Subtitles section Play video Print subtitles Have you ever sneezed and maybe… accidentally peed a little bit? Or, have you heard about 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.