Understanding the Pelvic Floor: Five Things Women Should Know

**By Una Lee, MD**

What is the pelvic floor and why is it important? 

The pelvic floor is not a “floor” but more like a “bowl” of muscles and connective tissues that sits within the bony pelvis. This is a critical structure because it supports urination, bowel function, sexual function, pregnancy, delivery, and physical functioning. In my opinion, the term “pelvic floor” is kind of a G-rated way of referring to parts of the anatomy that people are uncomfortable saying aloud. But even if people would rather At doctorsay “pelvic floor” than other anatomic terms, that’s OK, because it’s referring to the same area and talking about it is a good thing. Women are often embarrassed to talk about these issues, and therefore many cope with bothersome symptoms for years. There is a common myth that pelvic floor problems are a normal part of aging and nothing can be done. In actuality, pelvic floor problems are very common and there are many effective treatment options.

 How do I identify my pelvic floor?

Many women are familiar with the Kegel exercise, which involves squeezing the muscles of the pelvic floor. To find these muscles, place one or two fingers in the vagina and squeeze around your fingers. Once you’re able to do this, you don’t need your fingers to do the exercise. The sensation should feel like you are lifting your pelvic floor up and in, as if you’re trying to pull something up into the vagina. Be sure to breathe normally and not hold your breath. Avoid tensing the surrounding muscles, such as your abdomen, thighs, or buttocks. Squeeze for a count of five, then rest for 10 seconds, and repeat. If you are not sure you are doing it correctly, ask your doctor for a referral to a pelvic floor physical therapist. Doing Kegels correctly is a skill that you will serve you for a lifetime, so it will be worth the investment.

What happens when the pelvic floor fails?

We take for granted that this incredibly complex structure works perfectly most of the time. But when the pelvic floor is not working well, you will notice leakage of urine or stool, rushing to the toilet and urinating frequently, or a sensation of your pelvic organs falling down or out of place. Symptoms can range from mild to severe. Sometimes symptoms get better on their own or stay the same over time, but they can also get worse and become more bothersome. If pelvic floor symptoms are affecting your quality of life and getting in the way of doing the activities you enjoy, it’s time to see your doctor or a specialist.

Did you know that November is Bladder Health Month? Please join us for one of our free education sessions presented by pelvic floor disorder experts on November 8 and 9, at Virginia Mason’s Federal Way and Seattle medical center locations.

Did you know that November is Bladder Health Month? Please join us for one of our free education sessions presented by pelvic floor disorder experts on November 8 and 9, at Virginia Mason’s Federal Way and Seattle medical center locations. Click a location to register, or call (206) 341-0360. These events are open to women of all ages, offering the latest information on conditions and treatments in a relaxed atmosphere.

What is a urogynecologist? 

A urogynecologist is a urologist or gynecologist who dedicates themselves to being a specialist in female pelvic floor problems — primarily urinary incontinence, pelvic prolapse, fecal incontinence, and also reconstructive surgery of the female genito-urinary system. Urogynecology is the intersection of urology and gynecology, and is a new board certification. Three board-certified urogynecologists currently practice at Virginia Mason including myself (Una Lee, MD), Kathleen Kobashi, MD and Alvaro Lucioni, MD.

What helps prevent pelvic floor problems?

Maintaining a healthy weight is one of the best ways to keep the pelvic floor healthy. Excess weight puts additional pressure on the pelvic floor, but even modest amounts of weight loss, just 5 to 10 percent, can improve symptoms significantly.

Avoiding things like chronic coughing due to smoking (quit!) and straining due to constipation will also decrease stress and pressure on the pelvic floor. Maintaining your overall health through good nutrition, hydration, sleep, sexual activity, and exercise also supports a healthy pelvic floor. Just having a better understanding of pelvic floor function is a step in the right direction. It’s an amazing part of the body that rarely gets discussed, so let’s start talking about it!

Lee_UnaUna Lee, MD is a urogynecologist in the Section of Urology at Virginia Mason who enjoys sparking discussion on these intimate topics, to help raise awareness and ultimately improve the health of women.


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