Pelvic floors and continence are feminist issues?

(53 Posts)
gussiegrips Tue 06-Nov-12 12:19:32

So, I'm a physio with an interest in women's health - specifically why physios are so bad at getting the message across to women that they need to look after their pelvic floor. I know we are rubbish at communicating that because 1:3 women age 35-55 wet themselves when they cough/laugh/sneeze...over 55's it's half. And, those are the official stats, the reality's much worse.

I'd quite like to get MN to run continence as a campaign - given that most of their readership will either have ishoos or know someone who does, and that MN is a powerful voice...we could change the UK's pelvic floors.

There's a link to a brilliant blog dealing with these topics on the front page just now... which led me to post this thread

So, why do women put up with this dreadful intrusion on their lives?

What happens is this:
pregnancy leak...post-childbirth worse...gets a bit better...more kids...gets a bit worse...knows she should be doing something in the way of exercises, but is too busy dealing with life, so solves problem with occasional absorbant pad...sex life disappears as sensation is reduced and she's worried she smells of pee...starts to wee more often to reduce frequency of leaks...can hold less...leaks more...more pads....feels embarrassed....low self esteem...worsening problem, mortified incase she's goign to become a smelly old lady...eventually, reaches breaking point and sees GP...surgery.

Add in the joy of vaginal prolapse and you have a debilitating condition that disempowers women, destroys relationships, interferes with every single thing she wants to achieve, is associated with pain and depression...and 70% of cases (of simple stress incontinence) would be resolved by doing the blardy exercises.

Are we effectively de-sexing ourselves by not educating girls in school about their pelvic floor, reminding them when they are pregnant, again after they have a baby, again when baby starts nursery, again when menopausal symptoms start...etc, etc, etc.

Would be very interested in your thoughts, the more I read, the more I think it's a political disgrace.

gussiegrips Wed 07-Nov-12 23:58:54

Oh, hiya!

I've just been reading the bumf with the toner. It actually says 10 mins a day - that's what their research is based on.

I'm getting muddled with other research which says exercises need to be done 3 times a day, that's without a gadget.

Remember to quote the mumsnet discount code at checkout for a fiver off.

Prolapse can be silent - lots of folk have no idea they've got one. More common after menopause, and, a minor grade one can be improved without surgery - some of which is great and some of which is not so great.

Right, am off to bed. Do your exercises before you go to bed too, please! x

SolidGoldYESBROKEMYSPACEBAR Wed 07-Nov-12 23:59:54

I remember reading in Cosmopolitan about 30 years ago about the iimportance of Kegels, and ever since then I have done mine almost as a nervous twitch, whenever I'm bored or cold or whatever. Still fairly toned in that department at 48 and after one DC, but I'll keep doing it...

Ozziegirly Thu 08-Nov-12 04:05:22

Could you give us a run down of exactly what we should be doing 3x a day - like, how many squeezes, long or short, holding it for as long as possible etc.

I try to remember to do exercises but no one has ever actually said "this is what you need to do". I have no issues with my pelvic floor at this stage and I would ideally like it to stay that way!

Davinaaddict Thu 08-Nov-12 04:44:07

I'm rubbish at remembering to do them - I always try to associate it with something (brushing teeth etc), but I still struggle. But, there is an app (for the iPhone, not sure about android etc) - have a look for 'My PFF'. It can give you a discreet daily alert too grin

TanteRose Thu 08-Nov-12 05:30:21

<joins thread, clenching madly>

Ozzie , here are the exercises from GG's website gussetgrippers.weebly.com/what-are-the-exercises.html

sommewhereelse Thu 08-Nov-12 05:35:45

Gussie I just had a quick google and found an article by a French urologist (in French) which compares the situation in different countries.

here

It may have been translated into English and if you scroll down to the end there are lots of references to studies in other countries.

