The complete guide to pelvic health

Pelvic health may not be a common topic of conversation—but it is a common problem for women. In fact, the New Jersey-based National Women’s Health Resource Center estimates that one in three women will have some kind of pelvic health problem by the age of 60.

Many women approach their doctors thinking they are alone in their pelvic problems, but in fact, pelvic organ prolapse–which occurs when the bladder, uterus, vagina, small bowel and/or rectum begin to droop–is very common, particularly post-pregnancy. Prolapse can lead to incontinence,  but that’s just one of the pelvic issues that can affect women. Other kinds of incontinence, fibroids, and ovarian cysts are also not unusual, and they’re treatable and, in many cases, preventable.

Getting a diagnosis

The first step in dealing with pelvic floor problems is keeping a written diary to document urinary frequency, occurrences of incontinence, diet and other factors that may cause bladder and urinary irritation. Urinary incontinence, for example, can be caused by laughing, sneezing, coughing and other stressors, or by muscle spasms.

Your written diary, along with a physical exam to look for masses, tumors and other abnormalities, and other tests to measure the amount of urine in the bladder, can help your physician identify the cause of your symptoms.

Treatment options

Treatments for pelvic problems vary, of course, based on the disease. For prolapse, as many as 90 percent of patients who choose to have a mid-urethral sling get relief from stress incontinence. The mesh sling does not lift the urethra but supports it, thus reducing the drooping effect. The sling can be put in place in an outpatient procedure.

Cancers can be more challenging to catch and treat. Ovarian cancer, for example, can have such subtle symptoms as weight gain, bleeding and gastrointestinal pain, while cervical cancer can be indicated by bleeding after intercourse, and endometrial cancer can be tipped off by irregular bleeding. But bloating, irregular bleeding and other symptoms can be benign issues as well, so doctors urge women to see a physician quickly after the onset of symptoms. Coming in early can make a big difference.

An ounce of prevention

You can do kegel exercises to strengthen the pubococcygeus muscle, which reaches from the pubic bone to the tail bone to support the pelvic organs, to help stop incontinence or to reduce the risk of prolapse. Be sure to pull up when you do the exercises rather than bearing down. You may also want to work with a physical therapist who can demonstrate how strengthening other muscles, like the hip flexors, can help the pelvic muscles.

You may also need to change some lifelong habits, such as squatting so you don’t touch the toilet seat in a public bathroom. When you’re squatting, it’s hard for the pubococcygeus muscles to do their thing.

Instead, try using good posture when you urinate so that you get all the urine out, even rocking on the seat a little to empty the bladder. Retaining urine can lead to infections. Another way to prevent infections is by avoiding potential irritants such as douche, scented panty liners and tampons, and even tight pants.

But the most important thing you can do is watch your body for changes. At the age of 16, everyone just takes the pelvis and shoves it to the side. But if you shove a body part over there, you are not going to pay attention and not know if something is wrong.