Ah hormones, it’s a love-hate relationship for most women, we can thank them for the raging acne we had during our teenage years, or the emotional roller coaster we go through each month. However, the role they play in our bodies is much greater than this and can even influence pain and injury risk.
Let’s talk about their impact on our pelvic floor. First off, what is our pelvic floor? Our pelvic floor is made up of muscles and ligaments that support the bladder, uterus or prostate and the bowels. Our hormones have a direct impact on how our pelvic floor functions.
I’ll explain the role of the hormones and the body and the effect it plays on the pelvic floor.
Oestrogen is produced at vary levels in your menstrual cycle, with highest levels during ovulation. Higher levels of oestrogen cause ligament laxity, this is when the ligaments become relaxed and loose, to get ready for pregnancy. When this happens, the muscles in the pelvic floor and surrounding areas may need to work harder to compensate. You may notice an increase in incontinence symptoms at this time, such as leakage when you laugh or sneeze too hard.
On the other hand, decreased oestrogen levels can cause a decrease in vaginal lubrication, as oestrogen helps with lubrication production. This is a common compliant by menopausal women. Decreased lubrication can lead to vaginal irritation and pain or tearing with penetration.
Testosterone has many great benefits such as boosting mood and cognitive function and maintaining bone health. Testosterone peaks around ovulation, you may notice during this time you have more energy, you feel stronger and have a higher libido. You can thank testosterone for this!
During ovulation is a great time for women to do more strength training, as testosterone levels reduce before menstruation, you should do more low impact exercise such as walking, yoga or Pilates.
Progesterone and Relaxin:
Both hormones are produced to help prepare the body for birth (even if we are not pregnant!), by relaxing ligaments, joints, and muscles. Levels of progesterone and relaxin peak around the time of menstruation. Symptoms are likely to increase during this time as both your muscles and ligaments are relaxed. Urinary incontinence is the most common symptom associated with excessive levels of these hormones!
Having the knowledge about your cycle is key. There are many apps available to tract your cycle. You may need to alter your exercise or rehabilitation throughout your cycle to account for these hormonal changes. If you do experience any symptoms such as urinary leakage during ovulation or menstruation, you may have an underlying pelvic floor dysfunction.
Pelvic floor dysfunction can lead to several conditions including, but not limited to:
- Urinary frequency or urgency
- Urinary stress incontinence (i.e. leakage when coughing, sneezing, exercising, etc)
- Faecal incontinence
- Pelvic organs prolapse
- Pain during penetration
Although these symptoms are common, they are not normal and are not something we should play off as a “normal part of being a woman”. Although, we cannot directly control our hormones, the good news is that we can improve the function of the pelvic floor muscles by addressing strength, endurance, and areas of tightness. If you are experiencing any of these symptoms, please visit a pelvic floor specialist for a full assessment.