When humans originated, it’s believed they walked on all fours like their related species, the apes. As time progressed, they began to walk on their feet in an upright posture. Now the large opening in the pelvis was positioned against the force of gravity. Muscles and fascia (tissue that covers and supports muscle) developed to cover the opening in the pelvis and support the organs above. These muscles are divided into two groups and, along with the fascia, form the pelvic floor. They are attached to the bony pelvis and anchor the pelvic organs (see diagram 2).
The pelvic floor stabilizes and holds the pelvic organs in place like a funnel and stops them from falling through (see diagram 1). It supports the bladder (the container that stores urine) and the urethra (the narrow passage for urine). It also supports the vagina (the birth canal) and the anus (the passage for emptying the bowels). The size and shape of the bony pelvis can differ in women of different racial backgrounds. In the same way as some women have large pelvises while others have small, the pelvic floor may differ, too. Nevertheless, it still serves the same purpose of supporting the pelvic organs. Millions of women experience problems related to weakness of the pelvic floor muscles. Some women are born with defects in the pelvic floor. In others, weakness may develop following childbirth or as a result of diabetes. Women who have lifted heavy weights over a period of time or who have had frequent infections of the urine system can end up with a weak pelvic floor. Being overweight can also do damage. Women may experience problems after menopause due to a lack of female hormones. Older women have weak pelvic floors as a result of the natural process of aging.
Women may often develop stress incontinence and lose urine when they sneeze, cough, laugh, exercise or move suddenly. Less commonly, they may develop anal incontinence, which can result in unintentional loss of stool or gas. Both of these conditions are inconvenient and embarrassing. The pelvic organs, such as the bladder, uterus (where a baby develops) or intestines, may descend down (prolapse) into the birth canal due to reduced support. This can lead to bladder or bowel problems. There can be sexual problems, too, as the vagina becomes slack and roomy due to weakened muscles around it. Last, but not least, some women suffer from chronic pain in their lower abdomen and back.
Do not ignore them. Discuss your concerns with your family doctor and have an internal exam. Depending on the degree of weakness of the pelvic floor muscles, your doctor may advise Kegel exercises or refer you to a specialist for further assistance. Sometimes surgery helps to reposition the pelvic organs that have descended down and strengthen the pelvic floor. Surgery may also correct defects in the pelvic floor that are present from birth.
Kegel exercises: As with muscles elsewhere in the body, exercise makes pelvic muscles stronger. Kegel exercises were developed by Dr. Arnold Kegel in the 1940s. Make them a part of your daily routine to strengthen your pelvic floor muscles and prevent problems in the future.
To get the feel of these muscles, try to stop and start your flow of urine. These are the muscles you want to flex. Once you get the hang of it you can contract these muscles at any time. You can do Kegels while driving, cooking, or reading, no matter where you are. No one will know you are working on these muscles. The recommendation is to do a set of 10 to 20 contractions and relaxations at least 10 times a day. While doing the Kegel exercises, try not to contract your abdomen or leg muscles.
By doing the Kegel exercises regularly for a three-month period or longer, many women with trouble holding their urine find improvement in their bladder control. Continue doing the exercises to maintain the strength of your pelvic floor. An added benefit is better muscle tone in the muscles around the vagina, which can improve sexual sensation and response.
Remember the pelvic floor muscles when you are working on keeping fit. Visit your doctor if you are having problems. Pelvic floor muscles are an important part of your body and deserve attention too.