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Female Pelvic Health

Ladies only!

Do you leak urine when you cough or sneeze? Is intimacy uncomfortable to you? Are you avoiding physical exercise because of your female pelvis? Read this blog for everything you ever wanted to know about your pelvis!

The pelvic floor is made up of muscles, connective tissues, nerves, ligaments and supports the pelvic organs while also facilitating good voiding of the bladder. It allows good sexual functioning and is part of the postural control mechanism.

It is also implicated in good gut health which we are now understanding is crucial to our immune response and hormone regulation due to its role in voiding bowel movements.

Broadly speaking the pelvic floor can be underactive, essentially under-supportive, and present with complaints such as prolapse or stress urinary incontinence. On the other side, we can classify the pelvic floor as overactive. Presenting complaints are then more along the lines of painful intercourse ( a sense of hitting a wall), constipation or urinary urgency and frequency.

And then we can also encounter some asymmetries, or coordination issues as well as injuries to the pelvic floor.

I'm going to unpack all these complaints a bit more but really want to reiterate that as much as I am focusing on pelvic complaints, I am very mindful and aware of the fact that I am working with women whose entire health matters. Her perception of her concern, her overarching well-being, her sleep quality, her stress resilience and nutritional status: ALL of it matters and that conversation takes up just as much time as unpacking the pelvic details.

So let’s unpack those complaints a bit more:

Urinary incontinence is the unintentional loss of urine. Stress incontinence happens when physical movement or activity — such as coughing, laughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder, causing you to leak urine. Stress incontinence is not related to psychological stress. Stress incontinence is much more common in women than in men.

Stress incontinence occurs when the muscles and other tissues that support the urethra (pelvic floor muscles) and the muscles that control the release of urine (urinary sphincter) weaken.

The bladder expands as it fills with urine. Normally, valve-like muscles in the urethra — the short tube that carries urine out of your body — stay closed as the bladder expands, preventing urine leakage until you reach a bathroom. But when those muscles weaken, anything that exerts a force on the abdominal and pelvic muscles — sneezing, bending over, lifting or laughing hard, for instance — can put pressure on your bladder and cause urine leakage.

Your pelvic floor muscles and urinary sphincter may lose strength because of:

  • Childbirth. In women, tissue or nerve damage during the delivery of a child can weaken the pelvic floor muscles or the sphincter. Stress incontinence from this damage may begin soon after delivery or occur years later.

Contributing factors

Other factors that may worsen stress incontinence include:

  • Illnesses that cause chronic coughing

  • Obesity

  • Smoking, which can cause frequent coughing

  • High-impact activities, such as running and jumping, over many years

Risk factors

Factors that increase the risk of developing stress incontinence include:

  • Age. Physical changes that occur as you age, such as the weakening of muscles, may make you more likely to develop stress incontinence. However, occasional stress incontinence can occur at any age.

  • Type of childbirth delivery. Women who've had a vaginal delivery are more likely to develop urinary incontinence than women who've delivered via a cesarean section. Women who've had a forceps delivery to more rapidly deliver a healthy baby may also have a greater risk of stress incontinence. Women who've had a vacuum-assisted delivery don't appear to have a higher risk for stress incontinence.

  • Bodyweight. People who are overweight or obese have a higher risk of stress incontinence. Excess weight increases pressure on the abdominal and pelvic organs.

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