August 14th 2023.
Do you know what's 'normal' for you? Pelvic health is an important part of everyones life, but even more so for women and some non-binary people. Risks of not taking care of your pelvic floor can include incontinence and a decrease in sensation during sex - and no one wants that.
We all know that pelvic floor exercises are useful but what about the signs that tell us when we need to see a health professional? Clare Bourne, a leading pelvic health physiotherapist and author of Strong Foundations, shares her top warning signs to look out for.
Leakage of urine during exercise
Clare says: 'Incontinence of urine, or bladder leaks, are never normal at any time in life. Even if it’s something that happens more often after giving birth or when going through menopause, it’s still not normal. Urinary leakage can happen during coughing, sneezing, exercise and movement.'
The most common time for this to happen is during activities that involve impact, like running or lifting weights. This is known as stress urinary incontinence and the first line of treatment in the UK is to receive guided pelvic floor rehabilitation from a specially trained physiotherapist.
Pain during intercourse
Intercourse and sex should never be painful. Clare explains: 'If there is pain, it might be related to the pelvic floor muscles and a condition called vaginismus, where the pelvic floor muscles tighten up in response to penetration during intercourse, or when using a tampon or mooncup, or during a medical examination.'
A pelvic health physiotherapist will be able to assess the cause of the pain and help you understand it, before creating a treatment plan to improve your symptoms.
Heaviness in the vagina
If you have a feeling of heaviness or something there that shouldn’t be, don’t ignore it. Clare says: 'It could be a symptom of a vaginal prolapse, which is the descent of one or more of the vaginal walls and/or the cervix into the vagina. It can happen at any age, but it’s usually more common after pregnancy and childbirth.'
Fortunately, there is help. Pelvic floor rehabilitation is the first line of treatment for this, as well as preventing constipation. Some physiotherapists will also fit vaginal pessaries to support your symptoms in the short or long term.
Constipation
Clare explains: 'In order for us to do a poo, our pelvic floor needs to be able to relax fully. But sometimes when we try to poo our pelvic floor can actually tighten up rather than relax. This can make it difficult for us to open our bowels. Constipation and struggling to poo isn’t just related to the pelvic floor muscles, so a pelvic health physiotherapist can help you to understand why you’re experiencing this and work with other specialists to find a solution.'
Not emptying fully
If you’re able to poo, but it feels like not everything is coming out, it could be because your pelvic floor muscles aren’t relaxing fully, or it could be related to a vaginal prolapse involving the back wall of the vagina.
The first step is to understand why this is happening and then create a plan to make it better.
Urgency when you need to wee
If you’re experiencing urgency or needing to go often, then it’s time to take action. Clare says: 'These symptoms can make it feel like your bladder is controlling your life, and it’s possible to have urinary leakage with the urgency, which is called urge incontinence. It’s helpful to consider what you’re drinking, reducing caffeine, fizzy drinks or artificial sweeteners. Working with a pelvic health physiotherapist on bladder training and pelvic floor rehabilitation can also help your symptoms.'
Struggling to hold in faeces or wind
Anal incontinence is more common than you might think, with one in 10 people experiencing faecal incontinence. Clare says: 'This can really impact a person’s confidence, self-esteem and ability to go out and live their life, so it’s important to get support and treatment early. Strengthening the pelvic floor and anal sphincter muscles can help to improve symptoms.'
If you’re worried about any of these pelvic health warning signs, or have a story to share, get in touch with Clare by emailing email.
And remember to check out Clare's pelvic floor playlist which demonstrates what orgasms, childbirth and periods sound like.
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