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July 13, 2020  
UTERINE NEWS: Feature Story

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  • The Secret’s Out: Pelvic Floor Disorders

    The Secret’s Out: Pelvic Floor Disorders and How to Handle Them

    September 19, 2005

    By: Laurie Edwards for Uterus1

    If forced to, many women will tell you that pelvic floor disorders are their embarrassing little secret. But what may surprise most is just how many women keep this health problem hidden until they are forced to seek help – and how many effective ways there are to combat this problem that remain out of their reach because of this.
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    Tips to beat PFDs:

    Honesty is the best policy – while leakage or overactivity is common, it is never normal, so tell your doctor right away.

    Work out anywhere! The beauty of Kegel exercises is that you can do them anywhere – your car, reading the morning paper or sitting at your desk. Start with 3 reps of 50-60 a day and slowly work up to 100, but not all at one time!

    You are what you eat. People carrying excessive weight in general have less muscle tone, and pelvic muscles are no exception.

    Researchers at Temple University School of Medicine found that 72 percent of all women they surveyed suffered some form of pelvic floor disorder (PFD), and a staggering 70 percent of these women had not sought medical help for their problems. With early intervention, the incontinence and other more serious problems that ultimately disrupt women’s lives can be avoided altogether.

    It’s a complicated subject, because in addition to the very real physical problems these women face, there are also social and emotional components: It’s embarrassing to not be able to adequately control your bladder, and many women limit social activities or stop them altogether because of it, creating a cycle that means they don’t get the help they need.

    “Incontinence is an area of concern, but it is a problem area that remains in the closet,” said Dr. Charles Nager, associate professor in the UCSD Department of Reproductive Medicine and urogynecologist.

    Collectively, PFDs stand for problems or damage to the pelvic muscles that can escalate into incontinence and related symptoms. The pelvic floor muscles and tissue form a sling around the pelvis, keeping all the pelvic organs (bladder, uterus and rectum) in place and ensuring they function properly. Weakened or damaged pelvic floor muscles often result in incontinence, a condition characterized by frequent urination and leakage, or the inability to control the body’s release of urine.

    “They cannot tolerate the leaking urine and the disruption to their daily lives. But incontinence is usually just the tip of the iceberg. Many are also suffering from such pelvic floor disorders as uterine or rectal prolapse,” said Dr. Jack Mydlo, study researcher and professor and chair of urology at Temple University School of Medicine.

    More than 12 million women in North America experience some form of incontinence. Risk factors for such conditions include being overweight, elderly, smoking cigarettes, multiple vaginal births and having infections of the bladder.

    For younger women, most PFDs are a direct result of childbirth. Often, vaginal births put pressure on the vaginal walls, causing damage to the pelvic floor muscles. Then, as women age, and especially if they do not exercise, the muscles continue to weaken, making it harder for normal pelvic functioning to continue.

    As women enter menopause, estrogen levels decrease, causing a thinning of the vagina. The urethral walls do not close as well as they did, which can cause an overactive bladder or incontinence.

    Rest assured that there are many things you can do to alleviate these problems. Like any muscle in the body, pelvic muscles can be toned and strengthened. Experts recommend Kegel exercises, contracting and releasing the pelvic muscles, to combat muscle weakness. In fact, many experts think pregnant women should begin doing them even before birth.

    Often in women with PFDs, these exercises are used in combination with medications that help control bladder function or treat any infections that may contribute to the problem. The next step is using inipramine, an anti-depressant that helps stimulate the muscles that close the bladder neck. A bulking agent can also be injected into the bladder neck to spur its closing.

    While this course of action is often successful, in some cases where more serious problems occur, surgery to insert a new “sling” to hold up the bladder neck is recommended.

    The right medication and targeted exercises can offset muscle damage, so don’t be afraid to discuss any concerns you may have with your doctor.

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    Preserving Continence as We Age
    Traumatic Brain Injury Leads to Urinary Incontinence
    In Women, Loss of Elastic Fibers Leads to Pelvic Floor Disorders

    Last updated: 19-Sep-05

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