muscles, ligaments, and connective tissues that support the pelvic organs — the bladder, vagina and uterus (female) , prostate (male), and rectum. Damage to or weakening of the pelvic floor can impact the normal functioning of these organs. Patients may be hesitant to discuss concerns or symptoms though it is estimated that pelvic floor disorders will impact one in three women during their lifetime.

Why is pelvic health important?

A healthy pelvic floor provides active support to the weight of abdominal contents and pelvic viscera against intraabdominal pressure. It prevents constant strain on connective tissue. It narrows the urogenital hiatus (female) which is the space that allows the vagina and urethra to pass through the pelvic floor muscles and an increased of this opening may result in pelvic organ prolapse. It draws the distal urethra, vagina, and rectum toward the pubis. It acts a postural stabilizer that contracts before or with movement to assist with core stabilization.

What are common pelvic conditions?

• Pelvic organ prolapse - dropping of the bladder, urethra, cervix and rectum caused by the loss of normal support of the vagina. In severe cases, women may feel bulging tissue protruding through the opening of the vagina.
• Bladder control problems include the inability to hold urine long enough to reach the restroom (urge incontinence), frequent urination during the day and night (urge frequency), and urine leakage caused by increased abdominal pressure (stress incontinence). Urge frequency and urge incontinence are also defined as overactive bladder.
• Bowel control problems include the loss of normal control of the bowels that can lead to constipation or fecal incontinence (FI). FI, leakage of solid liquid stool or gas, is also called anal incontinence (AI) and accidental bowel leakage (ABL).
• Chronic pelvic pain - pain that lasts greater than 6 months, is localized to the pelvis, anterior abdominal wall or below the umbilicus, radiates to the top of thighs or genital origin and severe enough to cause functional disability.
• Myofascial pelvic pain – just like any muscular region in the body, the pelvic floors muscles will develop myofascial pain syndrome or myofascial trigger points, hyperirritable spot in the skeletal muscles associated with a hypersensitive palpable nodule in a taut band which gives rise to referred pain patterns, tenderness and/or motor dysfunction.
• Coccyx pain - pain in the region of the tailbone and symptoms could include pain upon sitting, a deep ache, cramping or generalized pelvic pain, pain upon transfer sit to stand, headaches related to dural tension, pain with coughing, low back pain/sciatica, pain with coughing, pain during sex
• Female sexual response and sexual dysfunction is the departure from normal sensation and function experienced by a woman during sexual activity. Pelvic floor muscles (PFM) are a necessary component of sexual response especially the female orgasmic experience. This will include vaginismus which is marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts which occurs when the PFM are too tensed and unable to relax.
• Nerve injury which may be caused by trauma or during childbirth. Nerve entrapment to the abdominal nerves may be caused by intrapelvic trauma, direct abdominal trauma, rapidly expanding uterus during pregnancy, abdominal surgery.

What pelvic screenings are available?

Your healthcare provider will assess the health of your pelvic organs and surrounding structures by visual inspection of outer genitalia, external and internal palpation. May require you to get diagnostic imaging or testing for details of how these organs are functioning. If they determine you will benefit Pelvic Floor Physical Therapy, the Physical Therapist will take a detailed medical history and functional history. She will perform external and internal vaginal exam and/or rectal exam to determine the functioning of your PFM that will include its strength, endurance and ability to contract simultaneously with the core muscles, and integrity of the pudendal nerve -the nerve that supplies the PFM.

Tips For Maintaining Good Pelvic Health

Good pelvic health begins with nutrition, exercise, good posture, good toileting habits, and well-coordinated functioning of the PFM with the core muscles. Here are several tips and healthy behaviors you can practice maintaining the health of your pelvis.

Do Pelvic Floor Exercises

Pelvic floor exercises can strengthen the muscles around the organs in your pelvis, such as your bladder. These exercises can often help you avoid loss of bladder and bowel control, and organ prolapses.

Exercise Regularly

In general, staying physically active can improve your blood flow, circulation, and digestion. It can also help you avoid constipation and improve your sexual function. Try to exercise on most days of the week. Do a combination of aerobic and weight training exercises for the best health benefits.

