Episode #46: 7 reasons your pelvic floor symptoms may have changed recently
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In this episode, Rhonda and Dayna chat about 7 reasons your pelvic floor symptoms may have changed recently. It’s super common to have people graduate from our programs, and then come back upset because symptoms have come up again for them. A lot of factors are at play - physical, stressors, sleep, and more - and we are going to go through some of the big ones, today! Remember: symptoms are our bodies talking to us - so let’s get curious and allow information to be power!
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PODCAST LINKS & RESOURCES:
🔹 Episode #25: Tips to have great poops with Aliya Dhalla
🔹 Check out Rhonda’s Strong at Home Membership
🔹 Pelvic Health and Fitness Podcast
SHOW NOTES:
(2:49) - Episode intro
(4:56) - Reason #1: Change in sleep pattern
(6:53) - Reason #2: Shift in hormones
(9:43) - Reason #3: Increase stress and anxiety
(12:01) - Reason #4: Change in breastfeeding schedule/weaning
(15:36) - Reason #5: Change in bowel habits (e.g. constipation)
(17:10) - Reason #6: Change in exercise routine
(20:15) - Reason #7: Sickness
(25:43) - Do I have to keep doing these things forever?
(28:52) - Wrap up!
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Episode #46: 7 reasons your pelvic floor symptoms may have changed recently
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Welcome to the pelvic health and fitness podcast. We have Rhonda and myself, Dayna here today to chat about seven reasons your pelvic floor symptoms may have changed recently. Um, as a public physio, it's, it's super common for me to sort of, graduate people and say, you know, go and play with your movements, your symptom free, and then have them end up back in my office, you know, several days or weeks, maybe months, years later, um, upset because their symptoms have come up again for them.
And while I never want anybody to experience symptoms, and obviously the goal is to always have you. Symptom free from, you know, the time we graduate until forever it happens. We are creatures of, um, our environment. We have a lot of factors at play, especially as a female, um, as moms, there's lot. Uh, there's a lot of physical demands, stressors, mental health demands, changes in schedule, depending on where you are in your motherhood journey.
Maybe you're not getting a lot of sleep hormones. Um, so we're going to go through, uh, some of the big ones, uh, today. Yeah. And I think it's, you know, serves as a reminder. We've talked about this on the podcast before that symptoms are our body's way of talking to us, letting us know how it's doing. It's It's hard to not be afraid of symptoms, but let's try to just be curious about those symptoms and not blame ourselves if symptoms do arise because they are, there are many reasons, and we're going to go over seven of those reasons today, why your symptoms may have increased or decreased.
So a couple of these might be about decreasing symptoms as well. So, oh, sorry. Just to be clear, when we say symptoms, it could be anything. Leaking, urgency, constipation, pain, heaviness, anything. Yes, yep. Thank you for clarifying that. Okay, so the first one on our list for a reason why your symptoms may have increased is Um, so one of the things that we've noticed lately is a change in your sleep pattern so this is obviously super common in those early postpartum phases where your sleep is dependent on what your baby is doing so sleep regressions are real.
So even fast forward to where Dayna and I are at in our parenthood journey where our kids are the oldest ones are. How old is your oldest? Seven? Six? Oh, thanks. That's for a time that much. I know. Uh, six and five and you know, they'll be up in the night for a multitude of reasons. Still. I feel like that was like an epiphany for me.
Oh, like once your kids sleep through the night, that's the end. No, they still get up in the night. Sorry, if that's bad news. Yes. Um, but yeah, so change of sleep pattern. So our sleep is affected by our kids sleep. And so we might be up for different reasons and that can affect your symptoms. So. You know, many of us know it's sort of common knowledge that we do a lot of healing in our sleep.
And so if we're lacking sleep, our sleep is all over the place. We might have an increase in inflammation, which may contribute to worsening symptoms. Um, our sleep can affect our hormones and chemical levels in our body. Um, That might, you know, make us more susceptible to pain. It's also going to affect our mental health, which many of us know when we are tired, we are more irritable and this might make us more sensitive to pain, which seems, you know, um, you can understand that when you are irritable, you're going to be more likely to be annoyed by the pain that you're experiencing as well.
So that is a totally normal occurrence. If you're lacking sleep, your symptoms might increase. Absolutely. Um, you sort of touched on this next one a little bit, but a shift in hormones, um, variety of reasons this can happen. It can be your cycle starting for the first time postpartum. It can be that, you know, maybe you have a little bit of what we all do.
