What and where is your pelvic floor?
Jean Hailes’ pelvic floor physiotherapist Janetta Webb says there are some women who need to be particularly aware of pelvic floor fitness; those who are pregnant, or who have had children, women transitioning to menopause, and women who have had abdominal, hip or back surgery.
For women who already have pelvic floor issues, such as bladder leakage, Janetta says an intensive pelvic floor program is needed – “not just a few squeezes a few times a week!”
Janetta urges women to seek help for any pelvic floor symptoms, no matter how small.
“The pelvic floor should be a part of every fitness program; don’t ignore it and don’t be embarrassed to talk about it,” she says.
Listening time: 8 mins
Quiz | Bust those bladder myths
Do you know your waterworks? Take the quiz, bust the myths, and learn how to be kinder to your bladder and more in tune with your pelvic floor.
It’s best to empty your bladder often and ‘just in case’ – for example, before going on a long car ride or into the cinema.
Your bladder is a reservoir. Its job is to store urine until an appropriate time and place that suits you to empty it. Going ‘just in case’ may train the bladder to hold smaller amounts of urine. Then, when you really need it to store urine, it's harder to hold on.
It’s better to hover over, rather than sit down, on public toilet seats.
Your bladder empties itself much better when you are seated and relaxed on the toilet. If you need to, use a disposable toilet seat cover or pop down some loo paper, but don’t get into the habit of hovering over the toilet. Remember, you can’t catch an infection from a toilet seat.
Even if you’ve had children by caesarean section, or no children at all, you still need to exercise your pelvic floor.
Every woman should be exercising their pelvic floor muscles every day. This helps to prevent bladder and bowel leakage and pelvic organ prolapse (in which your bladder, bowel, vagina or uterus can ‘drop down’ and sit lower than usual). Tie your pelvic floor exercise in with a daily task such as brushing your teeth, standing at the train station, sitting on the bus – make it not negotiable!
For optimal health, you should drink 2 litres of water a day, in addition to all your other fluids.
Unless instructed otherwise by your doctor, aim to drink 1.5-2 litres of fluids in total every day. This includes everything that you drink, not just water. Tap water is still the recommended choice for optimal hydration, but other beverages such as fresh juices, decaffeinated tea and coffee, even soups and smoothies all count. There is no evidence to suggest that drinking more than 2 litres of fluids a day is necessary.
It's OK to leak a bit of urine when you go to gym or for a jog – at least you’re exercising, right?
Unfortunately, this type of bladder leakage tends to worsen over time, so it’s best to change your exercise routine and seek help from a pelvic floor physiotherapist, with the aim of returning to these types of exercises later. If you have issues such as incontinence or pelvic organ prolapse, you’ll need an intensive program of exercises which aims to get you back to your fitness activities.
Once you reach a certain age, it's too late to strengthen your pelvic floor.
As long as a muscle can work, you can always improve how well it functions.
As a bonus, investing in your pelvic floor health might also improve your sex life.
Many women do report that strengthening the pelvic floor muscles leads to greater pleasure from penetrative sex and more intense orgasms. The vaginal walls are layered with the pelvic floor muscles. So exercising these muscles can also increase blood supply and nerve activity in this area which, in theory, can all lead to greater pleasure.
You got out of 7 correct
Hopefully you now know a bit more about your pelvic floor and how to keep it in tip-top shape. Any answers there that surprised you? That’s OK – every day is a school day in the world of women’s health. But the more knowledge you have, the better placed you’ll be to take the best possible care of yourself. After all, that’s what Women’s Health Week is all about – being the best you can be to yourself, for yourself.
The release is just as important as the squeeze
There are two parts to pelvic floor exercises. They begin with the squeeze, which is the internal tightening of the pelvic floor muscles. The second part of the exercise is the release – the letting-go. Janetta Webb says that while many women are aware of part one, they often don’t know about the importance of part two.
“I tell all women: the release is just as important as the squeeze, and you should be just as good and just as quick at letting it go, but not pushing or forcing it,” says Janetta.
Overactive pelvic floor
Some women may be unable to release after they squeeze, or their pelvic floor muscles are in the squeeze position to begin with. This is what is known as an overactive pelvic floor.
