Achís! Laura has sneezed, a very normal and everyday action for most of the population. Apparently this has no repercussion or significance beyond the sneeze itself. However, for Laura it is a big problem, since it is accompanied by an involuntary and unwanted loss of urine.
This accidental loss of urine generates a feeling of shame and fear that the stain may be noticed on the clothes, or worse yet, that it may smell. To deal with this worry, Laura is forced to wear panty liners at all times, assuming that this is part of being a woman.
Pelvic floor dysfunctions cover a series of problems that have in common the involvement of one or several muscles that support the bladder, the uterus or the final part of the large intestine, among others. This means that, especially when she performs physical effort that causes an increase in intra-abdominal pressure – coughing, laughing, running… –, the woman may have involuntary leaks of urine, feces, constant pain in the pelvic area or, Even some of these organs (bladder, rectum or uterus) protrude and can be seen through the vagina.
Far from being a minority problem, half of women report having one of these problems, the most frequent being urine loss, with a clear upward trend. However, it is estimated that only 1 in 4 women who have this problem go for a consultation. Because? Mainly because of the shame they feel, but also because of the lack of information and awareness about the problem, which, since it does not endanger the woman’s life, is not perceived as something that requires health care.
On the other hand, there is a significant deficit of specialized consultations that address the problem specifically and in which women feel listened to, understood and cared for.
Although pelvic floor dysfunctions can affect any woman, there are a series of factors that make it easier for them to appear. Specifically, they are more common in women who have given birth through a vaginal birth – even more so if an instrument such as suction cups or forceps was used to help the baby to be born – and also in those who are overweight, elderly, in menopause or who have had children weighing more than 4 kilograms at the time of birth.
At first it is easy to fall into the temptation of minimizing the consequences that the “leaks”, the discomfort or the pain derived from these problems can have on women’s lives. However, the implications are important. Affected women tend to have less physical activity and may even fall into inactivity, which has been related to a higher risk of diseases such as cancer or heart disease.
In addition, women with pelvic floor dysfunctions also have poorer sexual health and a greater presence of problems related to sexuality.
Likewise, it has been related to poorer quality of sleep and even worse quality of life. Mental health also suffers, requiring greater attention from specialist professionals.
All of this means that these women may end up suffering from social isolation, seeing their personal and intimate relationships affected and reducing their participation in leisure activities.
The fundamental pillar to solve this public health problem is prevention. On the one hand, it can be carried out by avoiding exposure to identified risk factors, such as maintaining an adequate weight. But there are also simple and specific exercises for the pelvic floor that have proven effective: Kegel exercises.
They consist of squeezing the pelvic floor muscles and holding them for about 3 seconds and then relaxing them. And they must be repeated between 10 and 15 times.
In addition, other pharmacological, physiotherapy, medical and surgical treatments are available. Among them, a wide arsenal of medications such as anticholinergics, injections of botulinum toxin (botox) or platelet-rich fibrin, and hypopressive exercises.
In any case, affected women should not be shy about consulting midwives, nurses, physiotherapists and family doctors about this health problem. With this, they will improve their quality of life and help eliminate the gender bias present in health problems that mainly affect women and that perpetuate inequality between men and women in the field of health.
This article was originally published on The Conversation. Its authors are: Juan Miguel Martínez Galiano, Professor at the University of Jaén; Antonio Hernández Martínez, Professor of Maternal and Child Nursing at the Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha; Rocío Adriana Peinado Molina, assistant scientist at the University of Jaén; and Sergio Martínez Vázquez, Professor of Nursing at the University of Jaén.