You have changes in your hormones throughout your actual cycle month to month. So for some of us, we're going to have sensitive zones, whether that's ovulation or right before your period starts. Um, but we also have hormonal shifts that happen sort of for a variety of reasons. One lack of sleep, lack of sleep can change with sleep regressions.
Um, any of that sort of Change sick kids, which this is January of 2023 if you're listening currently. So if December 2022, if you know, you know, um, shift in hormones, your cycle, uh, sleep breastfeeding changes, whether, you know, you're starting to wean, we'll touch on this one a little bit. Um, going forward.
But if you're weaning, if you're trying to develop a breastfeeding schedule, if it's changing for whatever reason, hormones affect us directly. They affect the pelvic floor. They are involved with our sexual organs. They are involved with the uterus itself. The uterus does tend to, uh, swell a little bit and sit a little bit lower, especially in those first few days of your period.
So that can lead to a little bit more load. Um, heaviness is very common in this state. It's in this time period for some, it's one of the reasons I don't jump my first day of my period. It just doesn't feel comfortable for me. Um, so hormones, they're constantly changing, especially in that first year postpartum, but certainly we are not exempt from the fluctuations as we go further from our births and can affect symptoms.
And I'll just throw this one in here, uh, just talking about cycles and periods, um, with leaking. So I know me personally, I feel like I've heard this more too with, uh, like wearing tampons and diva cups that I get a little bit more worsening of my leaking and urgency symptoms during that time. And for me, I think it's related to, I feel more pelvic floor tension when I have a diva cup in.
So it's. Sort of, I'm subconsciously clenching a little bit more. Um, so those can all be factors as well. And all that to say to, you know, if you want to see a pelvic floor physio to work on these things. Awesome. I know for me, the urgency and leaking isn't enough of a disruption of my life to make huge changes.
Um, I do a lot of more pelvic floor relaxation during my period to help. But, uh, so yeah, just to add that, throw that in the hat too, that, you know, You know, if you want to change your symptoms and you want to make them better with pelvic chlorophyseo amazing, but if you're okay with symptoms and that is totally valid too.
Absolutely. Yeah. All right. So the third one we have on our list is an increase in stress and anxiety, which is a big one. Dayna and I've touched on this a bunch of times in our podcast. Uh, so pandemic, um, sicknesses, whether that's We are sick. Our kids are sick. Getting back to work. I find that's a big one with my clients, you know, when they are transitioning back to work at a year or 18 months, whatever it might be sudden surge of symptoms, um, and the holidays.
So Dayna and I just kind of talked about this before we hit record. A few of our clients have been mentioning an increase in symptoms after Christmas. Um, So yeah, so all of that to say there's, you know, many reasons our mental health might be affected and this can directly relate to symptoms. It could be leading to an increase in pelvic floor tension because when we are tense and stressed, we'll have a tendency to hold that tension, literally hold that tension in our bodies, in our belly, in our glutes, in our pelvic floor.
I know that for myself in our jaw. Thank you, Dayna. Um, yeah, and that irritability and increased stress that we feel will impact our nervous system as well. So again, it'll make us more sensitive, more sensitized to pain. So our threshold for pain will be that much lower and, you know, during the holidays, for example, or when our kids are sick, we just don't have as much downtime because we're so busy taking care of everybody and going places during the holidays, doing all the things.
So our body again, feels that constant busyness and our, our nervous system, our body needs that downtime. And when we don't have that downtime, our symptoms might increase. For sure. Our pelvic floor muscles are not different than any other kinds of muscles in our body. I think that's important to know. So like, if you're someone who gets neck tension, when you are stressed, your pelvic floor could very well be tight as well.
It's, you know, They're not specialized types of muscles. They have a lot of special functions, um, but they essentially operate the same as your bicep and your neck and your traps and things, um, already sort of touched on breastfeeding, um, as one of the reasons that your pelvic floor symptoms may have changed, but.
Certainly, I think it's worth bringing up again. I often will mention this to people if I'm sort of graduating them, maybe let's, let's just pick a random six months postpartum. They're sort of symptom free. I go over all of these when they, you know, any, so that, because I think information is power. One that can surprise people is the change in the breastfeeding.
So when and if you decide to stop breastfeeding, um, if there's any sort of weaning, maybe baby's on a hunger strike, you know, for whatever reason, it changes the hormonal picture. And I don't know all of the ins and outs of that. of it specifically, but anytime our hormones are involved, coming back to sort of that second one, their breastfeeding being a big hormonal, um, hormonally driven activity, it can affect the public floor as well.
