As we women get older, many things about our bodies start to change. We may obsess about our double chin, lax tummy or butt. But there’s another area that needs our attention just as much to maintain our health and quality of life.
The pelvic floor is the collection of muscles, nerves and blood vessels that support our pelvic organs, like the vagina, uterus and rectum. If things get weak down there due to pregnancy or menopause, we can experience a leaky bladder or other uncomfortable or embarrassing symptoms. This is known as pelvic floor dysfunction. “As women get older, in particular after menopause, when estrogen levels start to decline naturally, those muscles of the pelvic floor can start to weaken,” says Jessica Opoku-Anane, M.D., a gynecologic surgeon at Columbia University Irving Medical Center.
But by seeing your health care provider, you can avoid these problems — or at least minimize their impact on your life. “For African American women, I think there’s even more stigma about going to the physician and bringing up their concerns, and issues of concerns not being heard by providers,” Dr. Opoku-Anane notes.
For patients who are routinely doing their Kegels, it can maintain their vaginal tone. That may help with sexual function and the appropriate sensation during sexual function.
This is not the time to be shy or let embarrassment prevent you from getting better. If you have noticed changes down there, talk to your doctor about getting the care you need. Physical therapy (PT) for the pelvic floor is a specialized treatment that many women can benefit from but only a few may have heard about, and it’s often covered by insurance. You may have used PT to recover from a knee or shoulder injury; the good news is that PT can help improve your lady parts too!
The pelvic floor exam
Whether you suffer from a weak or a painful pelvic floor, a physical therapist can help you start to turn things around by identifying the cause. “Generally, a physical therapist will do an internal exam,” Dr. Opoku-Anane says. “They are also going to examine other sources of pain or discomfort or whatever the symptoms are.” A pelvic floor physical therapist will provide a thorough evaluation of the vaginal area and may also evaluate the abdomen and the bones of the pelvis to get to the bottom of the condition. The next steps include PT visits and exercises to learn, such as Kegels, that you can practice at home.
How PT can improve pelvic floor function — and your life
It may help keep you dry and comfortableAfter pregnancy and during menopause, women may notice that they are leaking urine and are not able to hold it as long as they used to. The same may be true for fecal incontinence. “For cases where the pelvic floor is really weak, [a therapist will] work to help you to strengthen those muscles,” Dr. Opoku-Anane says. Kegel exercises, used to shore up pelvic floor muscles, and other techniques such as biofeedback, can help prevent or alleviate leaks. The physical therapist can make sure you’re performing Kegels correctly so they become a habit.
It may help keep you tight and toned down there
Another consequence of a weak pelvic floor is prolapse, or the bulging of surrounding organs into the pelvic area. “As the muscles of the pelvic floor weaken, different structures in the pelvis can start to come down, or prolapse, through the vagina,” Dr. Opoku-Anane says. Pelvic floor physical therapy can either prevent or stall the progression of prolapse and the discomfort that comes with it.
It may help decrease pain
Women who have medical conditions like endometriosis, have had accidents or have suffered sexual assault may struggle with pain in the pelvic floor. In that case, the physical therapist would show them how to stretch the pelvic floor muscles, even by using a wand or dilator, and provide exercises to do at home.
It may support more satisfying sex
Lovemaking can get uncomfortable with age. But physical therapy can make it more pleasurable. “For patients who are routinely doing their Kegels, it can maintain their vaginal tone. That may help with sexual function and the appropriate sensation during sexual function,” Dr. Opoku-Anane says. It may also lead to better orgasms!
It may help boost confidence
Pelvic floor symptoms can make women feel embarrassed or helpless in the face of physical changes. But getting treatment can empower you. “Going to a physical therapist helps to normalize that these are common things that happen to many women, and you do have things you can do to make it better,” Dr. Opoku-Anane says.