Your Pelvic Floor: Why it Matters (Even if You've Never Given Birth)
Is peeing when I sneeze normal? What exactly IS a Kegel? How can a strong pelvic floor improve my sex life? Your questions, answered by the pros.
Not too long ago I had very little knowledge about what pelvic floor therapy actually is, or why pelvic floor health plays such a powerful role in women’s health. Then, in 2017, I gave birth to my daughter. Immediately afterwards, my delivery doctor sent me to weekly pelvic floor therapy to treat my vaginal tear and broken tailbone (which involved internal massage, you guessed it, via the butt— it was totally fine, I promise!). Although I made a mistake by not continuing treatment when I started back at work two months later (I would absolutely advocate for my treatment schedule now), I credit those critical pelvic floor sessions for laying a solid foundation for my slow— but ultimately successful– recovery.
Since that experience and co-founding Nyssa two years later, I’ve interviewed dozens of professionals about the role our pelvic floor plays in women’s health generally— regardless of whether or not someone has given birth (and if you have, it’s worth noting that the work you put in now can profoundly benefit your health and diminish your risk of prolapse for decades to come!).
It’s estimated that 1 in 3 women will experience pelvic floor dysfunction during their lives. Yet the vast majority of us live our lives disconnected from our own pelvic floor (one survey of 1,000 women found one in six didn’t know where it was, and a quarter didn’t know what it did). Even worse, many of us live with all-too-common Pelvic Floor Dysfunction that causes pain, discomfort and confusion– and suffer in silence. There’s a lot of research that still needs to happen around PFT (which The Cleveland Clinic defines as a "condition where you’re unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement”)– especially with regards to how the condition may be related to interstitial cystitis.
Pelvic floor wellness is an emerging and important field helping more women understand how critical it is to care for this dynamic part of our body. As awareness of the pelvic floor grows, I’m hopeful that pelvic floor physical therapy will emerge not only as an increasingly common treatment option, but also as a form of preventative care. It’s just as important to take care of your pelvic floor in your 20s as it is in your 30s, 40s or 50s. The most important thing is to get started right now. It’s never too early or too late to start looking after your pelvic floor health.
Take good care,
Mia x (Body of Knowledge Editor & Nyssa Co-Founder)
We’ll get deeper into this later but, first up, let’s get clear about what the pelvic floor actually is. Your pelvic floor is a layer of muscles that sits between your tailbone and pubic bone. These muscles support your pelvic organs — this includes your bladder, bowel, and uterus. And are important for urinary control, bowel control, and postnatal recovery.
If these muscles become overstretched, it can lead to:
urinary incontinence
decreased sexual sensation
pelvic organ prolapse (POP)
Here’s a great Pelvic Floor primer:
I recently spoke to the legendary Dr. Sara Reardon, aka The Vagina Whisperer, about all things Pelvic Health. In this video Sara shares her expert opinion on topics such as:
- The role of Pelvic Floor Therapy in general health and wellness.
- What to expect in your first appointment.
- The myth of the ‘tight’ pelvic floor and how to think about Kegel exercises.
- The proper way to pee (and a warning against ‘power peeing’).
- Tips for dealing with vaginal dryness.
- Dealing with pain during sex.
- Preparing for pregnancy, childbirth and postpartum (including the dreaded first postpartum poop!)
- Healing diastasis recti after delivery.
You can learn more about Pelvic Floor Therapy by visiting Sara's website and Instagram, where she happily digs right in to everything from postpartum peeing, pooping, sex and more. She also has a fantastic free e-book, How to Take Great Care of Your Pelvic Floor, packed with simple tips to help prevent or overcome pelvic floor problems.
If you can’t get enough of Dr. Reardon– I can’t!- then check-out this podcast interview I did with her back in 2020, shortly after starting Nyssa. This episode is more focused on pelvic floor health during pregnancy and postpartum and contains a quote (related to the topic of postpartum incontinence) that I’ve thought about many times since: “Just because it’s common, that doesn’t mean it’s normal.”
If you’ve got your headphones in and are hankering after some more expert advice, have a listen to my episode with Dr. Samantha DuFlo is a Baltimore-based Pelvic Floor Therapist who runs the clinical practice, Indigo Physiotherapy– an innovative, evidence-based care practice of pelvic physical therapists and bodyworkers working together to elevate healing and care for its clients. In this episode, Sam shares her perspective on all things related to pelvic wellness– from understanding topics such as endometriosis and pain with sex and to addressing postpartum-specific issues such as diastasis recti, incontinence and more.
Have you heard of Pelvic Floor Mapping? In this article for Nyssa, Holistic Pelvic Care Practitioner Veronica Rottman talks through the process of pelvic floor mapping and explains the benefits of the practice such as:
Optimized blood, nerve and lymph flow in the pelvic floor and surrounding tissues/organs.
Release and relaxation of areas of chronic tension, weakness and dehydrated tissue.
Restoring areas with scar tissue from perineal tears and episiotomies
Ability to contract (kegel) more effectively
Greater body literacy
Increased sensation during arousal.
Can heal issues such as: pelvic pain, incontinence, hemorrhoids, anal fissures, chronic yeast infections and UTIs, menstrual pain, prolapse, and more.
Bring emotional and energetic healing to the whole body
If you’re pregnant, or actively preparing to become pregnant, check out our Viva La Vulva webinar on Pelvic Floor Health During Childbirth and Postpartum Recovery with Kim Vopni, aka The Vagina Coach. Here she dives into why it’s critically important to take care of your pelvic floor during pregnancy and birth, how you can train your muscles to be responsive to labor and birth, plus ways to optimize postpartum recovery so that you’re are less likely to experience issues such as incontinence, pelvic organ prolapse and painful sex.
Kim also offers a deep-dive into preventing Stress Urinary Incontinence during pregnancy, below. Did you know that research shows that if someone experiences SUI while they are pregnant and don’t address it, the chances of them continuing to experience it five years later is significantly higher?
Want to go deeper on Pelvic Floor Health? Check out these articles, research and first-person stories:
The Big Squeeze: Welcome to the Pelvic Floor Revolution.
The Experiences of Women Living with Pelvic Floor Disorders: A Qualitative Study.
We’re Getting Down with the Pelvic Floor– and Serious About Caring for It.
Finally, check-out this new, no-nonsense guide. Post a comment about your own pelvic floor journey, or ask a question (we’ll confer with one of our experts and share the answer) to be in for a chance to win a complimentary copy. Winner chosen at random. Good luck!
This article is so chock-full of resources that I have bookmarked it! As someone who has not been pregnant ever, but who is graced with lifelong IBS and, recently, Crohn's Disease, I can confirm that what affects one part of this complex system can affect the whooooooole thing. I keep intending to start PT but it's so easy to put off. This was a helpful nudge!
I’ve noticed a huge difference postpartum between my pregnancy before pelvic floor PT and after a pregnancy with lots of PT support. No more leaking and I feel in a much better position overall with the knowledge and strength I’ve gained through paying attention to my pelvic floor!