Understanding Pelvic Floor Health: Insights from the "Vagina Coach"

Pelvic floor health is a critical yet often overlooked aspect of women's health, especially as they age. In this podcast episode, the host and the guest, known as the "Vagina Coach," delve into the intricacies of pelvic floor health, its importance, and actionable tips for maintaining it. The Vagina Coach, a personal trainer, women's health educator, menopause support practitioner, and published author, shares her journey and expertise, providing invaluable insights for women at various life stages. This blog post will break down the key points discussed in the episode, offering detailed advice and expert recommendations.

The Journey to Becoming the "Vagina Coach"

Early Influences and Personal Experiences

The Vagina Coach's journey into pelvic floor health began with childhood experiences and personal observations. Witnessing her mother's struggles with chronic back pain and incontinence, coupled with a fear of childbirth, planted the seeds of her future career. Her turning point came after witnessing her sister-in-law's childbirth, which inspired her to learn more about pelvic floor health and childbirth preparation.

Professional Development

Her curiosity led her to discover the Epi-No, a biofeedback device designed to help women prepare their pelvic floor for birth. This experience spurred her to become a distributor for the device in Canada and eventually recertify as a personal trainer with a focus on pregnancy and postpartum health. She developed the "Prepare to Push" program and co-founded Bellies Inc. to optimize postpartum recovery through pelvic floor muscle training and wrapping techniques.

Understanding the Pelvic Floor

Anatomy and Function

The pelvic floor is a group of muscles forming the base of the pelvis, with attachment points at the pubic bone, sit bones, and the base of the spine. It consists of three layers:

  • First Layer: Responsible for sexual response.
  • Second Layer: Manages the openings of the vagina, urethra, and anus.
  • Third Layer: Supports organs like the bladder and uterus.

The pelvic floor is crucial for pelvic and spinal stability and works in synergy with the diaphragm. It plays a significant role in core stability, yet it is often left out of core health conversations.

Signs of Pelvic Floor Dysfunction

Common signs of pelvic floor dysfunction include:

  • Stress Urinary Incontinence: Leaking urine during exertion like laughing or sneezing.
  • Urgency Incontinence: A strong urge to urinate triggered by stimuli like running water.
  • Anal Incontinence: Less common but life-altering.
  • Pelvic Organ Prolapse: Affects about 50% of women who have given birth.
  • Pelvic Pain: Often linked to low back pain and can be a sign of pelvic floor issues.

Risk Factors and Life Stages

Pregnancy and Childbirth

Pregnancy and childbirth are well-established risk factors for pelvic floor dysfunction. Hormonal changes and postural adaptations during pregnancy can affect pelvic floor health. Even cesarean births can pose risks due to the pressure and changes in the pelvic region.

Menopause

Hormonal changes during menopause, particularly the decline in estrogen, can lead to pelvic floor issues. Estrogen helps maintain the health of vaginal tissues, and its decrease can result in symptoms like dryness and increased risk of prolapse. Testosterone also plays a role in muscle health, and its decline can contribute to muscle atrophy, further impacting pelvic floor function.

Other Risk Factors

  • Chronic Coughing: From conditions like asthma or smoking.
  • Chronic Constipation: Especially for women with thyroid issues.
  • Scar Tissue: From previous surgeries, including hysterectomies.

Proactive Care and Treatment

During Pregnancy

  • Posture and Pelvic Floor Exercises: Focus on maintaining proper posture and incorporating pelvic floor exercises to prepare for childbirth.
  • Understanding Birth Positions: Learn about optimal birth positions and exercises that strengthen and relax the pelvic floor.

Postpartum

  • Pelvic Floor Physical Therapy: Schedule an appointment around 6 to 8 weeks postpartum to assess healing, check for scar tissue, and ensure proper pelvic floor function.

Perimenopause and Post-Menopause

  • Regular Check-Ups: Continue to prioritize pelvic floor health through regular check-ups with a pelvic floor therapist.
  • Pelvic Floor Exercises: Incorporate exercises like Kegels into the fitness routine.

Kegel Exercises

  • Correct Technique: The gold standard is three sets of ten-second holds, three times a day. Ensure proper engagement of the pelvic floor muscles, avoiding the buttocks or inner thighs.
  • Professional Guidance: A pelvic floor physical therapist can provide guidance and ensure correct technique.

Vaginal Estrogen

  • Importance: Vaginal estrogen helps restore moisture and elasticity to vaginal tissues, alleviating discomfort and improving overall vaginal health. It is considered the gold standard for managing symptoms of genitourinary syndrome of menopause (GSM).

Testosterone

  • Role in Muscle Health: Testosterone is important for maintaining pelvic floor muscle strength, which is crucial for pelvic floor support.

Final Advice

  • Start Early: It’s never too late to focus on pelvic floor health. Start the conversation early, especially with younger women.
  • Proactive Care: Regular check-ups and consistent pelvic floor exercises can make a significant difference.
  • Seek Professional Help: If experiencing issues, seek help from a pelvic floor physical therapist.

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