Grace: Welcome to the Pelvic Floor Clinic video series.
These videos are for our patients, as well as anyone with pelvic floor concerns.
I am a nurse from the Calgary clinic, and I'm here to give you some information about the pelvic floor issues that you are dealing with.
There are 4 videos that we recommend you watch. There are also other videos that may be helpful to you.
 This video series will:
Help you understand how your pelvic floor works.
Help you find out what might be causing the symptoms that are bothering you.
Give you information and suggestions to help you manage your symptoms.
Help you choose the best treatments for you.
In this video, I will introduce you to your pelvic floor.
It's a part of your body that you might not think about until concerns arise.
You'll learn where it is, how it works with other parts of your body, and the common issues that may lead you to seek treatment.
Many people discover they have more than 1 issue.
So it's a good idea to watch all 4 videos to learn what might affect you and how to prevent problems in the future.
Let's start by looking at where your pelvic floor is in your body.
 Your pelvic floor is at the base of your abdomen (your belly), between your legs.
Think of it as the bottom of a canister.
Your abdominal muscles and bones are the back and sides of the canister, and the top is your diaphragm, the muscle that moves your lungs up and down to you breathe.
The weight of your abdomen sits on the base of this canister, the pelvic floor.
 There are no bones at the bottom of your pelvic floor, only circling around it.
 Your pelvic floor muscles work like a trampoline.
They bear the impact of your abdomen and everything in it.
This group of muscles surrounds 3 openings—the urethra, the vagina in the middle, and the anus at the back.
You can see the layers of muscle that surround these openings and affect how they work.
 From the inside, you can see the urethra where urine drains from the bladder, the vagina where sex happens and where babies pass through during vaginal birth, and the rectum and anus, where stool collects and is emptied with a bowel movement.
At the top of the vagina is the cervix, the opening to the uterus where babies grow.
The red line shows where the muscles lie, extending from the pubic bone in the front to the tail bone in the back, and the 3 openings.
Grace: Think of your pelvic floor as a trampoline which supports the weight of your abdomen.
Trampolines stretch and give and bounce back.
But they can become weak or damaged over time from too much impact and weight.
Your pelvic floor muscles need to give support and work around the 3 openings for your whole life.
But there are many factors that can affect how well your pelvic floor works.
In general, there are 2 types of pelvic floor problems.
One type is pelvic organ prolapse, which means the position of the pelvic organs.
The other type is problems with how your bladder and bowels work.
 Prolapse means “falling down."
Prolapse is when your bladder, uterus, vagina, or rectum shift from their normal positions and push in towards your vagina.
Prolapse can be mild to severe.
If it is a problem, you usually have symptoms like pressure or heaviness in your vagina, bulging tissues, and trouble peeing or having bowel movements.
Even if you don't have symptoms, you can make changes now to help prevent prolapse in the future.
There's more about prolapse in video 2.
Grace: About one third of people have bladder problems at some point in their lives.
The most common bladder problem is incontinence, or leaking urine when you don't want to.
You'll learn more about incontinence in video 3.
Bowel problems may include leaking from the rectum when you can't fully hold bowel movements or gas.
It can get worse with age and can make you feel embarrassed, which affects your quality of life.
Another common bowel problem is constipation, which can actually make prolapse worse and affect how your bladder works.
There is another video about bowel control concerns and how to deal with them.
 Like this whistling fish, it's not always easy to hide these embarrassing issues.
 Bladder and bowel problems can have a big impact on your quality of life, self-esteem, and sexuality.
Learning as much as you can about these issues is an important part of learning to deal with them.
Grace: Let's look at some reasons why you may have pelvic floor issues.
These are factors that can change how well your muscles support your organs and how they work.
There are some factors you can't change, but there are also some you can.
Many people find they're dealing with more than 1 factor.
And when you know what you're dealing with, you can choose the treatment that's best for you.
 The most common factors that can change your pelvic floor are getting pregnant and giving birth.
This is often where pelvic floor issues like leaking and prolapse start.
The extra weight of the baby during pregnancy and pushing the baby through the birth canal (or vagina) create a lot of pressure.
This pressure can stretch muscles, damage nerves, and tear tissues.