Um, I also too, if you've sort of like. changed position. So I find, you know, in the beginning, and I've, I think about this too with me, everybody's always in sort of this quiet, calm environment in the, in the nursery, as you start to get a little bit more adept, or maybe you've just got other kids around. If you're starting to breastfeed while doing all sorts of other things, I think it can just sometimes be the overall, again, load on your pelvic floor.
Um, if you're starting to breastfeed while sweeping the floor and teaching algebra to your other kids, like honestly, cause moms are amazing, it can be, it can be just overall work. Yes. Yeah. And I think it's worth noting with that too, is, um, I have heard people mention that their pelvic floor symptoms get better when they wean.
Not to say that that's a reason to stop your breastfeeding journey early, because obviously, you know, there's so much benefit to that. But, um, yeah, if you're noticing that, that your pelvic floor, like your heaviness or your leaking improves, it could just be again, that shift in hormonal picture, um, that might improve your symptoms.
Yeah, it's, it can affect the level of estrogen in our bodies, right? And so estrogen is involved in the plumpness of, for lack of a better description, of the pelvic floor. Um, it can be involved in how readily we self lubricate for arousal, for intimacy, or intercourse as well. So those are sort of the big ticket items.
Um, so yes, certainly I have had several clients where we sort of get to a spot where was better, but we're stuck. And even we'll refer to gyne. Is there anything you can try like a topical estrogen? Um, and again, check with your doctors for this. If it's a really bothersome symptom, my understanding is that that doesn't make it into the breast milk, but always double check with your, um, providers, your medical providers.
Um, but I've had several gynecologists say, yeah, if you've done pelvic physio, you've had some success and you're still having it, it might just be something that sort of lingers until you. Stop breastfeeding and it's not immediate. It can take up to six to eight weeks after. So if that is you, there is hope for some people.
It just is the, the change there really affects the floor and its symptoms. For sure. Yeah. And, uh, it kind of ties into like the increase of stress too, because not for every person, but there might be people who wean their baby as soon as they're getting back to work. So the stress of getting back to work, um, mixed with weaning.
Yes. Of course. It's a recipe for maybe symptoms getting worse. Yes. All right. So the next one on the list, and this is one we touch on, on the podcast all the time as well, is a change in bowel habits. So there is a huge link to things like constipation and pelvic floor symptoms. So if you want to go back to an episode that we did with Aaliyah, Box Wellness Co, she did an amazing job of talking about this.
Um, you know, having, um, Good, healthy, healthy poops, how that can make your pelvic floor that much happier. So yes, when we're constipated, we are straining more on the toilet, having that downward pushing force into the pelvic floor, which might contribute to symptoms, might increase that, um, heaviness feeling that we might be having.
Um, just having more work on the pelvic floor can lead to maybe more leaking symptoms, that type of thing. So if you're noticing a change in your bowel habits. you know, addressing sort of the big ticket things with that would be making sure you're drinking enough water, making sure you're having enough fiber, using a squatty potty, um, just looking into those things to help with the constipation.
And most likely that will also help with your pelvic floor symptoms. Yes, don't delay the urge to go poop. It's the hardest one with kids. Oh yeah. Try not to delay the urge. That stool moves back up into the body relatively quickly and more water gets drawn out so that it's harder right the next time you try.
It's a little bit harder to fully empty. So yeah, constipation is a big one. For sure. Any change in your exercise routine, up or down, maybe you're moving your body a little bit more, maybe you're moving your body a little bit less, maybe you've changed the intensity of your exercise and the frequency is the same, up or down.
Any, um, I often use the analogy of a bank account in our pelvic floor. So, you know, depending on how many resources you've used up in your day to day life, um, If you've been, you're in the thick of it with a six month old and a two year old, and now you've been sort of increasing your exercise steadily, no troubles, but now you're running and you're doing a lot more impact.
For example, you're, you're using a lot more of that resource. So we might just need to sort of reallocate some funds. Um, I'm suddenly a banker, um, uh, reallocate some funds to make you symptom free. Or, you know, Up or down, maybe for you having that sort of consistent exercise routine is good range of motion.
You're really good at having your, your down trainers at the end of a workout and Christmas got busy, life happens, and you've gone away from sort of that checking in with tension, whether that's jaw, belly, bum checks throughout the day, or. Specifically doing some sort of breathing exercise. And so now you, you've, um, got some pelvic floor symptoms, very, very common.
