By Sherrie Palm 

I was laying in bed in the wee hours this AM thinking about a conversation the ladies were having in the APOPS Chatroom. As often happens, I felt compelled to share a few thoughts from years of navigating the POP dynamic. It’s truly important we recognize our pelvic floor needs continually fluctuate as time marches on. Every decade brings a shift in hormones, every decade brings a shift in household dynamic, and frequently each decade brings a shift in employment. Everything that impacts our bodies physically impacts our pelvic floor and we truly need to continually adjust in order to maintain ballast. Whether in our twenties or in our sixties or beyond, pc contraction awareness is pivotal to pelvic floor health. 

Of all the things I've experienced over the years, I'm the most thankful I optimized my pc contraction awareness early on. I honestly can’t tell you how or why I was so aware of “the squeeze”, no physician had ever brought it to my attention, and no physician had ever instructed me to Kegel (including pre and post-partum dialogue). I’m guessing I recognized the value during bedroom intimacy and since intimacy is important to me, I wanted to do what I could to keep things on track as I aged. 

After I gave birth to my son at the age of 35, I made it a point to see how well I could Kegel contract and was thrilled when I was able to recapture my former internal muscle strength. But as I hit peri-menopause in my late 30s, I started to notice a subtle shift-a gradual loss of internal muscle strength. It made me go hhmmm, what’s going on down there. Moving forward through my 40s and 50s and now stepping into my 60s, I’ve continued to use my pc contraction awareness to gauge my pelvic floor stability. 

As time takes its toll on the human body our muscles do not react the same as they did in younger years, so continual modification is key. Knowledge of proper Kegel contraction is pivotal to pelvic floor awareness. The value of guidance from a women’s health physical therapist is significant, especially for women who’ve never had pc contraction knowledge. Awareness of contraction sensation and muscle memory has truly helped guide me in multiple self-treat modalities I’ve utilized over the years. We all need to figure out what works for us individually. I swear I've used nearly every device and a multitude of treatments out there but I maintain pelvic floor awareness in order to optimize pc strength by keeping up with basic Kegels along with yoga, core strengthening, proper posture (that’s a tough one when you’re hunched over a computer all day) and myofascial release as part of my weekday exercise routine. 

On the weak muscle days, I wonder, is it MS muscle weakness, general fatigue from work load and long hours, hormone shift despite supplementation with bio-identicals, loss of contraction from constipation stool backup, loss of contraction from adhesions or scar tissue not fully released? I also wonder if there is something related to muscle tissue integrity or hormone cascade that simply has not been discovered at this point. Or perhaps some genetic marker? What I recognize personally is that despite doing all the right stuff, my contraction is not what it used to be. 

And the advocate in me needs to know why, not just to help myself, but to help millions of other women who deserve to know. I've had more conversations with researchers regarding "the missing link" than I care to say (they probably think I'm nutsville sometimes). I’d play guinea pig in a heartbeat to get the answers.

It bears mentioning that women with a hypertonic pelvic floor have even greater need for guidance from physical therapists (any gymnasts out there listening?), their dynamic is unique and a hyper-tight pelvic floor is no picnic. We all need to increase awareness of pc contraction for a multitude of reasons. Better sex. Less Leaking. Less pain. And more than anything else, pelvic organ prolapse awareness and understanding.

It also bears mentioning that young women who have not given birth should be made aware of pc contraction and the role it plays in life-long pelvic floor health. But that’s a topic for another article.

As the POP arena moves forward, we'll capture more and more answers-stay tuned ladies! 


 December, 2013