 Aging is an important factor in your pelvic floor health.
 Your body, including your pelvic floor, changes as you age.
Some age-related changes that can affect your pelvic floor include:
Your pelvic floor muscles may become weaker and unable to give the support you need—especially if you're not actively using and exercising them.
You may find it harder to move as easily and get to the bathroom when you're older, and you may not be able to hold your pee that long.
When you're older, your body actually makes more urine overnight, so you may be peeing more at night because of this.
If you've gone through menopause, you'll have lower levels of estrogen in your body.
There are many estrogen receptors in the vagina, urethra, and bladder base.
As they no longer get estrogen, the tissues become thin and dry and (like dry skin) get irritated more easily.
 The bladder on the left, with healthy estrogen levels, has a urethra that is plump and thick and stays closed better.
Imagine it like a sponge full of water—plumper and moister.
On the right, with lower estrogen levels, the urethra no longer is as moist.
It's more like a dry sponge and no longer stays tightly closed.
 Smoking or using tobacco is another factor in your pelvic floor health.
You know that smoking isn't good for your health, but you may not know that smoking irritates the bladder and the rectum.
Smoking is also associated with bladder cancer.
Also, most people who smoke for a long time will get a cough that won't go away.
This is called chronic coughing.
It puts pressure on the pelvic floor and can make problems like incontinence and prolapse worse.
 Carrying extra weight can affect your pelvic floor.
Every extra pound pushing down on your pelvic floor can stretch and change it over time.
Losing weight doesn't always make symptoms go away, but it may help to make symptoms better.
 Talk to your doctor if you think weight is an issue for you.
They can recommend lifestyle changes and programs to help you get to your healthy weight and stay there.
 Another factor is your genetics, or genes.
If your close relatives have pelvic floor issues, you may be more likely to have them.
 Constipation, or trouble having bowel movements, affects bladder issues and vaginal prolapse.
 Years of bearing down, hard straining, and heavy stool in your system pushes down on your organs.
What happens in one area affects the areas nearby and can lead to prolapse.
 Some medicines may affect bladder and bowel issues or make them worse.
For example, diuretics (or water pills) can cause you to make more urine right after taking them.
Medicines to help you sleep also make your bladder slow down, as do medicines for depression.
Some of these medicines, as well as some pain medicines, can also cause constipation.
 Always talk to your doctor about your prescription medicines before you stop taking them.
There are medicines that can help with leaking, which we talk about in video 3.
 Activities that involve running, jumping, or lots of impact with the ground can make prolapse or leaking worse.
Exercise has many benefits, but you need to think carefully about your risk factors and the symptoms you have.
There are safe exercises and ones to avoid for people with pelvic floor issues.
It is best to confirm this with a pelvic floor physiotherapist or a pelvic floor clinic.
 You may notice that prolapse or leaking symptoms get worse after a day of heavy lifting—whether it's from daily activities like laundry or gardening, your job, or exercise.
The extra weight transfers down to your pelvic floor.
Make sure you lift with proper form so you don't damage your pelvic floor or other parts of your body.
 You may have other health problems that affect your pelvic floor.
There are diseases that involve the nerves that help control this area, such as diabetes.
Sometimes, accidents or injuries can also affect your pelvic floor and organs.
 The last factor you should know about is foods and drinks that affect how your bladder or bowel function.
Your bladder stores everything you drink.
If you drink a lot, you pee a lot.
But if you do not drink much, the urine stored in your bladder is concentrated and harsh, which can make symptoms worse.
The same can happen in your bowels.
For some people, there are certain foods or drinks that irritate the bladder or bowel.
Others may find some foods are constipating or cause loose stools.
It is helpful to figure out what these foods and drinks might be for you so you can avoid them.
We talk about these foods and drinks in the other videos.
 So as you can see, pelvic floor issues are quite common, and they have many possible causes.
Knowing this information is a good place to start if you want to make changes or get treatment for your pelvic floor issues.
Grace: Now that you know more about your pelvic floor and what can affect it, you can watch the other videos in this series.
They'll help you understand even more about your pelvic floor issues.
You'll learn about things only you can do to improve your symptoms and other treatment options that might be right for you.