Pelvic Floor

Pelvic Floor

Pelvic Floor

I am going to start with a pretty shocking statistic; one in three women and one in nine men wet themselves. Given the stigma and shame that accompany incontinence, it is likely that the figures are actually much higher. Somewhere between 1 in 10 and 1 in 20 people have problems with bowel control. Incontinence is common, but it is not normal.

The pelvic floor muscles are a sling of muscles forming the base of a group of muscles commonly referred to as the core. They play an important role in supporting the pelvic organs, bladder and bowel control and sexual function in both male and female bodies. Check out Pelvic Floor First (“Follow” link below) for more details on the anatomy.

Most people with symptoms have a mixed picture of urge and stress incontinence.

Stress incontinence is when you leak urine when you cough, sneeze or laugh. Often people with stress incontinence stop exercising and reduce their fluid intake to manage their symptoms and they go to the toilet more often “just in case” which, in turn, can cause further problems.

Urge incontinence is when you cannot wait 2 to 4 hours before emptying your bladder from the time that you first feel the need to go. This is the classic “key in the door” situation; you are used to going to the toilet as soon as you come home and you become conditioned so that as soon as you reach for your key, you leak urine.

You can work on behavioural cues (eg holding on for a very short time when you get home) to train your body and, for some patients, medication can be helpful. In menopause, decreased oestrogen can cause urge incontinence, even if you have not had any issues previously.

Simple lifestyle measures are often really helpful:

  • cut down on caffeine and alcohol, as both irritate the bladder;
  • maintain a healthy weight, so as not to exert additional pressure on your pelvic floor;
  • don’t regularly go to the loo “just in case” as this will reduce your bladder’s capacity over time;
  • eat plenty of fresh fruit and vegetables and stay well hydrated to avoid constipation and the additional pressure of straining.

Despite the fact that there is good evidence that pelvic floor exercises can help the majority of people with incontinence, it is estimated that only one in four women seek help for incontinence and it takes them an average of seven years to do so.

In the video below (“Watch this”), a pelvic health expert talks you through how to do your pelvic floor exercises – you need to do a long hold and short squeezes whilst continuing to breathe. In both cases you need to relax your pelvic floor muscles completely between squeezes. If you don’t see an improvement after doing your exercises consistently for 12 weeks, then see your GP for a referral to a specialist.

Incontinence is more common than hayfever or athlete’s foot but we remain embarrassed about it, despite the fact there are simple measures we can take which have been proven to help significantly.

In later life, continence is the greatest indicator of quality of life. It’s never too late to seek help.

I am sharing some of my favourite resources, if you would like to delve deeper.

I simply couldn’t write this blog without referencing the utterly brilliant Elaine Miller aka “the Fanny Physio” – she is a fantastic advocate for pelvic floor health and the value of doing your exercises regularly. She is also a stand up comedian.

A very funny, honest and informative read, tackling the taboo of incontinence following childbirth, written by a physiotherapist.

Pelvic health is just as important for male-bodied people too; this podcast covers some of the common issues encountered in male bodies. Dr Susie G (the guest) has her own podcast series if you want to learn more.

Connect

Download the award winning NHS Squeezy app for reminders (we all need reminders!) to do your exercises as well as great resources.

Follow

Pelvic Floor First on YouTube – lots of short, very informative videos on pelvic health for men and women

Email Me

If you would like any further information or resources, or have any suggestions on how I could improve this blog, please let me know.

Share Blog

If you think someone you know would benefit from this blog, you can forward it here.

All content and information on this website is for for informational and educational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making any decisions in respect of your healthcare.

Osteoporosis

Osteoporosis

Osteoporosis

Osteoporosis is a condition where your bones lose strength, making you more likely to break a bone (fracture) than the average adult. Not everyone who has osteoporosis breaks a bone.

Whilst there are some risk factors that you cannot do anything about (such as getting older, being female, your genes and certain medicines), there are lots of things you can do to help keep your bones healthy, even after a diagnosis of osteoporosis.

  • Lift weights or do body weight exercises, such as press ups and planks, to build and maintain strong muscles and dense bones.
  • Do balance exercises, e.g. standing on one leg, to reduce the risk of trips and falls. You could try yoga or T’ai Chi classes.
  • Ensure you have adequate calcium in your diet as it is vital for bone health. Dairy is a great source but there are plenty of good non-dairy sources such as lentils, sesame seeds, almonds, broccoli, kale, tinned salmon and sardines (with bones), soy beans and tofu.
  • Vitamin D is needed to help the body turn calcium into bone. Dietary sources include oily fish, eggs and mushrooms (leave them in sunlight before cooking to increase their vitamin D content). The recommended supplement dose is 10 micrograms (400 units). You may need a supplement if you don’t spend much time outdoors with your skin exposed, especially in winter.
  • Exercise regularly – daily walking, and any other impact exercise you enjoy, boosts heart health and keeps bones strong. You could walk carrying light weights or wearing a rucksack to get even more bone benefits.
  • Eat some protein at every meal for muscle repair to keep your body healthy and strong. Good sources include lean meat, fish, eggs, nuts and soy.
  • Reduce alcohol and caffeine (because they interfere with calcium absorption).
  • Reduce or, ideally, stop smoking (because it slows down the cells that build bone).

Following a consultation, we can provide you with personalised advice regarding dietary and lifestyle measures and appropriate exercises.

There are questionnaires that can be helpful to establish your risk of fracture and whether you need to have a bone density scan. If you are concerned about your fracture risk, we can take you through a questionnaire, either during an appointment in clinic, or by phone. Bone density scans are cheap and quick and have a much lower dose of radiation than x-rays.

3 million people in the UK have osteoporosis and there are half a million osteoporotic fractures in the UK every year. However, it’s not just the pain and inconvenience of the fracture itself; people often have long term consequences following an osteoporotic fracture and these can be social and emotional as well as physical, with people becoming depressed, fearful or isolated and unable or unwilling to attend social activities etc. Wherever possible, prevention is better than cure.

I am sharing some of my favourite resources if you would like to delve deeper.

Join Dr Jen to learn about simple things you can do to strengthen your bones, other than drinking milk.

It is believed that prunes (dried plums) contain nutrients that enhance bone formation and reduce bone resorption making them an easy win for bone (and bowel!) health.

The Royal Osteoporosis Society website is jam-packed with excellent advice and information as well as a free specialist nurse helpline.

Connect

The Poole Support Group of Osteoporosis Dorset provides an opportunity for people  to share their experiences of living with osteoporosis and how to continue living an active and independent life – and there’s a Zumba Gold class at the monthly meetings.

Email Me

If you would like any further information or resources, or have any suggestions on how I could improve this blog, please let me know.

Share Blog

If you think someone you know would benefit from this blog, you can forward it here.

All content and information on this website is for for informational and educational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making any decisions in respect of your healthcare.