Laura Keyser, DPT, MPH


Public Health Consultant & Physical Therapist

2 articles Following

In my colleague’s post earlier this weekDr. McKinney covered the various ways aging can affect the health of a woman’s pelvic floor. Pregnancy, childbirth and the hormonal changes of menopause, along with the general muscle loss that comes with aging, can all impact the healthy functioning of this important group of muscles. A weakened pelvic floor can contribute to problems such as urinary incontinence, which, if left untreated, can significantly impact a woman’s health and quality of life. The good news? There are proven interventions that can help women regain pelvic floor function and strength.

Like any health issue, awareness is key. Too many women aren’t talking about bladder leakage,. In fact, data show that 50% of the women aged 50 and older experience urinary incontinence, and most of them “just live with it”. The adult diaper and pads market—expected to reach $8 billion by 2025—is an indicator of how many women experience UI and simply manage and conceal their symptoms. But there’s reason to believe the problem is emerging out of the shadows. In 2018, the Women’s Preventive Services Initiative (WPSI), a federally-supported program led by The American College of Obstetricians and Gynecologists (ACOG), issued recommendations for healthcare providers which included doing the following at women’s annual wellness exam: ask about the presence or absence of UI, the degree to which any UI is bothersome, and if they are interested in pursuing treatment. My colleague, Dr. McKinney, wrote about the screening guidelines within the context of the pandemic’s impact on women with incontinence in the article: “Female Urinary Incontinence – Screening Guidelines and the Impact of COVID.

Once you identify the problem, there are many ways to address it. Maintaining a healthy lifestyle in general leads to better functioning of all muscle groups as we age. It’s helpful to avoid or quit smoking. Diet and fluid intake is also important. Certain foods and caffeine, alcohol and carbonated drinks may irritate the bladder and worsen symptoms of UI. Achieving or maintaining a healthy weight, resolving constipation issues and incorporating exercise and movement into daily life are all essential for pelvic floor health.

Like any other muscle group, your pelvic floor can be exercised and strengthened! Even if your pelvic floor is already weakened and you know it isn’t working as well as you would like, it’s not too late to start and be successful. Pelvic floor muscle training—or PFMT—involves a program of exercises that women follow regularly for a period of several weeks or months. Women are most successful when they can work with their healthcare provider because doing PFMT effectively is key (data show as few as 25% of women can do it effectively on their own). Women who are successful are significantly more likely to report cure or improvement of symptoms when compared to those who do not.

The expansion of digital health technologies has ushered in smartphone applications and devices that are available to help women with daily PFMT practice. Not all devices are created equal, however. Aim for an FDA-cleared device supported by published data and clinical studies that allows a healthcare provider to participate in a woman’s training. I’m partial to our device at Renovia, which is the leva® Pelvic Health System, as it has several features designed to support successful PFMT: it’s the only device that uses real-time visualization of movement during muscle contraction and relaxation as the primary way of delivering feedback. Recently, the Digital Therapeutics Alliance (DTA), a global, non-profit group that validates the quality of digital therapeutics in healthcare, added leva to its product library. This important accomplishment means that leva meets the DTA’s 10 rigorous Core Principles for world-class, evidence-based, patient-centric therapeutic interventions—a bar set intentionally high.

One of the most important things a woman can do to protect her pelvic floor health is to have an open, honest dialogue with her health care provider. PFMT may be started early in life to maintain strength and function with age and can also be started at older ages to restore and maintain function. Each woman’s body is unique and requires individualized care, but the variety of interventions available means women can find the right treatment options for their specific pelvic floor issues. Aging may be inevitable, but pelvic floor dysfunction is not!