Pelvic floor – key facts
By Madeleine Speed
In addition to supporting important organs, the muscles within the pelvic floor play a role in continence. They need to keep sufficiently firm and tense to close the bladder outlet and prevent urine leakage from it and wind or faeces leaking from the bowels. These muscles relax to allow the passing of water or for a bowel motion. Then the muscles tighten again to exert control. They are also designed to squeeze during laughter, coughing or sneezing to stop leakage. The strength of the muscles also contributes to the enjoyment and heightened sensations of sex. These three key functions are obviously important and if the pelvic floor becomes weak, some or all of the functions are compromised to a greater or lesser extent.
When the pelvic floor muscles don’t work properly
According to the NHS, some six million people (men and women) are affected by urinary incontinence. Around one in three women will be incontinent by the age of 55, and about one in two by the age of 65. It’s a significant number and compares to around only one in 10 men who experience leakage at the same age. Women are probably more affected by incontinence as they get older because of childbirth which can damage muscles and/or weaken them, although the muscles can deteriorate naturally as we get older. There are several different types of incontinence, but those that most of us experience are stress incontinence where we leak on exertion, coughing sneezing, lifting, etc., and urge incontinence where we just don’t make it to the toilet in time.
You may have a problem if:
- You have to get up in the night: you shouldn’t have to go to the toilet normally (unless you are pregnant or older than 50 and even then it should just be once in the night).
- You keep having to visit the toilet: you should be able to manage 3-4 hours between visits to the toilet.
- You leak if you cough or sneeze or when you are taking exercise.
If you need to empty your bladder a lot, it may be due to habit more than anything and it is possible to retrain your bladder. To do this you can:
- avoid things that irritate the bladder e.g. tea, coffee, coca cola, alcohol and particularly hot chocolate. Water is best for the bladder but cranberry juice is good (on its own), as is lemon barley water.
- defer going to the toilet by pressing on the perineum to support the pelvic floor, counting backwards from 50 so that your brain has to think of something else!
- check how many times you need to use the loo in a day. Normal is 4-6 times , 7 is borderline and 7+ is abnormal.
- defer going to the loo when you don’t need to. Going just in case isn’t a good idea as it is undermining awareness of the natural fullness of the bladder.
- make sure you empty your bladder properly each time you go, so you end by relaxing the pelvic floor, which can’t happen if you are in a rush.
There are a number of ways you can treat incontinence but the most effective, non-interventional and cheapest are pelvic floor exercises. This is because you shouldn’t need fancy or expensive equipment, just you and your pelvic floor…