Menopause Forum - “I wish I had known about this earlier..."
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“I wish I had known about this earlier..."
Everything you never thought you needed to know about your pelvic floor, incontinence and prolapse, and how to help yourself improve.
By Alexandra Frankham, Pelvic Health Physiotherapist, Performance Physiotherapy https://physio.je/
“I wish I had known about this earlier”, is what 99% of women in their 50s and 60s say to me at our first consultation. Whilst there is access to good health prevention information, we rarely think it applies to us. We never think that it will be us on the receiving end of treatment, for whatever it may be. We are all invincible, until we are not. If we're fortunate, we are all going to age and with age comes weakness and change. Pelvic health disorders are even more common as we get older but rarely talked about. The earlier we start to work on prevention and cure the better the outcome!
Pelvic health is particularly challenging because it’s so taboo. Did you know that it takes women on average 10 years to visit their GP about pelvic health problems such as urinary incontinence or pelvic organ prolapse? The ‘why’ behind this is simple:
- It’s embarrassing and personal!
- Women who have had children sometimes think this is an acceptable consequence of childbirth. Whilst it may be a consequence for some it should not be acceptable.
- Young women feel it’s an old lady problem and therefore do not actually go and do anything about it until they become an old lady!
- Mostly, I find that women don’t want to inconvenience medical professionals because they have trivialised the issue themselves.
But these symptoms are serious. They seriously affect women's relationships, their self esteem and their general health (even mortality) and it is worthy of a good old conversation!
Did you know?
- 1/3 of women will have significant urinary incontinence?
To me, all urinary incontinence is significant so this statistic is likely much lower than the real percentage. More recent data would say it is more like 2/3rds of menopausal women!
- 20% of new mums will have anal incontinence (leaking of wind or poo) after childbirth.
- By the time we women reach the young age of 40, 50% of us will have a pelvic organ prolapse.
- 70% of women age 40-65 years will have sexual dysfunction. This means low libido, poor arousal, pain and dryness, low desire (clearly unsurprising if you are dry and sore or might wet yourself!)
Women who see their doctor early may well be told this is all normal and they could feel dismissed. They are being dismissed if this is the case! Whilst these things are clearly common, they do not have to be normal and women certainly do not have to suffer! Why? Because appropriate person-centred (i.e. one on one) education and pelvic floor muscle training can cure or improve most incontinence; significantly improve prolapse symptoms as well as prevent it getting worse; AND improve orgasm and sexual enjoyment! Now that is worth doing something about!
So what should I be doing about these things?
Well, like anything it’s firstly finding out specifically what is wrong. In a simple blog post I cannot answer that question for you. What I can do is direct you to somewhere you can start learning more and where you can get help. I can also teach you how to do pelvic floor muscle exercises (however, most women struggle to learn how to do these just from reading such instructions, so if this is you then you will benefit from a one on one appointment with a pelvic health physiotherapist like myself). In the absence of a personal consultation, I will just highlight some of the things we discussed at the Menopause Forum evening with links for you to find out more.
Tips and pointers:
- Pelvic floor muscle training – for incontinence & prolapse. Here are some useful links to help you find your pelvic floor and get it working. If it doesn’t work – go and see a pelvic health physio. 75% of women will have cure or improvement with correctly guided exercises.
https://thepogp.co.uk/patients/pelvic_health_advice/pelvic_floor_muscles.aspx
https://restoreyou.mykajabi.com/
- Fluid management
Did you know that caffeine (tea, coffee, green tea); alcohol; artificial sweeteners and fizzy drinks all irritate the bladder? This may mean you are rushing to the loo all the time, possibly leaking on the way, and planning your day around toilet locations.
Aim to drink 8-10 glasses of fluid a day that is not an irritant!
Consider completing a bladder diary – there is one in the Squeezy App you can use or you can print this one:
https://www.yourpelvicfloor.org/media/Bladder_Diary-5.pdf
- Menopausal vaginal dryness
Loss of oestrogen within the vulva, vagina and bladder causes a few issues: cuts, sores, increased urine infections, increased bladder irritation and it can aggravate the sensation of a prolapse etc. Topical vaginal oestrogen can be prescribed by your GP (in the UK it's becoming available over the counter) and can make a significant improvement. Don’t delay on this as there is real help available.
https://www.yourpelvicfloor.org/media/Low-Dose_Vaginal_Estrogen_Therapy.pdf
The other thing you can consider is using a decent vaginal lubricant. I recommend both https://www.yesyesyes.org/ and https://sylk.co.uk/ and these can be purchased directly from the websites or coming soon from Performance Physiotherapy https://physio.je/
- Bowel function
A regular bowel function is not only important for bowel health but constipation could be the cause of an irritable bladder and bladder leakage. Straining to empty your bowels is certainly a risk factor for developing or sustaining a prolapse. See someone about it! If you are having trouble it may be to do with the mechanics of how your pelvic floor is working, a physio can help. So too can a Squatty Potty! Links below to other amusing unicorn rainbow poo and bowel information.
https://thepogp.co.uk/patients/pelvic_health_advice/bowel_health.aspx
So in summary your take home message is this:
- You are worthy of being looked after and having your best health, so please, please, take care of yourself.
- Small changes make a big difference over time.
- Pelvic floor exercises work -they are daily for life, but they work!
If you find this information has prompted you to ask more questions do feel free to get in touch. You can find me at Performance Physiotherapy Jersey https://physio.je/
01534 733913; [email protected]
You can also find me on social media on LinkedIn, Insta, Twitter just type in my name: Alexandra Frankham or Alex Frankham (so far it’s just me)
