Women experiencing urinary urgency and frequency, stress incontinence or pelvic heaviness and pressure often assume their condition is just a natural part of the aging process that must be endured. In reality, these conditions aren’t inevitable and women don’t have to live with them. Dr. Erinn Myers helps women recognize the signs of common pelvic floor issues and learn about non-surgical and surgical treatment options.
Women commonly experience pelvic floor issues, especially if they’ve ever been pregnant and given birth. It can be the frequent urge to pee, leaking a little urine when you cough or feeling a heaviness in your pelvic floor—an area of interconnected muscles and organs that helps with bladder and bowel control, posture and sexual function. Female pelvic organs include the bladder, urethra, rectum, uterus, cervix and vagina.
“I often see women who’ve suffered for years in silence,” says Erinn Myers, MD, a urogynecology surgeon at Atrium Health Women's Care Urogynecology & Pelvic Surgery. Unfortunately, it’s often not until a friend tells them about getting treated for the same issue that they seek help, she says.
Pelvic Floor Weakeners
Dr. Myers notes that prevention is the best medicine. That’s why it’s important to understand the things that can weaken the female pelvic floor, which can be managed:
- Increase water and fiber intake to reduce chronic constipation
- Lose weight to decrease excess pounds in the pelvic area
- Limit repetitive heavy lifting
Pregnancy and childbirth are the other big precursors to pelvic floor issues. According to Dr. Myers, a woman’s body often naturally repairs itself in the months immediately after giving birth, but the symptoms can reappear over time.
Common Pelvic Issues
The three most common female pelvic issues include:
- Urinary urgency and frequency: The pressing and frequent urge to urinate.
- Stress incontinence: Involuntary urine leakage with certain physical activity, such as coughing, sneezing, laughing or jumping.
- Pelvic prolapse: A pelvic organ presses on or descends into or out of the vagina, causing pelvic pressure or heaviness.
If left untreated, stage 4 pelvic prolapse can ultimately lead to kidney damage. Dr. Myers explains where organs have fallen to in the vagina at each stage of pelvic prolapse:
- Stage 1: About halfway down
- Stage 2: To its opening
- Stage 3: Just past its opening
- Stage 4: All the way through the opening
Another way to prevent a weakened pelvic floor and treat related conditions is by routinely exercising your pelvis. OB/GYNs typically recommend that expecting women do Kegel exercises during their pregnancy. Dr. Myers indicates that it helps to continue Kegels as you age, as long as you’re doing them correctly.
According to the American College of Obstetricians and Gynecologists (ACOG), here is the correct way to start and continue a Kegel exercise routine:
- Squeeze the muscles you use to stop urine mid-flow
- Hold the muscles for three seconds
- Relax them for another three seconds
- Repeat until you’ve completed 10 full Kegels
- Perform this routine three times per day
- Increase the hold by one second each week up to a 10-second hold
For the best results, Dr. Myers recommends seeing a pelvic floor physical therapist, especially if you’re experiencing pelvic symptoms. These specially trained physical therapists can coach you on the correct way to do Kegels, including how to appropriately use biofeedback mechanisms or apps meant to help you do them accurately when performing them on your own.
Other Pelvic Treatments
When lifestyle changes and Kegels aren’t fully relieving pelvic symptoms, women have several other non-surgical and minimally invasive surgical options, such as:
- For Urinary Urgency and Frequency: Botox injections, Percutaneous Tibial Nerve stimulation (PTNS) and Sacral Neuromodulation (SNM), a form of electrotherapy.
- For Stress Incontinence: Vaginal devices called pessaries that provide pelvic support, bulking agents injected near the urethra to narrow it to help prevent leakage and the Sling procedure, a mesh-based outpatient surgery.
- For Pelvic Prolapse: Pessaries and one of two outpatient surgeries: a suture-based repair using natural tissue or a mesh-based repair. Often, these can require a hysterectomy (removal of the uterus) as well.
Talking to a Doctor about Pelvic Symptoms
Muscles weaken with age, but women shouldn’t view pelvic floor issues as unavoidable impositions.
“It’s important for women to pay attention to their pelvic health as most pelvic conditions are easily treatable,” says Cyrita Taylor, MD, an OB/GYN with Atrium Health Women’s Care Union OB/GYN. “Being able to identify any pain or concerns early on with your OB/GYN can limit the need for more advanced interventions and ensure any woman can continue to enjoy all facets of her life.”
It is important to describe your pelvic symptoms to your primary care physician or OB/GYN. They may refer you to a pelvic floor physical therapist or to one of the physicians at Atrium Health CMC Women’s Center for Pelvic Health, who can discuss all of your treatment options, including the latest in.
Want to learn more about Atrium Health CMC Women’s Center for Pelvic Health? Visit online here.
Need to make an appointment with a gynecologist? Schedule it now.
This article originally appeared in Atrium Health's Daily Dose