Drink Plenty of Water

Water can help flush waste and toxins out of your system. This can reduce your risk for constipation and urinary tract infections. Drink plenty of water throughout the day to stay hydrated and to maintain good bladder health.

Eat High-Fiber Foods

Foods that are high in fiber can help push waste out of your system to prevent constipation. Many high-fiber foods are also rich in vitamins, minerals, and antioxidants. All these nutrients can keep your organs functioning well and reduce your risk for disease.

Foods high in fiber include:

• Beans and legumes, including chickpeas, pinto beans, and black beans
• Whole-wheat pasta
• Berries, including blueberries, raspberries, and blackberries
• Apples and pears
• Nuts and seeds, including chia seeds, almonds, and walnuts
• Quinoa
• Avocados
• Bananas
• Sweet potatoes

Most fruits and vegetables are high in fiber. Talk to your doctor about foods you should add to your diet if you have constipation or other pelvic issues. Your doctor may even refer you to a nutritionist who can help you create a healthy meal plan.

Visit the Restroom When You Feel the Urge

Try to use the restroom whenever you feel the urge to urinate or have a bowel movement. Keep in mind that urine and feces are waste. Holding these substances in for too long can lead to inflammation and increase your risk for an infection.

Urinary tract infections and colon cancer are some complications that can happen if you don’t go when you feel the urge. Make it a priority to use the restroom, when possible, especially if you’re on a road trip or traveling by plane.

Avoid Straining During Bowel Movements

Straining and pushing too hard during bowel movements can cause many complications. In terms of pelvic health, one of the most serious complications is rectal prolapse. Rectal prolapse occurs when you push too hard, and a small part of your intestine comes out of your rectum.

If you need to strain during bowel movements, it’s possible you are not drinking enough water, or you do not have enough fiber in your diet. You may also be straining due to irritable bowel syndrome, a large intestine disorder. Ulcerative colitis is another possible cause. This condition is marked by inflammation and sores in the lining of the rectum and large intestine.

To avoid straining during bowel movements, drink plenty of fluids throughout the day and eat a nutritious diet. Exercise regularly, as exercise can also promote regular bowel movements without straining.

Drink Less Alcohol

Alcohol works like a sedative to help you relax. This means it can also weaken your pelvic floor muscles to cause problems with loss of bladder and bowel control. It is also a diuretic and can cause you to go to the restroom more often, leading to irritation and an overactive bladder. An overactive bladder can also lead to loss of bladder control.

Reduce your alcohol intake to improve and maintain your pelvic health. The CDC recommends having one drink or less per day if you’re female and two drinks or less per day if you’re male. A standard drink is 12 ounces of beer or 1.5 ounces of a spirit.

Reduce Your Caffeine Intake

Beverages with caffeine like coffee and tea can irritate your bladder due to the way they work as diuretics, making you urinate more often than usual causing an overactive bladder. In some instances, excessive amounts of caffeine can increase your anxiety and lead to problems with diarrhea.

Try limiting your caffeine intake to one or two cups a day. You can also try switching to green or white teas, which have less caffeine than black tea and coffee.

Avoid Heavy Lifting

Lifting objects that are too heavy can increase your risk for organ prolapse. Do not lift heavy objects on your own if you lack the strength to do so. Get help when lifting heavy objects or use machinery and other devices that can do the work for you.

If you lift weights at the gym, go slow and start with smaller weights. Increase your load gradually to avoid compromising your pelvic health.

Don’t Smoke

People who smoke are at higher risk for urinary incontinence than people who don’t. This is partly because many smokers cough a lot, which increases the amount of pressure on their pelvic muscles. Over time, coughing can weaken the pelvic floor muscles and lead to loss of bladder control.

If you don’t smoke, please do not start. If you do smoke, ask your doctor for help with quitting. Your doctor may prescribe medications or suggest other interventions that can help you stop for good.

Managing Pelvic Health at Lompoc Valley Medical Center

At Lompoc Valley Medical Center, we are devoted to helping you maintain your pelvic health. We treat a wide range of pelvic conditions and offer pelvic screenings and pelvic therapy services to help you stay healthy. Contact us today at (805) 737-3382 to request an appointment and learn more about our many healthcare services.

Citations: Pelvic Health APTA 2015, www.ucla.org , www.unc.edu