What is the Pelvic Floor?

The part between the the pelvis bonesin the lowest part of the body is called the “pelvic region”. Inside this region are the pelvic organs that take part in urination (urinary bag, urethra, prostate, reproductive; uterus, ovaries, vagina) and defecation (rectum, anus).

Pelvic floor; It is a structure consisting of a group of muscles and connective tissue and nerves that hang like a hammock between the anterior part of the pelvis, the pubis, the lower part of the spinal column and the coccyx, thus forming the base of the pelvis. >

Why are pelvic floor muscles so important for our overall health?

While the smooth muscles in the bladder and large intestine work against our will, the work of the pelvic floor muscles is under our control,that is, we can tighten our pelvic floor muscles and relax them whenever we want. For proper control of urine and stool, these voluntary and involuntary muscle groups must act in harmony.

We can control the process by using our pelvic muscles while urinating and defecating. In cases where there is no need or suitable environment for urination and defecation, inability of the pelvic floor muscles to contract adequately leads to leakage of urine, gas or feces. In cases where the muscles cannot relax sufficiently during urination and defecation, problems such as urinary and defecation difficulty arise.

In addition, for various reasons, pelvic The function of the floor muscles to support and hold the pelvic organs may also be impaired. This situation causes the pelvic floor muscles to stretch and relax more than necessary, resulting in various diseases under the name of pelvic organ prolapse (prolapse).

In addition, pelvic floor muscles can be weakened. It also has important functions in sexual intercourse. While strong pelvic floor muscles increase the quality of sexual intercourse, pelvic muscles that are too tight can cause problems in sexual intercourse.

What kind of symptoms and ailments does a pelvic floor show itself?

Pelvic floor dysfunction; is a condition in which the pelvic floor muscles around the bladder, anal canal, and vagina do not work properly. It is possible to talk about many complaints in the dysfunction of this region, such as:

• Incontinence of urine, stool or gas

• Long-term constipation

• The need to defecate frequently

• Inability to relax after toilet, feeling of incomplete emptying of stool, necessity of emptying stool with fingers

• Pain and bleeding in the anus area due to severe straining

• Feeling of severe pain in the rectum, groin, vagina or bladder

• Frequent urination, inability to delay urination or the feeling of insufficient urination

• Fullness in the vagina or anus, a feeling of protruding pelvic organs or the appearance of prolapse

• Sexual disorders; Feeling of pain during sexual intercourse or inability to have intercourse, decreased arousal and orgasm during sexual intercourse, sexual desire disorders, erection disorders.

Who is at greater risk of experiencing pelvic floor problems ?

Weakening of the pelvic floor muscles leads to the emergence of various diseases. Some conditions that cause weakening of the pelvic floor muscles are:

• Being overweight

• Advanced age

• Giving birth (the problem increases as the number of births and the difficulty level increase)

• Past surgeries on the uterus, intestines and urinary tract

• Conditions that increase intra-abdominal pressure such as constipation, excessive straining, chronic coughing, and heavy lifting

• Smoking

• Lack of exercise

• Diabetes

• Psychiatric diseases

• Radiotherapy application

• Collagen tissue diseases.

Which lifestyle habits affect pelvic floor health?

What caused the deterioration of pelvic floor health and changed have acceptable lifestyle habits. Insufficient fluid intake, low consumption of fibrous food and being overweightare important nutritional disorders that need to be changed and negatively affect pelvic floor health. In addition, not doing enough exercise in daily life, smoking and mistakes in toilet habits (such as staying on the toilet for a long time, sitting on the toilet inappropriately, delaying urination or defecation unnecessarily) negatively affect the health of the pelvic floor.. p>

How is the pelvic floor affected during pregnancy and after having children?

We mentioned that the structure of the pelvic floor muscles is like a hammock. Especially in the case of pregnancy, which increases the intra-abdominal pressure too much, these muscles may relax. If pelvic floor dysfunction has started during pregnancy, the dimensions of these complaints may increase if no precautions are taken. It is recommended that women who are pregnant or have given birth recently should do pelvic floor muscle training, which helps prevent symptoms of pelvic floor dysfunction.

