How Healthy Is Your Pelvic Floor? Take This 50-Second Test To Find Out
A top urogynecologist shares why catching symptoms early can mean a healthier, happier life
Lately, millions have been Googling for information about pelvic floor dysfunction. And it’s no wonder. After menopause, around 50% of women develop symptoms that can be minor (peeing a bit when we laugh) or quite bothersome (sudden, frequent urges to urinate). Then there’s pelvic prolapse, when the uterus, bladder and/or rectum drop into the vagina because the body can’t hold them in place anymore. Scary, right? Yet if we don’t bring up the topic first, most doctors don’t either, per the American Journal of Obstetrics & Gynecology. So we need to be proactive, says Sarah Boyles, MD, a top-rated urogynecologist in Portland. An easy place to start: Taking a 50-second pelvic floor test to see how well your pelvic floor performs.
A quick test to check your pelvic floor
“As women age, pelvic floor muscles tend to gradually lose their tone and strength, much like other muscles in the body,” explains Dr. Boyles. On top of that, “the natural decline in estrogen that occurs during and after menopause also leads to reduced elasticity, strength and health of these muscles, making the pelvic floor more vulnerable to weakness and dysfunction.”
Meanwhile, factors like chronic stress and poor posture can actually make your pelvic floor uncomfortably tight. But every body is different, and about half of us will never have issues. Here’s how use traditional exercises called kegels to help gauge where you’re at.
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How to do the 50-second pelvic floor test
- Sit or preferably lie down comfortably.
- Tighten the muscles you’d use to stop gas or urine. Hold for 5 seconds, then fully relax for 5 seconds.
- Repeat 5–10 times.
You aced the test if: You could hold the contractions steadily without shaking and then were able to fully relax between contractions. And you were able to do it without pain, holding your breath, or tightening your butt or thigh muscles,” notes Dr. Boyles.
Signs your pelvic floor isn’t working as well as it should: You weren’t able to hold contractions for 3–5 seconds, you had trouble relaxing your muscles after a contraction or you experienced pain, pressure or cramping as you performed the test. Should you panic if you had these test results? Definitely not. “These symptoms aren’t urgent, but if issues show up during a pelvic floor test, it often means you can improve your quality of life with treatment,” Dr. Boyles notes. She suggests talking to your doctor. “You can start with a primary care provider or an Ob-Gyn.”
Other signs your pelvic floor may need some TLC
Even if you passed the pelvic floor test, there are other signs to be on the lookout for.
Treatment could improve your quality of life if you have:
- Urine leakage during activities like coughing or sneezing
- A sudden urge to go that you can’t control
- Difficulty starting urination, especially if persistent or worsening
- Feeling like you can’t empty your bladder completely
- More than two UTIs in one year
Signs you may be at risk of pelvic prolapse
“If you notice a bulge or protrusion at the vaginal opening, it’s important to have it examined,” says Dr. Boyles. And be clear with your doctor. “Prolapse is always better when you’re lying down and worse when you are standing, which makes it really easy to miss in an exam unless your doctor knows to look for it.” You should also talk to your doctor if you’re experiencing the following:
- A feeling of heaviness or a “falling out” sensation in your pelvic area
- Lower abdominal or pelvic discomfort that doesn’t have another clear cause
- Lower back pain without an obvious source
- Difficulty with bowel movements or chronic constipation
- Pain during intercourse
How are pelvic floor issues treated?
”For many women, pelvic floor physical therapy can be an important part of treatment,” notes Dr. Boyles. “A specialized pelvic floor therapist can teach proper strengthening techniques and help address any imbalances you might have.”
Support devices can also provide symptom management while you’re working on strengthening or as a long-term solution, she adds. Dr. Boyles is a medical advisor for the company that makes Uresta, a reusable silicone device that inserts like a tampon to help support the bladder and reduce urine leakage when you laugh, cough, exercise, etc. Called a pessary, “it can offer immediate relief from stress incontinence, and it doesn’t require a prescription,” she notes.
Your doctor can also help you address your specific symptoms through lifestyle modifications, such as reducing caffeine or acidic foods that can irritate the bladder.
What about surgery?
It’s typically considered only when conservative options have been fully explored. “Surgery can treat stress incontinence and prolapse,” says the doctor. “It’s a good option for some women, but muscle strengthening is almost always part of the answer. It’s important to know the nonsurgical treatments as well.”
Why timing matters for pelvic floor treatment
“If symptoms are affecting your quality of life, don’t wait to seek help,” says Dr. Boyles. A basic pelvic floor test can be an important first step. Because the sooner you address potential issues, the easier it tends to be to get relief. And the impact that relief has on your life should not be downplayed.
“It’s hard to feel like a vibrant, active, attractive person when you are leaking, having pelvic pain or feeling pelvic pressure,” notes Dr. Boyles. A recent study in the International Urogynecology Journal even linked pelvic floor issues to an 80 percent higher risk of depression. “Advocate for your health when you feel something in your body is off. If your body isn’t working the way it should, bring it up with your doctor.
The bottom line on your pelvic floor
“Improving pelvic floor health can have a powerful impact. Beyond reducing physical symptoms like urinary leakage, women often regain freedom of movement, return to activities they enjoy and feel more confident in social and intimate situations,” she says. “Better pelvic floor support can also reduce anxiety and restore a sense of control and comfort in everyday life. You just want your pelvic floor to work without having to think about it.” It can be empowering and life-changing.
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