Healthy Geezer: Pelvic-floor problems
Q. I’m a 61-year-old woman and I’ve been experiencing some incontinence lately. A friend told me there are exercises I can do to help the situation. Do you know what she’s talking about?
First, talk to your doctor about the incontinence. Don’t begin any exercise program without a check-up.
Your friend is probably referring to “Kegel exercises,” which were developed 60 years ago by Dr. Arnold Kegel to control incontinence in women after childbirth. These exercises are now recommended for women and men who experience urinary or fecal incontinence.
Kegel exercises strengthen the muscles of the pelvic floor. The exercises improve the functioning of the urethral and rectal sphincters.
The muscles that are developed through the Kegel program are the ones you feel when you try to stop the flow of urine. After about eight weeks of exercising, you usually see results, such as less frequent urine leakage.
Urinary and fecal incontinence are examples of “pelvic-floor disorders.” Others include constipation, rectal pain, vaginal prolapse, rectal prolapse, pelvic pain and sexual dysfunction. In medicine, prolapse means that an organ has slipped out of place.
The pelvic floor is a network of muscles, ligaments and other tissues that hold up the pelvic organs: the vagina, rectum, uterus and bladder. When this network, often described as a hammock, weakens, the organs can shift and create disorders.
Women who delivered several children vaginally and suffered tissue damage during childbirth, are at higher risk for pelvic-floor disorders. Another risk factor is obesity, because added weight strains the pelvic floor. A predisposition to have weak connective tissue can add to the problem.
Aging and menopause contribute to disorders. More than half of women age 55 and older suffer a pelvic-floor dysfunction.
About one in three women in the United States will have one of these dysfunctions in her lifetime. One in nine women will have corrective surgery for one of these problems. Because women are embarrassed by pelvic-floor disorders, they underreport them.
It should be noted that men can suffer from pelvic-floor disorders, but they are much more common in women.
In severe cases of pelvic dysfunction, women feel pressure or a pull in the vagina or lower back. The opening of the uterus may stick out from the vagina.
There are many ways to treat pelvic-floor problems. Some women relieve their symptoms with Kegel exercises. Eliminating caffeine, which is a diuretic, can help. Eating more fiber can improve bowel function. Pessaries, plastic devices that come in many sizes and shapes, can be inserted into the vagina to support pelvic organs. And then there is surgery, which can be done vaginally or through the abdomen. The surgical method is determined by the type of problem. More than 200,000 American women have corrective surgery annually.
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