Certain symptoms and conditions can indicate you may have an overactive pelvic floor. These include:
- painful sex (22.4% of women aged 18-35 who completed our survey said they had discussed this with their doctor in the previous 12 months, or needed to discuss it)
- difficulty or slow to get started doing a wee
- difficulty doing a poo, or getting it all out
- persistent pain in the pelvic area
- pain using a tampon.
If you are concerned you may have overactive pelvic floor muscles, talk to a trusted GP and see a physiotherapist who has expertise in women’s pelvic floor health.
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Gut health matters
You may not realise it, but the health and functioning of your gut (bowel) and pelvic floor are closely connected.
Pelvic floor muscles help to give us good bowel control, but they also help with easy emptying (pooing) by supporting the rectum and opening the anus at the right time. Listen to your body and go when you get the urge, but don't force it.
Straining on the toilet isn't good for your pelvic floor, so ensure your stool (poo) is like 'well-formed, soft sausages'.
One of the best ways to prevent straining and constipation is by giving your gut what it loves – fibre! Read more on fibre below.
Water makes up about three quarters of healthy stool (the rest, in case you're interested, is undigested fibre, fats and gut bacteria). So to keep your gut and pelvic floor in good health, aim to drink about two litres of fluids every day.
A high-fibre, gut-healthy recipe
Fibre can be your gut’s best friend, so let’s learn a bit more about it. There are two main types of fibre: soluble and insoluble.
Soluble fibre helps to soften stool. Good sources of soluble fibre include nuts, seeds, legumes (such as lentils and beans) and some fruits and vegetables.
Insoluble fibre adds bulk to the stool, helping it to move more quickly through the gut. Good sources of insoluble fibre include wheat bran, wholegrains (such as brown rice and oatmeal) and vegetables.
Want to start your day the right way? Here's a recipe that’s rich in both soluble and insoluble fibre and ticks the taste-sensation box too!
Ludi Wiggins, Women's Health Week ambassador, former Olympic and Commonwealth Games diver
"Life is busy, but it's so important to get into a routine and do what you can when you can. Even if it's just 15 minutes of physical activity in the morning at home or a short walk in the evening, it'll do wonders for your wellbeing and some is always better than none!"
Its causes can be many and varied, such as the ‘silent’ conditions we talked about on Monday – painful periods and endometriosis – but can also include conditions such as painful sex, adenomyosis, pelvic inflammatory disease, irritable bowel syndrome, painful bladder syndrome, pelvic muscle pain and vulvodynia (vulval pain).
A range of treatments are available to deal with pelvic pain, depending on its cause. In this short video below, Janetta Webb discusses how physiotherapy can help treat pelvic floor muscle pain.
Management also involves learning how your brain and nervous system change with persistent pain. It’s also usually really helpful to see a psychologist who has an interest in this area.
It’s important to know that pelvic pain is very common, and that you don’t need to put up with it. Help is available. You can also visit the Pelvic Pain Foundation of Australia.
You have the (pelvic) power! Spread good health and self-care this week by downloading this e-Card as our gift just for you, or share it with friends on your social media channels. Don't forget to use the hashtags #myhealthfirst #womenshealthweek
Want to know more?
Here are some more helpful articles, recipes and resources to download
How often do you need to visit the toilet in a day? What's healthy and what's not? Download our bladder and bowel fact sheet to get to know the basics on these important areas of health.
Bladder and bowel health
Tricky topics to talk about? Never fear, we cover it all... read about bladder leakage, bowel incontinence and prolapse as well as helpful tips to manage and treat these conditions.
Your guide to UTIs
Are UTIs (urinary tract infections) just part of being a woman? Something we have to put up with? Find out what causes UTIs, how to manage and treat them, and how to reduce your chances of getting them.
5 top foods to nourish your gut bacteria
In this article, Jean Hailes naturopath Sandra Villella talks about how to support your digestive system with everyday foods. Read about her top five foods to nourish your gut bacteria
Red rice salad recipe
This colourful salad of red rice, aduki beans and roast vegetables will help nourish and restore your friendly gut bacteria.
Pelvic floor-safe exercises
Want to work out at the gym but have a pelvic floor issue? Learn about the exercises that place less stress on your pelvic floor. For more information about pelvic floor-safe exercises, visit Pelvic Floor First.