I had no idea that this problem affected so many women (The only person I know who suffers has given birth 7 times so is something of an exception nowadays)

I have given birth in France twice and had physio both times and I don't have any problems. Once everything was back to normal, the course of physio stopped and the physio didn't mention carrying on at home but having seen your thread I will start exercising again to prevent problems after menopause.

NanaNina Thu 08-Nov-12 11:44:21

Just to say that the Pelvic Floor Toner is £24.48 on Amazon (free p & p) However there is also a digital one at £52. something, and the bit that goes inside you looks much smaller than the pelvic floor toner (although it is the same thing) It has a small remote that you can set to different programmes and according to the reviews you can use it while you watch TV!! Any thoughts on this GG -there are several items on Amazon but I really like the look of the digital one, although I didn't really want to pay that much. The reviews are almost all from people who are delighted with the product. I am very tempted............

gussiegrips Thu 08-Nov-12 18:07:38

Just checking in, sorry, this'll be a quicky as taking wheezy middley Gripper to GP. Again. Sheesh.

I've not seen a digital pelvic toner, Nana. Is it an EMS machine? Bung it in, press the button and the electrical stimulation works your muscles for you?

That's good science, in that very weak muscles will strengthen if you electrically stimulate them...but, my worry with EMS machines bought online is that women plug themselves in, leave it too long (more is better) and fry their fannies.

If you have pelvic floor dysfunction (pain with tampons/sex/general pelvic pain then using an EMS machine will make it worse.

so, they are good in the right cases - but TBH, you'd be better spending your cash on a private physio appointment.

There's no way round it, you've gotta do the blardy exercises.

Tante thanks for linking that - am always worried about accidentally dvertising

Some - brill, will read that when I get back. Am a bit behind, did a "Coffee, cake and clench" today and then had clinical work in the pm.

Right ho. #doyerblardyexercises - go!

TanteRose Fri 09-Nov-12 00:45:30

no worries, gg smile will do your linking for you

(loved the page for the menz, by the way - will pass onto DH)

<doin' me clenches...>

gussiegrips Sat 10-Nov-12 14:47:17

Thanks, Tante!

Menfolks - in an even worse state than women. For every one woman who does talk about pishing herself, there's 100 men who don't talk about their erectile dysfunction...

That's round 2. I'll get Gusset Grippers, The Movie up and running and then start tarting my wares round rugby clubs and get the menfolks sorted.

I just have a potty mouth.

FastidiaBlueberry Sun 11-Nov-12 00:50:15

OP what do you think of squats as an addition/ alternative? I remember reading somewhere ages ago, that too many kegels are bad and that we should all be focussing on doing squats instead. Is that a load of crap?

(As you can see, I didn't actually take anything on board as have done neither PFE's nor squats since. blush)

Hold on, will see if I can find the article.

FastidiaBlueberry Sun 11-Nov-12 00:56:21

I think this is the one:

mamasweat.blogspot.co.uk/2010/05/pelvic-floor-party-kegels-are-not.html

Does this sound credible to you or not? I haven't seen this advice replicated anywhere else, so am not entirely sure whether to give it credence or not.

gussiegrips Sun 11-Nov-12 21:56:37

Oh, I know this article fairly well...<wee sigh>

Kegels aren't for everyone - if you have pain during sex, when using tampons, difficulty peeing or pooing or pelvic pain, you should be checked by GP for pelvic floor dysfunction, and kegels will make you worse.

Mama Sweat is basing her article on a statement I disagree with - that the sacrum moves. my understanding is that the sacrum moves a couple of millimetres - in fact, pelvic pain during pregnancy is caused by too much movement at the joints in the pelvis.

What she is saying is that by working your gluts you can strengthen your pelvic floor. Well, I disagree, I'd say that's like trying to fix your bingo wings by working your biceps - you'll have some effect, but nothing functionally significant.

There are lots of reasons why you shouldn't do squats in pregnancy, or any other time. If you have a prolapse it'll be made worse.

