Care for Female Pelvic Floor Health Through the Years
If you’re like many women, you don’t think about pelvic floor health until something goes wrong and a pelvic floor disorder affects your quality of life. Then you think about your pelvic floor every day.
Pelvic floor disorders can be embarrassing and uncomfortable. They can cause pelvic pain and make you avoid social situations, but you don’t have to live with your symptoms.
“Some people think these conditions are a natural part of aging they have to deal with in silence,” says Dr. Larissa Rodriguez, board-certified urologist at Weill Cornell Medicine. “However, this is not a normal part of aging, and there’s no reason to suffer in silence.”
Natural Changes in Pelvic Floor Health
After you reach age 30, your body changes. It takes extra work to hold onto lean tissue and burn away body fat. At the same time, your body may lose bone density and muscle mass, including muscle mass in your pelvic floor.
The pelvic floor is a group of muscles that keeps your bladder, uterus, rectum and other pelvic organs where they belong. As you age, these muscles are more likely to weaken, and the organs they support may shift out of place, potentially causing a pelvic floor disorder.
Types of pelvic floor disorders include:
- Fecal incontinence. You have a difficult time controlling your rectum or anal sphincter, allowing stool leakage.
- Pelvic organ prolapse. Because your pelvic muscles and tissue weaken, they can’t hold one or more pelvic organs, such as the cervix or uterus, in place. These organs then drop into the vagina. In some cases, they protrude through the vaginal opening.
- Urinary incontinence. There are several types of urinary incontinence. You may leak urine, feel a frequent urge to urinate or urinate an excessive number of times in the day or night.
Increased Pelvic Health Risk
Age isn’t the only reason you experience changes to your pelvic floor health. Several other risk factors lead to pelvic floor health problems, including giving birth.
“Vaginal delivery is an important risk factor for developing these conditions,” Dr. Rodriguez says. “When women are younger and have estrogen in their bodies and stronger tissues, they might have very mild symptoms of pelvic floor disorders that they learn to deal with. As women age and estrogen leaves their bodies and tissues become more lax, symptoms become more severe.”
Along with age, pregnancy and vaginal delivery, other factors affect female pelvic health and increase your risk for pelvic floor issues. These include:
Reduce Your Risk or Symptoms at Home
While the Office on Women’s Health reports that one in five women experiences pelvic floor disorders, you can take steps to protect against these issues. The same steps can help reduce symptoms if you already have a pelvic floor disorder.
Improve your pelvic floor health with the following:
- Healthy weight. Any extra weight in your abdomen adds stress and pressure to your bladder and pelvic floor. By obtaining and maintaining a healthy weight, you may enjoy improved control over incontinence or prolapse.
- Kegel exercises. Exercising regularly helps limit urinary and bowel incontinence. Specifically, work on strengthening the muscles around the uterus, bladder and bowel with Kegels. Simply tighten the muscles that control urine flow for a few seconds, then relax. The National Institutes of Health recommends doing 10 repetitions, three times a day.
- Modified dietary habits. It’s important to drink water for good health. Drink too much, however, and your incontinence may worsen. Talk with your primary care provider about the right amount of water to drink each day. It may also help to limit caffeine and alcohol, as they can increase urine production. For fecal incontinence, dietary modifications, such as eating more fiber and avoiding diarrhea triggers, may help manage your bowel movements.
- Scheduled bowel movements. Having bowel movements at predetermined times can help improve fecal incontinence symptoms. Success can take months, so work with your provider to determine whether to continue with this method or try a different approach.
When Your Pelvic Floor Needs Professional Attention
In the event your symptoms remain after trying conservative approaches, Weill Cornell Medicine offers a comprehensive suite of female pelvic medicine treatment options, including surgery. Depending on your needs, you may benefit from one of the following:
- Botox. Your care provider injects Botox into the bladder. This injection helps prevent bladder spasms that cause urine leakage. You may need to repeat this treatment annually.
- Medications. The proper oral or topical medication can help relieve specific types of urinary incontinence.
- Neuromodulation. A device sends electrical impulses to the bladder. These electrical signals help retrain the bladder to function properly, helping to manage or remedy urinary incontinence.
- Pelvic floor physical therapy. A skilled Weill Cornell Medicine physical therapist creates a customized exercise routine that addresses your pelvic floor needs.
- Pessary. A plastic or rubber device holds prolapsed organs in their natural positions. While this treatment can provide long-term benefits, the device must be cleaned regularly.
- Sling. A gynecologic surgeon places a synthetic mesh sling under the urethra. Once implanted, the sling holds the urethra in its natural position and keeps it there, reducing urine leakage.
- Surgical correction. A gynecologic surgeon permanently returns prolapsing organs to their original location. Weill Cornell Medicine surgeons often perform this procedure laparoscopically with robotic assistance.
“As women, we take care of others, but there comes a time when we should take care of ourselves,” Dr. Rodriguez says. “It’s important to recognize that you’re not alone suffering from these conditions. Care exists, and it can be very effective. You're entitled to treatment, and you're entitled to quality of life.”
Do you live with urinary or bowel incontinence or pelvic floor prolapse? The talented and caring team at Weill Cornell Medicine offers the latest diagnostic and therapeutic advances to help you regain control of your body. Find a doctor today to get started.