Debunking common pelvic floor myths
I have strong pelvic floor muscles (PFM) from regular Pilates sessions
Pilates is a core strengthening exercise and does not necessarily teach you the proper way of activating your PFM. In some cases, it may worsen your pelvic floor symptoms and may not be the most appropriate exercise for your pelvic floor. A proper PFM training should be performed under guidance of a qualified pelvic floor physiotherapist. Dr Yong works closely with a group of women’s health physiotherapists and will be able to recommend someone close to your home.
I have good PFM tone and able to squeeze my pelvic floor muscle well, therefore there is no point seeing a physiotherapist
This is only true to a certain extent, but PFM training is more than squeezing the muscles. Aside from having good PFM strength and endurance, it is more important being able to activate the PMF at the right time e.g., before lifting, coughing etc to prevent bladder leakage. Conversely, a hypertonic PFM may also contribute to pelvic floor issues such as voiding difficulty, bladder overactivity and painful sex. In these cases, PFM muscle down training under guidance of pelvic floor physiotherapist may be required.
I need to drink 8 glasses of water daily to maintain hydration
This is another commonly heard myth in women with overactive bladder and urinary incontinence. There is no scientific evidence to support the consumption of 8 glasses of water daily. The water requirement may vary by individual and should let thirst guide your intake.
Bladder leakage or pelvic organ prolapse is normal after having children
While this may be common and true but not necessarily normal. In most cases, early conservative measures with lifestyle modifications and combination of PFM training may control your pelvic floor symptoms. If your symptoms failed to improve with this management, a specialist appointment with a urogynecologist is recommended to discuss further management options
Pelvic floor issues are part of ageing and menopause.
Similarly pelvic floor disorders are commonly seen in older women due to change in the estrogen level and its effect on the tissue quality after menopause. Most women feel embarrassed to discuss their problems and decide to put up with their symptoms. Ageing can be a healthy process and women are encouraged to seek for help early as these conditions are treatable.
I’ve only had a Caesaren section, so I don’t need to worry about pelvic floor problems
While women who had exclusive caesarean section may be protected from pelvic organ prolapse, approximately 40% of women may still experience urinary incontinence at some stage of their life after Caesarean delivery. Pregnancy on its own is a risk factor of pelvic floor disorders. Other risk factors include multiparity, obesity, chronic cough or constipation, repetitive strenuous activities or high impact exercises, menopause and connective tissue disorders e.g. Ehlers Danlos or Marfan Syndrome.
All pelvic organ prolapse requires surgery
Pelvic organ prolapse affects 50% of women and 40% may develop symptoms. Most women can be managed conservatively with PFM training, vaginal pessaries or both to control their symptoms. Around 19% of Australian women may require surgical correction at some stage of their life.
Prolapse surgery always involves the use of synthetic mesh
Native (own) tissue surgery is the common first line surgical management of pelvic organ prolapse. Dr Yong has been utilising fascia lata graft (own connective tissue) as a substitute to pelvic mesh use in selected patients with advanced or recurrent pelvic organ prolapse.
