kegels, the magical muscle exercise  that can make sex more pleasurable? 

Do  you struggle with bowel movements? Or lower  back pain?  Feel physical discomfort during sex?

Turns out, all of those things are  connected... because they all involve

a complex structure of muscles, tissues, and nerves  called the pelvic floor. And everybody has one! 

-One of the biggest mysteries about the  pelvic floor is that it even exists.  

I often feel that we learn in anatomy from head to  hips and then skip on down to our knees and toes.  

-So YES, the pelvic floor is a real thing. 

-So, we have a ring of bones here

the pubic bone in the front and the sacrum and tailbone in the back

and at the very base of this is that basket of muscles.

So these muscles sit like a hammock to support our pelvic organs.

-This includes the bladder, urethra,  rectum, bowel, and anus. In female-bodied people,  

they also include the uterus, cervix, and vagina.   In male-bodied people, the pelvic floor supports  

the prostate.  
This part of the body  is still kind of shrouded in mystery…  

and even though everyone has one, female-bodied  people are particularly affected because of  

pregnancy and childbirth. So a major reason  for the pelvic floor's enigmatic reputation  

could be linked to the lack of knowledge and  research around the female body in general.  

Another problem is that a lot of people are  embarrassed to talk about issues relating to  

the pelvic floor... because a lot of  these problems arise in the bathroom  

or the bedroom. And not everyone feels comfy  sharing those details, which I understand.

For a part of the body that people don't really  talk about, it affects so much of our everyday lives.

One study found that one in three women will  experience some sort of pelvic floor dysfunction  

in their lifetime. These issues can include fecal and  urinary incontinence (aka peeing and pooping your  

pants), constipation, and painful sex.   Experts still struggle to pinpoint the exact  

causes of many of these disorders, but here's  what we do know: The risk of pelvic floor  

dysfunction seems to increase as you age, probably related to the loss of elasticity  

and firmness of all your body's tissues as you get older.

Giving vaginal birth can also double your risk  

of developing a pelvic floor disorder, and  other health variables like regular intense  

exercise or obesity can play a role in these  problems.  Now I myself have not had a  

baby but I do know someone who has and the  baby was me, because she is my mom. 
So mom,  

what's up with your pelvic floor? -Well, it's hanging in there… for many reasons.  

You know, childbirth really didn't affect it that  much. I started to be completely post-menopausal  

and not have enough estrogen to keep the tissue  healthy. And my uterus was starting to fall out,  

prolapse, pulling the bladder with it.  -But you had surgery and that fixed it.  

-That's correct. So I had uterine removal, nothing  else removed, and then the bladder shored up.  

You just have to get used to the new  placement of things, and that's ok.  

- 
One major problem is when the pelvic floor  muscles are too weak or injured by events like  

childbirth. This can cause urinary or fecal  incontinence  and even pelvic organ prolapse,  

which is when your organs start to fall out of  place.

In extreme cases, they might press  into the vaginal wall and give the  

sensation that something is falling out  of the vagina. Not cool, man, not cool!  

Other times, an overactive pelvic floor could  be the issue. It's sort of like when you hold  

stress in your  shoulders—when you can't  fully relax your pelvic floor muscles,  

you might experience constipation,  frequent peeing, and pain during sex. 

Tightness of the pelvic floor can be caused  by lots of different things.  But luckily,  

there are lots of different treatments available  for pelvic floor problems like pessaries, surgery,  

medication, physical therapy. But even though  these treatments exist, not everyone who may need  

them knows about them.

While there's rightfully a lot of attention given  

to a newborn's health after birth, far less  is given to the person who birthed the baby

and their body. Despite the fact that there's a  big link between vaginal birth and pelvic floor  

compilations, not all postpartum care  providers emphasize the pelvic floor,  

or talk about it at all.   -The American College  

of Obstetrics and Gynecology is recommending a  visit at three weeks and then ongoing care for 12  

weeks for postpartum women. However, the current  standard of care is really just a six week visit,  

that the research is showing that 40% of moms  don't attend. 

Sometimes new moms get a green light  

to resume sex and exercise at six weeks postpartum, but then run into problems like pain

during sex or peeing during workouts, sneezes, and laughing too hard. 

-Our pelvic floor muscles go through such a change  

during pregnancy. And there's very little  guidance on how to rehabilitate afterwards. So,  

a check in with a pelvic floor therapist should  be the standard of care for every postpartum mom. 

-There are now doctors who specialize in this, just  like Dr. Reardon. Pelvic Floor Physical therapy  

can give patients a strengthening regimen if they  suffer from weakness or for those who have overly  

tense pelvic floors, breath work, biofeedback,  massage, and yoga can help too. Some countries  

are already implementing this knowledge on a large scale. In France, women get 10 free

pelvic floor therapy sessions after childbirth. 

That is so freaking cool, but  also...that should be the norm, right? 

And here's the thing. You don't have to wait  until there's a problem to start taking care  

of your pelvic floor. Because preventative care  is getting lots more attention these days too!    

Every person has a pelvic floor male, female,  transgender, of any gender of individual  

has a pelvic floor. And there can be issues  affecting the pelvic floor at any life stage. 

And yes, there's an app for that.  In recent years there's been an uptick of  

available trainers and toys to build your own home  gym for your pelvic floor…think fitness trackers,  

but for vagina. Some of them even incorporate  a game aspect for the more competitive among us.  

Others come with different weights,  so you can make those gains. 

Now you really don't need a fancy gadget

for pelvic floor health, though they might make  

taking care of your pelvic floor more fun.   And, I really can't emphasize this enough,  

you do have to talk to you healthcare provider about your issue

before you start any kind of regimen, to make sure  

you're actually doing what you need. Whether strengthening or relaxing is right for you.

And despite all of the options popping up,  

there's still a need for more investigation into  the complex world of pelvic floor disorders. 

Research is taking a look at whether vaginal  estrogen in combination with pelvic floor physical  

therapy can help with mild prolapse. Other  studies are looking into how changing birthing practices  

could improve postpartum outcomes. There's lots more investigation into how things

like posture, exercise, and even the way  we sit on the health of our pelvic floor.  

-I also think that there are more women entering  the medical field that will also say, “Hey,  

we are experiencing some of these problems, we  see the needs of our patients, and there needs  

to be more research to support and help advise  on how to better treat pelvic floor issues. 

I have a lot of hope that improved education—like  

including the pelvic floor in sex ed in schools for example—and making birthing people   

more aware of their pelvic floor, can

help break down the stigma and mystery that  still surrounds these really important muscles.  

-I think previous generations maybe felt like  again after having children or with aging,  

that our pelvic floor was just going to change  and we just had to deal with certain things like  

urinary leakage or discomfort with intercourse.  And we're realizing now that that is not the case.  

And we're really seeking help proactively and  almost demanding that we get some support and some  

resources to help alleviate some of these issues.

-Just because we've been told this is normal as  

we age or that is just part of being a new  parent, doesn't mean that it is normal...or  

that it has to be. Strong and healthy is the  goal for everything—including your pelvic floor.  

And now that you know what it is, you can have  candid conversations with friends, partners,  

and healthcare providers, to maybe get us some  more answers...and hopefully better solutions.

Thanks so much for watching Seeker's new series Body Language.

I hope you enjoyed this video, and if there's another women's health topic you want us to cover

leave us a comment. I'll see ya next time.