As women age, they may experience a range of physical changes that can impact their overall health and well-being. One area that is often overlooked, but is critically important, is pelvic floor health. The pelvic floor muscles play a vital role in supporting the bladder, uterus, and bowels, and weakness in these muscles can lead to a range of symptoms, including incontinence, pelvic pain, and sexual dysfunction.
In this post, we will explore the importance of pelvic floor health for women aged 40 and beyond, including common symptoms of genitourinary dysfunction and what can be done to strengthen the pelvic floor and mitigate symptoms.
The Prevalence of Genitourinary Dysfunction
Genitourinary dysfunction, including urinary incontinence, pelvic organ prolapse, and sexual dysfunction, is a common problem affecting millions of women worldwide. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), urinary incontinence affects an estimated 17 million adult women in the United States, with the prevalence increasing with age (1).
A study published in the Journal of Women's Health found that 37% (greater than one-third) of women aged 40-59 reported experiencing urinary incontinence, while 54% (more than half!) of women aged 60-79 reported experiencing the condition (2).
Genitourinary Syndrome of Menopause, or GSM, is a collection of signs and symptoms in the genitourinary tissues and structures resulting from drops in estrogen that lead to changes in tissue and anatomy.
Common Symptoms of Genitourinary Dysfunction & GSM
The symptoms of genitourinary dysfunction as well as GSM can vary depending on the underlying cause, but common symptoms include:
- Urinary incontinence (stress incontinence, urge incontinence, or mixed incontinence)
- Pelvic organ prolapse (prolapse of the bladder, uterus, or rectum)
- Pelvic pain or discomfort
- Genital burning or itching
- Sexual dysfunction (painful intercourse, decreased libido, decreased vaginal lubrication, or difficulty achieving orgasm)
- Frequency or urgency of urination
- Recurring urinary tract infections
The Role of the Pelvic Floor Muscles
The pelvic floor muscles play a critical role in supporting the bladder, uterus, and bowels. These muscles, including the pubococcygeus muscle (PC muscle), help to:
- Support the pelvic organs
- Regulate urine flow
- Maintain continence
- Enhance sexual function
Weakness in the pelvic floor muscles can lead to a range of symptoms, including urinary incontinence, pelvic organ prolapse, and sexual dysfunction. While many women believe peeing while sneezing, coughing, or doing jumping jacks is just a normal part of getting older (or of having babies), the truth is that these symptoms are chronic and progressive unless something is done about them -- and something can be done!
Strengthening the Pelvic Floor Muscles
Many women, as they age, believe that such symptoms are just something they have to deal with. But that is far from the truth! Fortunately, there are several ways to strengthen the pelvic floor muscles and mitigate symptoms of genitourinary dysfunction. These include:
- Strengthening exercises: These exercises involve contracting and releasing the PC muscle to strengthen the pelvic floor muscles. A study published in the Journal of Urology found that Kegel exercises improved urinary continence in women with stress urinary incontinence (3).
- Pelvic floor physical therapy: This type of therapy involves working with a physical therapist to strengthen the pelvic floor muscles and improve bladder control. A study published in the Journal of Women's Health found that pelvic floor physical therapy improved symptoms of urinary incontinence and pelvic organ prolapse in women (4).
- Biofeedback: This type of therapy involves using sensors to monitor the activity of the pelvic floor muscles and provide feedback to help strengthen these muscles. A study published in the Journal of Urology found that biofeedback improved urinary continence in women with urge urinary incontinence (5).
- Breathwork: The pelvic floor works synergistically with the diaphragm to help control intra-abdominal pressure. Focusing on specific breathwork patterns (such as Connection Breath) can strengthen the mind-body connection with the pelvic floor, and allow for stronger pelvic floor engagement during exercise and lessen symptoms like urine leakage (6).
Additional Tips for Maintaining Pelvic Floor Health
In addition to strengthening the pelvic floor muscles, there are several other ways to maintain pelvic floor health. These include:
- Practicing good bowel habits, such as eating a high-fiber diet and avoiding constipation
- Managing weight, as excess weight can put additional strain on the pelvic floor muscles
- Focusing on a nutritious diet that is rich in whole foods to reduce inflammation, manage weight and provide the body with minerals and nutrients needed for optimal function
- Avoiding smoking, as smoking can weaken the pelvic floor muscles and increase the risk of urinary incontinence
Pelvic floor health is critically important for women aged 40 and beyond. Weakness in the pelvic floor muscles can lead to a range of symptoms, including urinary incontinence, pelvic organ prolapse, and sexual dysfunction. Fortunately, there are several ways to strengthen the pelvic floor muscles and mitigate symptoms of genitourinary dysfunction. By practicing strengthening exercises, pelvic floor physical therapy, and biofeedback, and by maintaining good bowel habits, managing weight, nutrient dense diets, and avoiding smoking, women can take control of their pelvic floor health and reduce their risk of genitourinary dysfunction.
References
1. National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Urinary Incontinence in Women.
2. Journal of Women's Health. (2018). Prevalence and Correlates of Urinary Incontinence in Women Aged 40-79.
3. Journal of Urology. (2017). Kegel Exercises for Urinary Incontinence in Women.
4. Effectiveness of Pelvic Floor Muscle Training on Quality of Life in Women with Urinary Incontinence: A Systematic Review and Meta-Analysis. César Adrián Curillo-Aguirre, Enrique Gea-Izquierdo (2023).
5. Journal of Urology. (2020). Urinary incontinence in women: biofeedback as an innovative treatment method. Marta Kopańska, Silvia Torices.
6. Menopause Coaching Specialist Certification, GGS Academy. (2023)