The Joint Ventures' Blog

10 Myths About Your Pelvic Floor

Thursday, January 31, 2019

When your pelvic floor muscles don't work right, it's not “normal” and it's definitely not something you should accept as "happening with age" or "after the birth of a child". Here are a few common pelvic floor myths we’ve encountered: 

1. "Only women have pelvic floors." 

Men have a pelvic floor too; their anatomy is similar to the female anatomy. Pelvic floor dysfunction comes in many different forms in men, such as constipation, incontinence, and pain with erection and ejaculation. Anyone at any age can experience pelvic floor dysfunction. Pelvic health physical therapists treat men too!

2. "It's normal to leak urine after giving birth, as you age and with high intensity physical activity."

No! Leaking is never normal! It is common, but not normal! If you leak when you sneeze/cough/laugh, with physical activity, on the way to the bathroom or randomly throughout the day, it means that your pelvic floor muscles fail to seal the entrance appropriately. Don’t accept that as your new normal. Go see a pelvic health physical therapist. We can usually help.

3. "Kegels will “fix” all your pelvic floor symptoms."

Kegels are strengthening exercises for weak pelvic floor muscles. These exercises can improve muscle strength and help when the cause of your dysfunction is pelvic floor muscle weakness.  But not all pelvic floor problems are the result of weak pelvic floor muscles. In many cases, the cause is overactive pelvic floor muscles (they're contracting when they shouldn't or they're stuck in a contraction/spasm) or decreased core coordination (they don't contract at the right time). In these cases, doing Kegels can actually make your symptoms worse! Just like any other muscle, knowing how to relax your pelvic floor muscles is as important as knowing how to contract them....and it is actually often much harder!

4. "How about vaginal eggs, balls, Kegel weights and other similar accessories, should I use them?"

Walking around with weights inside your vagina is not functional. Your pelvic floor muscles are responsible for: 1) keeping pelvic organs inside; 2) for sphincteric control of urine and stool, and 3) for sexual function. None of these functions involve carrying extra weights around for hours. By doing so, you can create muscle fatigue and increase muscle over-activity.

5. "My Pilates/yoga teacher tell us to engage our pelvic floor during class, but I’m not sure I know how to do it."

If your pelvic floor muscles function well, we expect them to engage automatically with physical exertion to seal the opening and prevent leakage or organ prolapse. It is my belief that there is no added benefit to actively engaging your pelvic floor muscles as part of an exercise class (unless advised by you pelvic health physical therapist or a doctor). Instead, you should focus on breathing and making sure you are not holding your breath with effort.

6. "Uncomfortable or painful sex is normal when you first start being sexually active, after giving birth and as you age."

No, sex shouldn’t be painful at any point of your life. There are many different reasons why sex can be painful:  1) your pelvic floor muscles might be overactive, 2) it can be hormonal; 3) it can related to perineal scarring from a vaginal delivery...just to name a few. If you experience pain with sex, it doesn’t mean that you’ll never be able to enjoy sex. See a pelvic health physical therapist. Also, having pain with a pelvic exam or tampon use is also not normal.  We may be able to help with that too!

7. "I have to pee very often, but it's because I drink a lot of water."

Maybe, but....drinking more water throughout the day can actually make you pee less frequently. Drinking lots of water dilutes your urine and reduces bladder irritation. Caffeinated drinks such as coffee, tea, sodas and alcoholic drinks are bladder irritants and will increased urgency even if the bladder isn’t full. To maintain good bladder health, try drinking more water and decrease the amount of other drinks. You can also try adding a glass of water with your morning coffee that way you will have same amount of caffeine, more fluids, and less irritation.

8. "I should pee 'just in case' before I leave the house."

No, if you’re bladder isn’t full, you shouldn’t empty it! Peeing “just in case” often can be confusing to your body/brain and the message to empty the bladder will come sooner than needed when the bladder is only partially full. Instead of going “just in case”, ask yourself if you need to pee before you leave the house.

And listen to this one.....If you're a parent, PLEASE don’t tell your children to go to the bathroom before you leave the house. It's the same reasoning as above! instead, offer them the opportunity to use the bathroom and give them the chance to refuse.

9. "It is normal to strain with a bowel movement."

No, straining is not normal! A normal bowel movement should be formed, but soft. It should come out easily and with little to no effort. If you find yourself straining often, try sitting on the toilet with your legs elevated on a stool, lean a bit forward and take deep breaths instead of straining. Drinking more water throughout the day and eating more fiber can also help.

10. "Special soaps and gels help maintain good vaginal health."

No, your vagina is like a self-cleaning oven. Cleaning it with soap disturb its flora and PH balance. Soap can actually make you more susceptible to yeast and urinary tract infections. Warm water is everything you need to keep your vulva and vagina clean! A few more helpful tips: 1) always wipe front to back; 2) wear comfortable underwear, 3) avoid scented lotions, deodorants and vaginal wipes, 4) use a lubricant that is natural and free of parabens, preservatives and alcohol.

If you've ever said (or thought) any of the myths above; if you're constipated, leak or have pain; if you just had a baby and want to make sure everything is alright “down there”; YOU should be evaluated by a trained pelvic health physical therapist. We can help you determine a more accurate diagnosis and create an individualized treatment plan based on your goals. If you have any questions or would like to know more, please feel free to contact Noam Eitan at or stop by our Kendall Square Office.

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