As advanced as our society has become, many women are still reluctant to talk about their bodies. Incontinence and pelvic organ prolapse are rarely discussed, but it is estimated that nearly 50% of women ages 50-75 will suffer from some type of pelvic organ difficulties in their lifetime. Many physical therapists and women’s health experts are finding there are many ways to tone the pelvic floor and have found that variation in exercise is more effective than one type alone. Though you might feel shy to ask your doctor, it is important to learn what you should be doing along with Kegel exercises.
Many women experience pelvic problems after childbirth or when their hormones are in flux during perimenopause or menopause. Pelvic organ prolapse (POP) can range from mild to severe. It can be manifested as incontinence, a feeling of constantly having to urinate, being unable to properly void, tension, spasms and pain. It is a common occurrence after childbirth and during menopause because when estrogen drops, it thins the pelvic walls, resulting in a “loose” sensation, a feeling of bulging or fullness pushing on the pelvic floor.
The historical attitude was squeamish to dismissive when it came to discussing women’s health problems. Some doctors in the Victorian age even opted to forgo actual examinations and have women point out their ailments on a doll. In our modern era, or at least since the 1950s, doctors have recommended Kegels to strengthen pelvic muscles and curb incontinence.
Kegels target the muscles around the urethra and are located by the stopping the flow of urine. Once the correct muscles are located, Kegel exercises should be done at least three times per day. These sessions are performed by squeezing the muscles for up to ten seconds and repeated ten times each exercise session to progressively halt incontinence. The problem with Kegels is that for many women, they don’t work very well.
Often in childbirth there can be trauma or surgical issues that change the pelvic muscles, and occasionally there is also damage to the ligaments of the muscle that connect it to the bone. Kegels may temporarily help but cannot alleviate the problem entirely, and nothing short of surgical repair will work for the most severe cases of ligament damage, so it is important to consult with a healthcare provider to see what type of damage was sustained. For smaller problems, many women are turning to exercise to support the entire pelvic cradle, with the reasoning being rooted in physical therapy.