Did you know these things about your pelvic floor muscles? Let's talk!

Have you ever really thought about your pelvic floor muscles? Probably not. But these muscles play a very important role in our bodies, especially in some of the activities that are essential to our daily lives. So today we will talk about this in a simple way, in a way that you can understand.

What are the Pelvic Floor Muscles?

Simply put, your pelvic floor muscles are a collection of muscles and connective tissues that support several important organs inside your pelvic cavity, such as your bladder, bowel, and uterus, vagina, and prostate in women. Like a mesh, these muscles help keep these organs in place. They also provide the flexibility needed for things like urination, defecation, and sexual activity.

Think about it, the main muscle groups in your torso, which we also call ``Core muscles,'' work together with these muscles, the muscles of the pelvic floor. This is why you can protect your spine and internal organs from the pressure that comes when you lift something heavy, cough, etc. At the same time, these muscles also help you control your urine and stool (`Continence`).

What exactly happens with these pelvic floor muscles?

The main function of these muscles is to hold and protect the vital organs in the pelvic cavity in their proper positions. The ability to control these muscles – that is, to squeeze and relax – greatly helps in eliminating waste from our bodies.

Imagine, these muscles work in a very special way with your urethra and anus. When you tighten these pelvic floor muscles, these two passages narrow. Then waste cannot pass out. When you relax these muscles again, these passages widen and you can urinate or defecate.

For someone with healthy pelvic floor muscles, this tightening and relaxing happens naturally. And, you can control it at will, just like you would intentionally tighten a bicep.

There are also slight differences in the way these pelvic floor muscles work, depending on the parts of your reproductive system.

How do women's pelvic floor muscles work?

As a woman, your pelvic floor muscles do the following:

• It supports organs like your bladder, urethra, vagina, uterus, colon, rectum, and anus.
• You tighten and relax your bladder to control the passage of urine, stool, or gas.
• It helps increase blood flow to the vagina and cause vaginal contractions during sexual intercourse and orgasm.
• Provides support during natural childbirth (`Vaginal delivery`).

How do men's pelvic floor muscles work?

A man's pelvic floor muscles do the following:

• It supports organs like your bladder, urethra, prostate, colon, rectum, and anus.
• You tighten and relax your bladder to control the passage of urine, stool, or gas.
• It helps the penis become erect (`erection`) and ejaculate (`ejaculate`) during sexual intercourse.

Do you know where these pelvic floor muscles are located?

Your pelvic floor muscles form the foundation of your core muscles. These core muscles include your pelvic floor muscles, abdominal muscles, back muscles, and diaphragm (the muscle that controls breathing). Together, these muscles connect to your pelvis and spine, providing stability to your midsection.

To be precise, these muscles extend from the front of your pelvis (the `Pubic bone`) down the back of your spine to the small bone at the end (the `Coccyx`). Also, there are two bones that you can feel when you sit (the `Ischial tuberosities`), and these muscles extend on both sides. They are like a single membrane made up of several layers of muscles connected to each other. But they also have openings – the `Anus`, the `Urethra` and the `Vagina`.

You can also find out where these muscles are by doing a little thing. But you need to wash your hands thoroughly before doing this.

* If you are a woman, vaginal opening: Insert one or two fingers into the vagina and try to squeeze them together.

* Urethra: Imagine you are urinating and squeeze as if you are suddenly stopping the flow of urine.

* Anus: Tighten your anus as if you are trying to stop air from escaping.

>

No matter how you do this, you'll feel some muscles inside your pelvis pulling inward and upward. Those are your pelvic floor muscles.

What are the main muscles of the pelvic floor?

Your pelvic floor is made up of several layers of muscle and connective tissue called ligaments that connect those muscles together. There are two main groups of muscles that are important in this:

• Levator ani: This is the largest and most important muscle group in the pelvic floor. It is actually a combination of three separate muscles: the pubococcygeus, puborectalis, and iliococcygeus. This group extends all the way around your pelvis.
• Coccygeus: This is another small group of muscles in the pelvic floor. It is located at the back of the pelvis.

What are the common conditions associated with the pelvic floor muscles?

The pelvic floor muscles can either be weak (lax) or excessively tight (hypertonic). Both can cause problems. The most important thing is balance. That is, these muscles need to be strong enough to keep your core stable and your organs in place, but also flexible enough to contract and relax when needed.

What happens if the pelvic floor muscles become weak (lax)?

There can be several reasons why these muscles become weak. For example:

• Due to an accident or injury (`Injury or trauma`). It can be due to things like childbirth (`Childbirth`) or surgery (`Surgery`).
• Due to the stress of pregnancy.
• Excessive straining due to things like frequent heavy lifting, prolonged coughing, and constipation.
• Due to hormonal changes that occur with menopause.
• As part of the natural aging process.
• These can also be weakened by certain medical conditions, such as diabetes.

