Guide expert: Xue Yuxin, physical therapist in the Department of Obstetrics and Gynecology, Guangdong Maternal and Child Health Hospital
If you experience embarrassing symptoms such as leaking urine when coughing or sneezing, frequent constipation, feeling vaginal looseness, passing gas during sex, urinary frequency and urgency, feeling like your uterus is falling out, it may indicate problems with your pelvic floor. It is advisable to visit a hospital for a check-up.
The female pelvic floor is composed of multiple layers of muscles and fascia that close the pelvic outlet. Pelvic muscles, connective tissues, and bony structures form a support system to ensure the normal position and function of pelvic organs such as the bladder, uterus, and rectum. Pelvic floor muscles are responsible for vital physiological functions such as urination, defecation, and sexual activity.
However, if abnormalities occur in the pelvic floor muscles and fascia due to certain factors, it can lead to pelvic floor functional disorders, including urinary incontinence, uterine prolapse, vaginal wall prolapse, defecation disorders, chronic pelvic pain, and female sexual dysfunction, affecting patients’ quality of life to varying degrees.
Who is more likely to suffer from pelvic floor disorders?
1. Pregnant women and those with multiple pregnancies
The main cause of pelvic floor damage during pregnancy and childbirth is the increased weight of the uterus, which grows from about 50g at the beginning of pregnancy to around 1000g later on, increasing about 20 times. Additionally, hormonal changes during pregnancy can lead to relaxation of pelvic floor tissues, causing chronic damage.
Moreover, the process of childbirth puts strain on pelvic floor muscles, and complications during delivery can cause direct mechanical damage to the pelvic floor tissues. Difficult deliveries or the use of assistance tools can result in tears or ruptures in the pelvic floor muscles, leading to pelvic floor disorders postpartum.
2. Perimenopausal women
Women in menopause are also susceptible to pelvic floor functional disorders due to the decline in estrogen levels, which play a key role in regulating pelvic floor collagen metabolism and maintaining pelvic tissue structure and tension.
3. Individuals with increased abdominal pressure
Those who engage in heavy physical labor, suffer from chronic coughing, or experience chronic constipation may also be affected by pelvic floor issues due to increased abdominal pressure.
4. Individuals with a history of pelvic surgery
Previous pelvic surgeries such as laparoscopic removal of uterine fibroids, ovarian cysts, or total hysterectomy can result in pelvic floor muscle damage leading to pelvic floor disorders. Patients with a history of pelvic surgery are advised to undergo pelvic floor function evaluation during follow-up visits three months post-surgery.
Therefore, it is crucial for the aforementioned groups to be aware of pelvic floor disorders early on, engage in lifestyle interventions, Kegel exercises, and other preventive measures to minimize the occurrence of pelvic floor disorders. If symptoms of pelvic floor disorders are present, timely evaluation and treatment at a medical facility are recommended. Early pelvic floor rehabilitation can help improve and restore pelvic health, aiding in overcoming pelvic floor disorders through awareness, prevention, examination, and treatment.
Here is a checklist for preventing and managing pelvic floor disorders:
1. Maintain regular Kegel exercises at home
Home Kegel exercises, also known as pelvic floor exercises, are simple to perform. By contracting and relaxing the pelvic floor muscles rhythmically while ensuring normal abdominal breathing, these exercises help increase vaginal tightness, strengthen pelvic floor muscles, and improve support and sphincter function of pelvic organs.
These exercises can be done anytime, anywhere. To accurately identify the sensation of pelvic floor muscle contraction, try stopping urination midstream – the muscles contracting at that moment are the pelvic floor muscles. Tighten these muscles, hold for 4-5 seconds, and then relax, repeating this process 10 times before taking a break.
2. Correct poor posture
Avoid positions in daily life that may disrupt body alignment, such as crossing legs, lying with legs crossed, or standing on one leg, as these improper postures can lead to muscle tension, pain, and eventually pelvic floor disorders.
3. Treat chronic diseases causing increased abdominal pressure promptly
Promptly treating chronic conditions like coughing or constipation that increase abdominal pressure, avoiding or minimizing activities that raise intra-abdominal pressure, and refraining from vigorous exercise can help prevent pelvic floor issues.
4. Consider appropriate treatment methods when necessary
In addition to pelvic floor muscle exercises, combining methods such as electrical stimulation and biofeedback therapy to activate pelvic floor nerves and muscles can enhance pelvic floor function. In severe cases, surgical intervention may be required.
(Correspondent: Lin Huifang, Guangdong Maternal and Child Health Hospital)
