Your pelvis is a basin-shaped structure of bones located between your hips, at the base of your spine. It might seem far removed from everyday concerns, but this area plays a vital role in supporting your core and housing crucial organs. Within this bony structure lies the pelvic floor, a group of muscles that are essential for bladder and bowel control, sexual function, and core stability. Pelvic floor muscle weakness is a common issue, particularly as we age or experience certain life events. Understanding where your pelvis is and the function of your pelvic floor is the first step to maintaining pelvic health. Let’s explore some of the common causes of pelvic floor muscle weakness.
Common Causes of Pelvic Floor Muscle Weakness
Several factors can contribute to the weakening of your pelvic floor muscles. Recognizing these causes is important for both prevention and management.
Pregnancy and Childbirth
For women, pregnancy and childbirth are significant factors. The weight of the growing baby during pregnancy puts increased pressure on the pelvic floor muscles. Evidence suggests that weakening can begin during pregnancy itself, not just after delivery. Vaginal delivery, especially multiple births, assisted deliveries using forceps or ventouse, perineal tearing (particularly 3rd and 4th degree), and delivering large babies (over 4kg or approximately 8.8 pounds) further increase the risk of pelvic floor muscle damage. The physical stress of childbirth can stretch and weaken these muscles, impacting their ability to function effectively.
Menopause
Menopause brings about hormonal changes in women, most notably a reduction in estrogen levels. Estrogen plays a role in muscle health, including the pelvic floor muscles. As estrogen levels decline during menopause, these muscles, like other muscles in the body, can lose strength and elasticity. This hormonal shift can contribute to pelvic floor weakness and related issues.
Straining on the Toilet
Repeated or chronic straining during bowel movements, often associated with constipation, puts excessive pressure on the pelvic floor. This ongoing strain can weaken the pelvic floor muscles over time and may also lead to pelvic organ prolapse. In women, prolapse can involve organs descending into the vagina, while in both men and women, rectal prolapse can occur where the rectal lining protrudes from the anus. Addressing the underlying cause of constipation and adopting healthy toilet habits is crucial for pelvic floor health.
Ongoing Cough
Persistent coughing, regardless of the cause (such as asthma, bronchitis, or chronic smoker’s cough), significantly increases pressure within the abdomen and on the pelvic floor. This repeated stress from coughing can contribute to urinary incontinence and pelvic organ prolapse. Managing chronic coughs is not only important for respiratory health but also for pelvic floor support.
Pelvic Surgery and Radiotherapy
Medical interventions in the pelvic region, such as hysterectomy, prostate surgery, or radiotherapy treatment for cancers in the pelvic area, can inadvertently weaken the pelvic floor muscles. Surgery can directly affect muscle tissue and supporting structures, while radiotherapy can cause tissue damage and weakening in the treated area, including the pelvic floor muscles.
Heavy Lifting
Engaging in heavy lifting, whether as part of exercise routines, occupational demands, or daily activities at home, can place considerable stress on the pelvic floor. Incorrect lifting techniques exacerbate this stress. Always ensure you lift with proper posture, engaging your core and pelvic floor muscles before lifting to minimize strain and protect your pelvic floor.
High Impact Exercise
High impact exercises, defined as activities where both feet leave the ground simultaneously (like running, jumping, netball, basketball, and similar sports), exert significant downward pressure on the pelvic floor. While exercise is beneficial overall, high impact activities can increase the risk of urine leakage, particularly in women with pre-existing pelvic floor weakness or risk factors. Exploring pelvic floor friendly exercise options, as detailed on resources like the Pelvic Floor First website, can be a helpful strategy.
Age
As we age, a natural decline in muscle strength occurs throughout the body, and the pelvic floor muscles are no exception. This age-related weakening can contribute to pelvic floor dysfunction. However, pelvic floor muscle exercises can be effective in strengthening these muscles at any age, helping to mitigate age-related weakness and maintain pelvic health.
Weight
Being overweight or obese adds extra pressure on the pelvic floor muscles. This increased weight, particularly in the abdominal area, places constant downward pressure, contributing to pelvic floor weakness and increasing the risk of urinary incontinence and other pelvic floor issues. Maintaining a healthy weight is beneficial for overall health, including pelvic floor function.
Understanding these common causes of pelvic floor muscle weakness empowers you to take proactive steps towards maintaining your pelvic health. If you experience symptoms of pelvic floor dysfunction, seeking advice from a healthcare professional is recommended.
