STRENGTH SABOTEURS
Learn the everyday situations wrecking yours
1 CARDIO EXERCISE
High-impact exercise presents particular risks. A 2016 US study found high rates of stress incontinence among female triathletes, with 37.4% of those surveyed affected, while female runners were similarly afflicted. The sheer impact of pounding the pavement can slacken the pelvic floor muscles over time, while the motion also raises intra-abdominal pressure – the pressure inside your torso – which weighs down on your pelvic floor. It increases whenever muscles in the chest or abdomen are engaged; even holding your breath ups the pressure.
2 CHRONIC COUGHING
The force of the contractions in your diaphragm and the muscles between your ribs increases the pressure inside your chest, which pushes down on the pelvic floor, and if the muscles aren’t strong and taut enough, urine can escape from the bladder.
3 PREGNANCY AND BIRTH
A baby’s position in the body means it’s essentially sitting on your pelvic floor. This weight, as well as that of the placenta and amniotic fluid, means pressure will build. ‘There can be a perception that having a C-section will protect the pelvic floor, but it’s only partial protection,’ says Dr Dudley Robinson, consultant urogynaecologist at King’s College Hospital, London. A woman’s age during pregnancy (muscles are more likely to tear as you get older) and interventions during birth, such as having a forceps delivery, push up the risk not just of weakening your pelvic floor, but of long-term damage.
4 STRENGTH TRAINING
Those lifting sessions aren’t helping, either. ‘Weightlifting can be a challenge for the pelvic floor,’ explains Dr Robinson. ‘Lifting anything greater than 5kg has an effect.’ Right. This isn’t to say that you need to swerve the squat rack – just be mindful of your pelvic floor by focusing on form. In fact, while studies have shown that most exercise raises intra-abdominal pressure, the level of this increase can vary between individuals, suggesting that how you lift can make a big difference. A basic rule: don’t hold your breath, as this adds pressure, but activate and hold your pelvic floor while doing the move.
5 CONSTIPATION
Being blocked up is a risk factor for a weakened pelvic floor, as straining to ‘go’ also puts a lot of pressure on these muscles, explains Mann. Accordingly, piles could suggest you need to show your pelvic floor some love, as they can be a result of constipation. As for clearing that blockage, drinking more water and eating more fibre-rich fruit and veg should do the trick.
6 AGEING
Like any other muscle, the pelvic floor weakens as you get older, thanks to depleted collagen levels. The drop in oestrogen during perimenopause and after the menopause means that incontinence becomes more common then, too. The good news is that you can ease some symptoms of the menopause by, you guessed it, eating healthily and exercising often.
7 BEING AN UNHEALTHY WEIGHT
Carrying excess pounds can increase the internal pressure on your pelvic floor, causing the muscles, and your bladder, to weaken over time – making leaks more likely. ‘Achieving a healthy weight is crucial as, not only can this reduce your risk of developing incontinence in the first place, there’s good evidence that doing so can improve existing weakness by lightening the load on the pelvic floor,’ explains Dr Robinson. So, it’s not that slimming down will gift you a watertight pelvic floor – more that you’re giving your muscles less work to do. Equally, carrying too little body fat can pose issues, too. ‘Low body fat causes your oestrogen levels to drop and become hypo-oestrogenised, where your periods stop,’ says Dr Robinson. ‘This is crucial because there are oestrogen receptors throughout the pelvic floor, and if you’re not stimulating those receptors with your own oestrogen, the muscles will weaken.’