So, whilst I don't want to be disrespectful of a biomechanic expert's opinion - it is at odds with my functional undertanding of what the anatomy does.

In short, if you doyerblardyexercises you'll see a difference. If you do squats, you might, but you might also knacker your pelvic floor.

I was advised to get a set of the Aquaflex cones, to help fix a minor bladder prolapse. Sooo much easier than kegels, just a routine in the shower now, and no more prolapse or weeing myself country dancing. It does say not to use with a prolapse on the website, but I'm guessing it's with a uterine prolapse that it would be a problem, not a collapse of the front vaginal wall.

ConsiderCasey Mon 12-Nov-12 11:56:30

Travelin, I hadn't heard of Aquaflex cones, will look into that, thanks. I'm reading a book called "Saving the whole woman" which is about improving your posture to shift everything back into the right position and avoid prolapse getting worse. It does seem to make a lot of sense but will see how it goes..

gussiegrips Mon 12-Nov-12 19:41:22

Aquaflex cones are good - for the uninitiated, they are like wee plastic tampons that hold a series of weights. But, I once saw one lying in the cereal aisle of Sainsbos - so that's sort of coloured my opinion of them...not scientific, but there you are!

Have a look at www.incostress.co.uk - which is a silicone pessary that supports the neck of your bladder; and www.pelvictoner.co.uk - which is a resistance based exercising device. Both got good science behind them. And, to my knowledge, don't fall out in supermarkets.

"Don't use with a prolapse" will be a disclaimer. If you've got a prolapse you need an assessment from your GP or a women's health physio or a continence nurse.

shock at falling out in supermarket. Think she was probably being slightly overambitious when choosing the weights! (And no pants? confused)

gussiegrips Mon 12-Nov-12 22:10:15

Yep, I expect the scenario went like this: overambitious, forgot all about them, nipped to get essentilas en route to schoolrun, bagpuss knickers, oops.

Shame.

Makes me chuckle a little bit but, i'm not very nice

EmmelineGoulden Mon 12-Nov-12 22:28:34

I'm a bit shock and grin at the idea of vaginal weight lifting. I can see them at the gym next to all the other free weights. Maybe it could be an olympic sport?

Emmeline Best £20 I ever spent - changed my life!

FastidiaBlueberry Thu 15-Nov-12 22:00:13

So these aquaflex cones - do they mean that if you are too lazy to do kegels, if you buy these and use them, they'll do the work for you?

LOL at the idea of vaginal weight-lifting though, it does sound very macho. Might have to go in for that. grin

gussiegrips Thu 15-Nov-12 22:13:03

Ehm. No.

The evidence is that doing kegals will cure 70% of cases of simple stress incontinence.

There is evidence that doing your exercises whilst using aquaflex, pelvic toner or incostress, or soemthing a bit buzzy will help

But, sorry. You've got to actually #doyerblardyexercises.

hold for 10 seconds, 10 quick flicks, lift up 3 imaginary floors in your foofoo and lower back down, then relax. Three times a day. Every day. Until you die.

Oh, come on, you brush your teeth twice a day without complaint...

BelleDameSousMistletoe Thu 15-Nov-12 22:17:09

I found the aquaflex ones really quite painful. You basically pop it in, with a weight (you work up) and have a shower or whatever (you have to be standing up) and then you stop them from slipping out.

I think Kegels are probably more effective...

I did know about pelvic exercising and had been doing from about twelve years old. Trouble was I was doing it wrong - pushing instead of pulling. Did that for 20 years. I have to "undo" as well as do. sad

FastidiaBlueberry Thu 15-Nov-12 22:22:13

Oh I know, it's just habit isn't it.

It's getting the habit that's the problem.

Bummer about doing them opposite, BelleDame

BelleDameSousMistletoe Thu 15-Nov-12 22:27:08

Yes. On the plus side, I was able to give birth with no pain at all as epidural still fully in effect but could still push. Doubt I'm alone in that (even without the exercises) but trying to find a silver lining.

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