Muscles have the title of "engine of life", and any action of the human body is inseparable from muscles. With a certain amount of exercise, the muscles can become developed. Therefore, many people focus on muscle building, such as the muscles of the pectorals, abs, and limbs. The pelvic floor muscles are rarely noticed because they are in a more intimate corner. In fact, it's very important to exercise your pelvic floor muscles.
The pelvic floor muscles are susceptible to damage during the three phases
The pelvic floor muscles are a group of muscles that close the pelvic floor, and together with the fascia attached to their surface, they support pelvic organs, such as the bladder, uterus, vagina, rectum, etc. The pelvic floor muscles have a certain elasticity and tension that can withstand changes in abdominal pressure and maintain the stability and normal position of the pelvic organs. There are three periods in a woman's life that can lead to pelvic floor muscle damage.
1. Pregnancy period
During pregnancy, the amount of relaxin in the woman's body increases dramatically. The lining of the uterus, the placenta, and the membrane that surrounds the fetus can all produce relaxin, which is intended to make childbirth easier. However, relaxin can also cause pelvic floor connective tissue relaxation, making it less supportive of pelvic organs, unable to resist the long-term pressure of the gradually enlarging uterus after pregnancy on pelvic floor tissues, and then making pelvic floor tissues ischemia and hypoxia, resulting in decreased pelvic floor muscle tone, hyperextension, and reduced elasticity.
2. Childbirth
During childbirth, the baby's passage through the birth canal causes a strong stretch on the pelvic floor muscles, resulting in tears and injuries to pelvic floor muscle fibers. The damage is especially severe when the fetus is overweight, the labor process is prolonged, or there is a difficult birth. Childbirth can also cause denervation of the pelvic floor muscles, making it impossible for the body to perceive the pelvic floor muscles and control the activity of the pelvic floor muscles.
3. Menopause
After the age of 30, the human body loses muscle at a rate of about 1% per year, and muscle strength will continue to decline. If you don't deliberately exercise muscle, by the age of 75, the body's muscle mass can be attenuated by about 50%.
In addition, the significant decrease in estrogen levels in women after menopause will also lead to the atrophy of pelvic floor muscle fibers, making the support of pelvic floor muscles gradually weakened.
Pelvic floor muscle injuries have "signals"
If the elasticity and tension of the pelvic floor muscles are insufficient, the organs in the pelvis will not be able to maintain their normal positions, and the pelvic organs will prolapse, resulting in corresponding dysfunction. For example, uterine prolapse can cause difficulty walking, lumbosacral and lower abdominal pain, cystocele can cause stress urinary incontinence and difficulty urinating, rectocele can cause constipation, pelvic floor myofascial pain can cause dyspareunia, frigidity, etc. These symptoms not only affect women's quality of life, but can also negatively impact their mental health.
How pelvic organ prolapse is treated
The treatment of pelvic organ prolapse can be selected according to the specific condition and age of the patient, and there are usually two types of treatment: non-surgical treatment and surgical treatment.
Non-surgical treatment is the preferred option for patients with mild to moderate prolapse and includes several approaches.
1. Changes in life behavior. Patients need to quit smoking, actively lose weight, maintain a regular lifestyle, do not wear abdominal bands, and avoid spicy foods and caffeinated beverages. In addition, patients should avoid heavy physical labor, heavy lifting, long-term coughing, constipation and other behaviors that increase abdominal pressure to reduce the pressure on the pelvic floor muscles.
2. Pelvic floor muscle training. Regular Kegel exercises can strengthen the pelvic floor musculature and increase the support of the pelvic floor muscles. The specific method is that the patient contracts the anus and vagina independently, relaxes after 3~5 seconds of each contraction, and performs for 15~30 minutes continuously, 2~3 groups per day.
3. Pelvic floor biofeedback electrical stimulation therapy can promote local blood circulation in the pelvic floor and enhance muscle strength.
4. Apply a pessary. A pessary is a tool placed in the vagina that supports the uterus and vaginal walls so that the uterus does not come out of the vagina. It is a good option for patients who are older, cannot cooperate with the doctor for pelvic floor muscle rehabilitation, or have other medical conditions that cannot tolerate surgery. However, the pessary needs to be removed, cleaned, and replaced regularly.
If non-surgical treatment is ineffective or the prolapse is severe, surgery may be considered. The main goal of surgical treatment is to relieve symptoms and restore the normal anatomical position of the organs. Surgical methods include vaginal wall repair, cervical resection, hysterectomy, uterine suspension, etc.
In conclusion, the treatment of pelvic organ prolapse needs to be chosen according to the specific situation of the patient. At the same time, patients should actively cooperate with the doctor's guidance during the treatment process, and adhere to the treatment and rehabilitation exercises. In life, we should avoid bad postures and behaviors such as standing for a long time, sitting for a long time, lifting heavy objects, etc., and we can also often exercise pelvic floor muscles through Kegel exercises.
Text: Zhuang Huishu, Department of Obstetrics, Central Hospital of Qingdao West Coast New Area
Editor: Mu Xinyu and Li Shiyao
Proofreading: Yang Zhenyu
Review: Qin Mingrui, Xu Bingnan