Pelvic floor exercises The pelvic floor muscles are located in the pelvis and stretch like a sling from the pubic bone to the tail bone and from side to side. Strong pelvic floor muscles help support the bladder and bowel in men, and the bladder, bowel and uterus in women. When the pelvic floor muscles are weakened the internal organs are not fully supported and there can be difficulty controlling the release of urine, faeces or flatus (wind).
The pelvic floor muscles are located in the pelvis and stretch like a sling from the pubic bone to the tail bone and from side to side. Strong pelvic floor muscles help support the bladder and bowel in men, and the bladder, bowel and uterus in women. When the pelvic floor muscles are weakened the internal organs are not fully supported and there can be difficulty controlling the release of urine, faeces or flatus (wind).
There are a number of causes of a weakened pelvic floor, including:
- pregnancy
- childbirth
- genetic factors
- straining on the toilet or chronic constipation
- chronic coughing or sneezing including those linked with asthma, smoking or allergies
- heavy lifting
- previous injuring to the pelvic area
- age
- obesity.
Although the pelvic floor muscles are hidden they can be consciously controlled so can be strengthened with training, like abdominal muscles and arms and legs.
The benefits of pelvic floor muscle exercises:
- improved control over bladder and bowel function
- reduced risk of prolapse ('sagging' of internal organs)
- better recovery from childbirth and surgery (in women)
- better recovery after prostate surgery
- increased sexual sensation and stronger orgasm in women
- increased social confidence and quality of life
- some evidence to suggest that there may be improvement with erectile dysfunction in men.
The first thing you need to do is identify the pelvic floor muscles before attempting an exercise program. Pelvic floor exercises can be done at any time and any place; sitting, standing, waiting in a queue, driving a car or at your desk, and like all exercise needs to be regular and ongoing.
If you need advice on identifying the pelvic floor muscles or beginning an exercise program, you can visit a continence and pelvic floor physiotherapist, a continence nurse or visit the National Continence Helpline site or download the Pelvic Floor First Safe Exercise app.
There are also some other lifestyle changes you can make to help strengthen the pelvic floor:
- losing excess body fat
- cure chronic constipation
- regular general exercise
- good toilet habits
- seek advice and treatment for chronic cough.
For more information, please see:
Incontinence Incontinence describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or faeces or wind from the bowel (faecal incontinence). Incontinence is a common condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control. Incontinence can be treated and managed, and in many cases it can also be cured.
Incontinence describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or faeces or wind from the bowel (faecal incontinence). Incontinence is a common condition that ranges in severity from 'just a small leak' to complete loss of bladder or bowel control. Incontinence can be treated and managed, and in many cases it can also be cured.
Urinary incontinence
Urinary incontinence describes the involuntary loss of urine from the bladder and is a common condition experienced by women.
There are many other causes or risk factors of urinary incontinence, including:
- pregnancy
- childbirth
- menopause
- conditions such as diabetes, stroke, heart conditions, asthma obesity
- urinary tract infections
- constipation
- surgery such and hysterectomy (removal of all or part of the uterus and/or ovaries)
- reduced mobility that restricts access to a toilet
- neurological and musculoskeletal conditions such as multiple sclerosis and arthritis
- some medications
Urinary incontinence has a range of symptoms:
- an occasional leak when you laugh, cough or exercise
- need to go to the toilet urgently
- need to go to the toilet frequently
- complete inability to control your bladder
If you are always feeling thirsty as well as having to urinate frequently, talk to your doctor to check that you do not have diabetes.
Urinary incontinence can be managed, treated and often cured. However treatment and management will depend on the cause of urinary continence, so it is important to see your doctor if you have symptoms.
For more information, go to the Continence Foundation of Australia web pages - What is incontinence? and Who's at risk? and see the Women's Health Queensland Wide Urinary incontinence fact sheet.
Faecal incontinence
Faecal incontinence is a term used to describe leakage from the bowel due to poor bowel control. You may also find you have excessive wind or experience staining of your underwear. Poor bowel control can be caused or made worse by a number of things including certain health conditions or medicines taken for other problems.
