Pelvic Floor Health Care. It can be intimidating. 

Most people don’t engage with pelvic floor health care until something goes wrong. We might be vaguely aware of Kegel exercises from a magazine article we read somewhere about having a fabulous sex life but it's all a bit hazy and unclear. 

When something goes wrong, we become symptomatic. We might wet our knickers when we sneeze or struggle to make it to the toilet in time. Our basic bodily functions become more unpredictable or we develop pain or a heaviness in our pelvic area. 

For a while, we might feel like something is off but we don't do much about it. From our periods, we are used to coping with pain, mess and a bit of unpredictability. We are used to a cycle of feeling good and not so good so it's easy to put these symptoms down to a bad day or a bad week and try and get on with our lives.

But at some point, it gets too much and we decide we don't want to live like this anymore. 

That is when we start to become interested in pelvic floor health care. 

Pelvic floor health care is all the things we can do to make sure our pelvic floor is healthy and flexible throughout our lives.

A healthy and flexible pelvic floor can perform its essential functions of supporting our core and our pelvic organs (bladder, bowel and womb), allow us to wee and poo without leaks and have comfortable sex.

Pelvic floor health care starts with diet, exercise, lifestyle habits, and self care and can include mental health care, GP care, hormone therapy, Women’s Health physiotherapy, all the way to specialist care and/or surgery like Obstetrics, Gynaecology, Urology, or Colorectal Surgery (formerly Proctology), depending on your own unique circumstances.

What does pelvic floor health care look like for you?

Every woman is different and health is a personal journey. There is no one size fits all or magic bullet solution to pelvic floor health care that will serve you throughout your life.

Like your pelvic floor, how you take care of yourself has to be flexible and adapt to whatever is going on in your life at the time. 

If you are symptomatic of pelvic floor issues - if you leak wee or poo at any time, if you have pain, if you feel bulging in your vagina or bowel - then there is no substitute for professional medical assessment. 

The difficulty is, the right kind of medical care can be tricky to access.

That’s because pelvic floor issues incorporate lots of specialisms: obstetric (pregnancy and birth), gynaecological (female reproductive health), colorectal (bowel/poo), urological (bladder and urethra/wee), psychological (mental health) - even dieticians (what we eat and drink) can get involved.  

Waiting lists can be long (in Ireland, at the moment, it can take up to 3 years to see a consultant gynaecologist via public health [source: thejournal.ie]) and seeing lots of different specialists can be expensive. 

Pelvic floor issues can be complex and it can take a bit of trial and error to find the unique combination of interventions that will help your unique situation.

It can feel like you’re going around in circles, spending a lot of money, not making progress and not getting any answers.

At least that’s what it felt like for me. 

I was living in the UK when I suffered a third degree tear on the birth of my first child. This is a significant pelvic floor injury that requires surgery and physiotherapy after the birth. I did all my exercises religiously and attended all my appointments. I got to the end of the statutory period of treatment and while there had been some improvement, I wasn’t better.

I thought that I just had to accept my symptoms as my new normal and manage accidents as best I could. 

But after a year, I was so depressed about the impact my symptoms were having on every area of my life that I knew I had to find solutions. I banged on a lot of doors, saw a lot of people and tried a lot of things before I found what worked for me.

While professional help was invaluable in guiding me towards my solutions, I found that the things I learned that I could do myself, in the comfort of my own home, made the most profound difference on how I felt and how my symptoms improved. 

My recovery wasn’t something any doctor or medical professional did for me - my recovery was a result of my own efforts to support myself. 

Now, I want to help you find what works for you. 

At Sheela, we want to empower you to take care of your pelvic floor health; to know what it feels like when everything is working well, to know how to make adjustments when it’s not, and to know where to go for help if you need more support. 

As a first port of call, we recommend you visit a Women's Health Physiotherapist who can assess your own unique needs.

Women’s Health Physiotherapists are specially trained to understand the workings of the pelvic floor and will be able to assess your symptoms, give you an internal examination, and help tailor a management/ treatment plan unique to you. They will also be able to advise you which specialists you may need to see to help with your particular issues.

Alongside care from your health professional, you can empower yourself by learning about your body and how it works. After all, how can you say it hurts if you don’t know what it’s called.

Tracking your symptoms (including how you feel about them and the impact they have on your life) is a brilliant way to build up a history that can help medical professionals diagnose your unique circumstances more accurately and get you the help you need faster.

Exercising (in a way where the pelvic floor is supported) and building strength in the pelvic floor by doing kegels might not solve all your issues but it will mean you have a good foundation to build on. 

You can also adopt healthy pelvic floor lifestyle habits - these are simple lifestyle tweaks that will have a big impact on your pelvic floor health over time. We’ve created a simple guide to walk you through some of these. It’s available here.

Committing yourself to investing time and energy in your pelvic floor health will have a profound impact on your health outcomes over your lifetime.

For more accessible content like this, follow us on Instagram (@sheela.ie) and YouTube (@sheelawomen). 

Lastly, if there is a woman out there you think might need to hear any of this, please share. Talking about these issues is essential if we're going to help women move past them.