When the pelvic floor muscles become weak, the following conditions can occur:

• Stress incontinence: The involuntary leakage of urine when you laugh, cough, sneeze, or lift something. This is common after childbirth, prostate surgery, or pelvic trauma.
• Urge incontinence: The frequent need to urinate and the inability to control it.
• Fecal incontinence: Difficulty controlling the passage of stool .
• Anal incontinence: Difficulty controlling the passage of air .
• Pelvic organ prolapse: When your pelvic organs, such as your uterus, rectum, and bladder, lose their support and fall into or out of your vagina, this condition is common after menopause.

In general, if you have difficulty controlling the passage of urine, feces, or air (`incontinence`), it may be a sign of weak pelvic floor muscles.

What happens if the pelvic floor muscles become tight (hypertonic)?

Much is still being learned about this condition, known as ``Hypertonic pelvic floor.`` However, when these muscles become less flexible and more rigid, problems such as these can occur:

• Constipation or difficulty defecating.
• Pelvic pain.
• Pain in the back, hips, or legs.
• Painful intercourse.
• Difficulty urinating, frequent urination, or an urgent need to urinate.

This type of muscle tightness can be caused by sexual assault, other types of mental or physical trauma, accidents, childbirth, stress, and other gynecologic conditions.

What are the treatments for weak pelvic floor muscles?

The good news is that there are things you can do about this.

• Kegel exercises: These are often used to strengthen the muscles of the pelvic floor. Kegel exercises involve gradually tightening and relaxing your pelvic floor muscles, gradually building control over them. These exercises can also help with incontinence. Sometimes a doctor may use biofeedback to help you do these exercises. A sensor placed in your vagina can then measure how hard you are contracting the muscles and how much you are contracting them.

Important: Do not attempt Kegel exercises without your doctor's advice, especially if you have recently suffered any damage to your pelvic floor muscles (e.g., during childbirth).

• Controlling constipation: Things you can do to reduce constipation (diet, exercise, medications) can help stop unnecessary pressure on your pelvic floor muscles when you go to the bathroom.
• Vaginal weights/Kegel balls: By inserting specially designed ball-like objects into the vagina and holding them while going about your daily activities, you can gradually strengthen the muscles of the pelvic floor.
• Medical devices: If your pelvic floor muscles are very weak, a device like a vaginal pessary can be used to hold your pelvic organs in place.
• Physical therapy: A physical therapist who has received special training in pelvic floor muscles can help you coordinate and strengthen your core muscles, including the pelvic floor muscles.
• Surgery: In cases such as pelvic organ prolapse, reconstructive surgery to put the organs back in place or surgery to sew the walls of the vagina together to prevent the organs from coming out, such as colpocleisis.

What are the treatments for tight (hypertonic) pelvic floor muscles?

Treatments for this condition include physical therapy, breathing/relaxation techniques, pelvic floor muscle injections, medication, and cognitive behavioral therapy (CBT).

What are some simple things we can do to keep these pelvic floor muscles healthy?

Depending on your health, you may benefit from doing Kegel exercises regularly. They can improve urinary and bowel control, as well as increase sexual function. Many people used to think that Kegel exercises only increased sexual satisfaction for those with a vagina. But new research suggests that these sexual benefits are available to everyone.

The most important thing is to use the right muscles when doing Kegel exercises. So, consult your doctor or a physical therapist to learn exactly how to tighten and relax the right muscles.

You can do this exercise sitting, standing, or lying down.

• Tighten your pelvic floor muscles for 8 seconds. Be careful not to tense your buttocks, thighs, or any other muscles during this time. Breathe normally while you tighten them.
• Then relax those muscles for 8 seconds. It's just as important to tighten and relax them during Kegel exercises. Breathe normally while relaxing.
• Do this (tightening for 8 seconds, relaxing for 8 seconds) 8 more times.

Do this exercise three times a day. Try to make it a habit to do something you already do, whether it's when you brush your teeth in the morning, when you check social media at lunch, or on your way home from work.

If you find it difficult to hold the contraction for 8 seconds at first, start with 3 seconds. Over time, you will be able to hold the contraction and relaxation for 8 to 12 seconds. Gradually increase the time without straining the muscles.

After about 4 to 6 months, you will start to feel a change in the strength of your pelvic floor muscles.

Finally, remember this ! (Take-Home Message)

Many people only think about their pelvic floor muscles when they have problems like incontinence or prolapse. But don't wait until you have a problem to take care of your pelvic floor. Exercising these muscles can help you control your bladder and bowel movements. Pelvic floor exercises can also improve your sexual function, arousal, and even the intensity of orgasms. So, make keeping your pelvic floor muscles healthy a part of your exercise routine today. Don't worry, you can do it yourself!

` Pelvic floor muscles, pelvic floor muscles, Kegel exercises, urinary control, bowel movements, women's health, pelvic organ prolapse