Unfortunately, we live in a society in which women’s bodies have been all but ignored in modern health. “Historically, women have been excluded from clinical trials and biomedical research because researchers considered the presence of menstruation rendered the biological processes within female bodies too variable to glean reliable results, and/or because of fears of harming the prospects of a future pregnancy,” notes a recent study that looked at sex and gender gaps in medicine and the androcentric history of medical research. “Thus, most research data have been collected from males and generalized to females, intersex people, transgender people, or gender nonconformists.”
Because of this, many of us are wildly unaware of our bodies and the alarm signals it tries to send us. When it comes to the pelvic floor, this is especially true. “Many women feel embarrassed or do not know who to turn to when they experience urine leakage, a feeling of heaviness in the pelvis, or discomfort during sexual intercourse,” Lola Ibáñez Piñero, a physiotherapist specializing in the pelvic floor notes.
Luckily, this is starting to change. More and more women are becoming better informed about the importance of pelvic health and are seeking help. In that spirit, here’s a look at some important things to know about this under-discussed health topic.
The function of the pelvic floor
The pelvic floor is a group of muscles that support the bladder, uterus, prostate (in men), and rectum. These muscles form a sling at the base of the pelvis and play a crucial role in certain bodily functions, including bowel and bladder control, sexual function, and core stability.
To help visualize how the pelvic floor works, Piñero invites us to imagine a firm, elastic hammock strapped across the bottom of our lower abdomens. Its function plays an essential role:
- Support function—It protects the organs from abdominal pressure.
- Sphincter control—It allows us to avoid incontinence. Without the pelvic floor, we couldn’t cough, laugh, or jump without leaking urine, gas, or feces.
- Sexual function—The pelvic floor provides sensitivity and responsiveness, influencing lubrication and the intensity of orgasm in women as well as erection and ejaculation in men.
- Reproductive function—Supports the developing fetus during pregnancy, adapting to the growing uterus. Thanks to its capacity for elongation and relaxation, it allows the passage of the baby during childbirth.
- Postural and respiratory function—Together with the diaphragm, transversus abdominis, and multifidus, the pelvic floor helps to stabilize the trunk. It is also involved in the regulation of intra-abdominal pressure, which is key for protecting the internal organs and lumbar area. (It is reflexively activated by diaphragmatic breathing and core movements.)
What causes pelvic floor problems?
With all these essential functions, maintaining proper muscle tone in the pelvic floor is important—either too much or too little can have serious consequences. “Hypertonic pelvic floor muscles remain contracted instead of being relaxed and activated when necessary—even at rest,” says Piñero. “Paradoxically, this makes the area weak and painful.” Among the typical consequences? Urinary incontinence, pain during intercourse, frequency of urination, difficulty evacuating, constipation, a feeling of pelvic blockage, and perineal, vaginal, or anal pain.