Factors that can lead to loss of bowel control include:
- long term straining
- medications (e.g. antibiotics, medication for diabetes or arthritis)
- damage to the anal sphincter or pelvis floor muscles (may be caused by heavy lifting, child birth, surgery, chronic coughing or sneezing)
- diabetes
- inflammatory bowel disease e.g. ulcerative colitis, Crohn's disease
- a fistula or haemorrhoids
- nerve disorders resulting from multiple sclerosis, muscular dystrophy. Stroke, Parkinson's disease
- severe diarrhoea or constipation
Faecal incontinence has a range of symptoms including:
- not able to control the passage of wind of faeces
- not able to make it to the toilet in time
- diarrhoea
- constipation
- having lots of wind and feeling bloated
- unexplained weight loss
- pain or bleeding from the anus
Possible treatments include:
- pelvic floor exercises
- changes to diet
- medications (eg., laxatives for constipation)
- surgery to repairs damage to the rectum or anus
For more information, please see:
Bone density and osteoporosis Bone density testing is a medical test used to determine bone density or strength. These tests can identify if you have low bone density or osteoporosis, and the risk of future bone fractures. The test is simple, comfortable and easy to arrange at an imaging/X-ray site. No other test can provide the same information.
Bone density testing is a medical test used to determine bone density or strength. These tests can identify if you have low bone density or osteoporosis, and the risk of future bone fractures. The test is simple, comfortable and easy to arrange at an imaging/X-ray site. No other test can provide the same information.
As we age we lose bone mass. Osteoporosis is a disease that causes the skeleton to weaken from loss of bone mass. Osteoporosis is called a “silent disease” because it progresses without symptoms until a fracture occurs. Fractures resulting from osteoporosis most commonly occur in the hip, spine, and wrist, and can be permanently disabling.
Osteoporosis affects both women and men. According to Osteoporosis Australia, over 1 million people in Australia have osteoporosis.
Both men and women may have certain ‘risk factors’ that can make them more likely to develop osteoporosis. People should discuss risk factors with their doctor, and anyone over 50 with risk factors may need a bone check up with a bone density scan. General risk factors can include:
- Family history: Bone health can be strongly inherited so it is important to note if anyone in your family (particularly parents or siblings) has ever been diagnosed with osteoporosis
- Low calcium and vitamin D intake
- Medical history: Certain conditions and medications can have an impact on bone health
- Corticosteroids - commonly used for asthma, rheumatoid arthritis and other inflammatory conditions o Glucocorticoids (steriods)
- Low hormone levels
- Thyroid conditions - over active thyroid or parathyroid
- Conditions leading to malabsorption eg: coeliac disease, inflammatory bowel disease
- Some chronic diseases eg: rheumatoid arthritis, chronic liver or kidney disease
- Some medicines for breast cancer, prostate cancer, epilepsy and some antidepressants
- Lifestyle factors, such as low levels of physical activity, smoking, excessive alcohol intake, weight (thin body build or excessive weight)
To preserve bone health, both men and women are advised to:
- Avoid smoking
- Reduce alcohol intake
- Increase your level of physical activity
- Ensure a daily calcium intake that is adequate for your age
- Ensure an adequate intake of vitamin D
Women
Women are at a greater risk of developing osteoporosis because of the rapid decline in oestrogen levels during menopause. When oestrogen levels decrease, bones lose calcium and other minerals at a much faster rate. As a result a bone loss of approximately 2% per year occurs for several years after menopause.
Treatments for breast cancer that decrease estrogen levels even further can add to the risk of osteoporosis and breaks. To find out more about breast cancer treatments and osteoporosis, read this factsheet from Osteoporosis Australia.
Men
Men also lose bone as they age, however testosterone levels in men decline more gradually so their bone mass remains adequate till later in life. By age 65 or 70 years men are losing bone mass at the same rate as women. The male hormone testosterone helps maintain strong bones, so low testosterone levels can increase your risk of developing osteoporosis and breaking a bone. Certain medications, like therapy for prostate cancer (eg: androgen deprivation therapy), can affect testosterone levels. Men with testosterone deficiency or low testosterone levels can improve their bone density with testosterone replacement.
For more information, go to the Osteoporosis Australia site.
