Caring for women's health starts with pelvic floor rehabilitation

Author: Ma Xia, Taizhou Hospital, Zhejiang Province

Reviewer: Jin Xiaoxiao, Chief Physician, Taizhou Hospital, Zhejiang Province

Women are the "half of the sky" of human society, and female pelvic floor health is a major social issue. According to statistics, the incidence of pelvic floor dysfunction in Chinese women is about 60%, especially in postpartum, perimenopausal, and elderly women. Problems with female pelvic floor health can easily lead to a variety of gynecological diseases, and the proportion of progression to urinary incontinence is very high.

Female pelvic floor dysfunction, the unspeakable secret of mothers

In the outpatient clinic, patients often talk about the confusions in life - urine leaks whenever they cough or laugh out loud; they are afraid of not being able to control their urination in public places, so they have to wear sanitary napkins or diapers before going out... A series of unspeakable problems such as urine leaks when laughing out loud trouble countless mothers.

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Many studies have shown that the incidence of pelvic floor muscle dysfunction among married and childbearing women in my country is about 30% to 45%, and more than 50% of women have varying degrees of urination abnormalities. Many people cannot imagine that urinary system problems several years later may be related to childbirth!

The female pelvic floor muscles are like a "spring bed", supporting and supporting the bladder, uterus, rectum and other pelvic organs. The pelvic floor muscles have multiple physiological functions such as controlling urination and defecation and maintaining vaginal tightness. During pregnancy and childbirth, women will inevitably suffer varying degrees of damage to their pelvic floor muscles.

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Most women will experience pelvic floor relaxation to some extent after childbirth, which has a certain impact on their lives, such as relaxation, urinary incontinence, inability to hold urine when coughing or exercising, and inability to achieve orgasm. In addition, chronic cough, frequent lifting of heavy objects or constipation, aging, obesity, menopause, etc. are also likely to cause female pelvic floor dysfunction. Therefore, how to improve the quality of life of women and solve the unspeakable problems of mothers.

Do I need pelvic floor rehabilitation after a caesarean section?

Natural childbirth is one of the main causes of pelvic floor muscle relaxation in women. The diameter of the fetal head is about 9 to 10 cm. During vaginal delivery, the vaginal diameter will expand to 9 to 10 cm (the normal vaginal diameter is 2.5 cm). The pelvic floor muscles are damaged and their elasticity decreases. It is easy for everyone to understand this, but it is wrong to simply think that only natural childbirth can cause pelvic floor dysfunction.

Whether it is a natural birth or a cesarean section, it is recommended that women do pelvic floor rehabilitation after delivery. During pregnancy, under the action of the progesterone relaxin, the pelvic floor will also become loose. As the fetus grows slowly and the fetal position moves downward, the pelvic floor will be squeezed more and more. After delivery, as the fetus is delivered, some ligaments rupture, and the elasticity of the "spring bed" becomes poor, and the organs cannot be fixed in the normal position, resulting in functional disorders such as incontinence and organ prolapse. Therefore, women who have natural births and cesarean sections need to have their pelvic floor function evaluated after delivery.

Postpartum pelvic floor training can prevent diseases 25 years later

According to foreign research statistics, 30% to 45% of people will experience pelvic floor muscle relaxation after childbirth, which affects urination. Although it is not considered urinary incontinence in the strict sense, the impact of pelvic floor muscle relaxation on the quality of life of this group of people may not appear until decades later, so it rarely attracts people's attention. Many people don't think that the training done 42 days after childbirth is to prevent urinary incontinence, uterine prolapse, etc. 25 years later.

The concept of confinement is deeply rooted, and postpartum rehabilitation training is "forgotten"

Clinically, pelvic floor dysfunction prevention and treatment projects have been launched, and more and more hospitals and postpartum rehabilitation institutions have also started pelvic floor rehabilitation training, but there are relatively many obstacles in reality. First, women lack the health awareness of pelvic floor function, and feel that menopause or senile urinary incontinence seems to be a very distant thing from them. Secondly, some old concepts, such as "confinement" requires mothers to lie down more, are also practical obstacles faced by women. If mothers get out of bed to exercise pelvic floor function a few days after delivery, they may be strongly opposed by their elders. Furthermore, the focus of women's life after childbirth revolves around the baby, and the rehabilitation training of mothers is often delayed again and again, or even "easily" ignored.

Pelvic floor rehabilitation training, the sooner the better the effect

Childbirth causes severe damage to the pelvic floor muscles, causing women to have varying degrees of pelvic floor functional disorders. This removes the natural barrier that protects the uterus, ovaries and other organs, making it easy for bacteria and viruses to infect, leading to gynecological diseases. Therefore, it is recommended that women undergo a pelvic floor rehabilitation test 42 days after childbirth, and decide whether to need subsequent treatment based on the test results.

The first year after childbirth is the "golden time" for the recovery of pelvic floor muscle function. As the saying goes, "the sooner you do it, the better." If you do not do any pelvic floor muscle function training, as you age, your hormone levels drop, your muscles become loose, and your symptoms become more and more severe. When you reach middle age or old age, you are likely to experience mild or moderate stress cramps or varying degrees of stress urinary incontinence, and some may even develop uterine prolapse.

**What if you miss the golden training period starting at 42 after childbirth?** If you miss the golden training period after childbirth, don't worry. Gradually exercising from now on can also promote the recovery of pelvic floor muscles. Pelvic floor rehabilitation treatment at any time has therapeutic significance, the key is whether you persist.

Moms, pelvic floor examination is not scary

Many women have varying degrees of lacerations after childbirth, and they often feel fear when they hear that they need to undergo an examination. In fact, the pelvic floor examination is a non-invasive examination, and the examination process mainly relies on the strength of the pelvic floor muscle contraction. Many women do not know how to use the pelvic floor muscles to contract normally. The dual modes of pelvic floor electromyography screening and pelvic floor function assessment can intuitively see the numerical score report and understand the functional status of the pelvic floor. The screening time only takes about 3 minutes, and the treatment process is "non-traumatic, painless, and rehabilitative." Pelvic floor treatment includes low-frequency electrical stimulation, biofeedback therapy, and scenario training. According to the patient's degree of muscle fatigue and damage, each patient is given a different rehabilitation treatment plan to achieve the ideal treatment effect.

After learning the correct method of pelvic floor muscle contraction, women can also train at home with a rehabilitation ball. The pelvic floor rehabilitation training ball can promote the contraction of the pelvic floor muscles, increase fatigue, and slowly disengage your abdominal muscles, so that your pelvic floor muscles can achieve a good contraction effect.