3-month pelvic floor muscle training is particularly recommended in the presence of the following conditions during pregnancy and postpartum period:

• Pelvic floor muscle training from the 20th week of pregnancy for pregnant women with a first-degree relative with pelvic floor dysfunction.

• During delivery Pelvic floor muscle training during postpartum care for women experiencing any of the following risk factors.

• Assisted vaginal delivery (forceps or vacuum).

• Vaginal delivery with the baby lying face-up (occipito-posterior).

• Injury of the anal sphincter.

Does pelvic floor health affect sexual life and pleasure?

Many studies show that there is a relationship between pelvic floor disorders and sexual dysfunction. Due to the multifaceted nature of sexuality, it is not possible to point out the pelvic floor dysfunction as the primary cause of any sexual problem, but it is very important to note that it has a very important effect on the formation of some of the conditions mentioned below. It should be noted.

• Painful sexual intercourse (dyspareunia): Persons with pelvic organ prolapsedryness of protruding tissue to have painful sexual intercourse causes. In addition, as in vaginismus, the pelvic floor muscles that are excessively contracted and cannot relax may cause severe pain during sexual intercourse.

• Decreased sexual desire and arousal: People with urinary or fecal incontinence may be concerned that this may happen during intercourse. People with pelvic organ prolapse may also be disturbed by the appearance of their protruding organs. Such situations can reduce the desire to have sexual intercourse or arousal in people.

• Orgasmic disorder: Healthy pelvic floor muscles allow for stronger, longer-lasting orgasms. Weakened pelvic floor muscles, on the other hand, can impair the individual's ability to reach orgasm or have the same quality of orgasm as before.

• Erectile dysfunction (Erectile dysfunction): Weakened pelvic The floor muscles can also negatively affect the erection in men.

What is pelvic floor rehabilitation and what are the methods used?

Pelvic floor rehabilitation is the development of pelvic floor muscle and connective tissue. It is a set of treatments that aim to operate their functions at the most effective level. This process, which starts with patient education, includes exercises that strengthen the pelvic floor muscles and enable them to work in coordination, myofascial relaxation. methods, biofeedback applications, electrical stimulation and neuromodulation.

How does the treatment process of a dysfunctional pelvic floor proceed?

First of all, it should be noted that a single cause may be responsible for pelvic floor patients, or there may be more than one problem.

While evaluating pelvic floor dysfunction, it is necessary to be aware of potential cultural sensitivities and not forget that patients may feel embarrassed.

Factors that increase the risk of pelvic floor dysfunction it is necessary to explain the terms. Raising awareness about modifiable risk factors such as smoking, lack of exercise and constipation is critical in the treatment process. Regular physical activity, a healthy diet consisting of adequate fluids and fiberhelps prevent pelvic floor dysfunction. In the presence of pelvic floor dysfunction, it is also important to discuss the psychological impact of symptoms and to consider this impact when developing a management plan.

What can we do in our daily life to strengthen the pelvic floor muscles?

Increase pelvic floor muscle strength Exercises to improve endurance, strength, relaxation or a combination of these are defined as “pelvic floor muscle training”. There is no single movement or exercise program when practicing this muscle training, also known as Kegel exercises. An exercise program can be arranged according to the complaints of the person. For example; While a relaxation program is applied to the overly tense pelvic muscles, contraction exercises can be recommended to the relaxed pelvic floor muscles. It is a personalized exercise program that aims to improve certain deficiencies in the structure or function of the pelvic floor muscles.

What types of muscle training programs are there? Which training program should be used?

The pelvic floor muscle training program is divided into three groups:

• Controlled pelvic floor muscle training: A health professional is a pelvic floor muscle training program taught and monitored by.

• Pelvic floor muscle training programs: A physiotherapist or other healthcare provider with appropriate expertise in pelvic floor muscle training supervised by a specialist.

• Group pelvic floor muscle training: Performed in an exercise class. Prior personal training is not required to participate in group training.

A home pelvic floor muscle exercise program is an unattended pelvic floor exercise program performed by the individual at home.

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