It can be linked to exercise in general. It can be linked to just our overall activity in life, um, more or less. Can be, can bring on symptoms. Yeah. And I'll just touch on, cause this, this came up with a couple of my clients after the holidays. I know, you know, we're focusing in on the pelvic floor, but like we said in previous episodes, the pelvic floor muscles aren't special, they behave very similar to all the other muscles in our body.
And so I had a bunch of clients complain of like neck, upper back tension after the holidays. And so that could be a multitude of reasons. Again, just we're stressed. We're. Maybe around family situations that are stressful, we're here, there, and everywhere. Um, I know for me, I was lucky, we did a lot of busyness, but I, we also had some downtime.
Um, or if my kids are sick and I'm resting more and I'm laying on the couch more. My neck gets so angry. That's the first thing to get angry if I'm not moving my body as much. And so, yeah, getting back to this, I know, right. So for me, my body, it's just a reminder. And as I get to know my body better, That, you know, regular movement is so important.
And so a big one with that though, is learning and being wise enough to ease back in after a period of time where maybe you haven't been exercising. So that is also a, maybe an indication if your pelvic floor symptoms suddenly increase, making sure that you are tapering back in and not just diving right back into super high intensity, uh, super high load.
Um, working with a postpartum coach might help with that. If you're like, I don't know how to do that. Um, that's an important piece too. Absolutely. And our final one and sort of what prompted this topic when we were brainstorming some ideas for episodes is sickness. Sickness can be a major reason. So I mean, yes, your own body for sure.
I think coughing, sneezing, vomiting, those are tiny little marathon, not even tiny, they're a little marathon every single day that you are sick and blowing your nose and coughing. Coughing is very hard on your pelvic floor and it tends to go on for 14 days. Right. So it's like a really hard workout on top of your pelvic floor.
Many of us listening or many anyways, my grammar today is poor. Um, many of you listening us, we are moms as well. So again, you're likely caring for sick children. If you are not sick yourself and carrying for sick children, that can take a toll on your pelvic floor. You're likely out of your routines.
Maybe some of these other things that we've already discussed are coming up for you a little bit more. You certainly probably are carrying around younger children, snuggling them a little bit more. That, the stress of having kids, again, it's sort of early 2023. The illnesses in the end of 2022 were intense.
I don't really know what happened to the common cold, but everything seems to just be fine. Um, so it's stressful and that can bring on symptoms if you are also sick and you are now caring for other people on top of that, that load just multiplies. Um, and then depending on if you are somebody who tries to then get back into working out, maybe before your cold has passed and you're coughing and now you're jumping as well, or you're doing weight training that can also compound symptoms.
So. Just lots of grace and rest for yourself, understanding that symptoms can absolutely flare up when you have a cold. Again, hopefully the further you get away from your birth, this becomes less of an issue. I had a client this week who she's about six months, I think, postpartum and was feeling really great when I saw her in September and is quite active and was very upset.
She had only leaked once during her, during her illness, which was in my mind, actually quite great considering she had. She had, you know, sick children and a couple illnesses back to back, but for her, it was really upsetting. And so just a lot of reassurance about what her body has been doing, um, around Christmas.
Like we've already touched on, out of routine, sleeping in different beds, traveling around. Um, Sickness. Sickness is a big one. I often will give people that heads up when they leave my room as well, that maybe those are the times when you're sick that we sort of, uh, really try in the moments when we are not sneezing, coughing, blowing your nose, vomiting, to check in with tension, jaw, belly, bums, uh, checks.
Even if you're lying on the couch, you might be shocked. To find that you're sort of gripping everywhere. It's okay to do some reverse Kegels, maybe some gentle movement. If you're feeling up to it, like cat cow child's pose can really help ward off some of the effects of that big, big workout in the core.
Yeah, for sure. And yeah, if you've, you know, worked with a pelvic floor physio, listen to our podcast, we teach, you know, when you're coughing, when you're sneezing, when you're throwing up to do a little bit of the knack. So a little bit of like a pelvic floor lift to help with the strain, the downward strain on the pelvic floor.
So yeah, if you think about that, if you're constantly like gripping throughout the day, every time you're coughing to prevent that downward pressure, that is a huge workout. That's a huge amount of load you. Um, repetitively, uh, throughout that sickness. So yes, of course your pelvic floor is going to be fatigued.
And so I think, you know, a reminder in that regard too. So even for Dayna and I, you know, we do this for a living. We know all these things. The few sicknesses that I had recently, my pelvic floor was not happy. I was getting some of like the lower abdomen discomfort that I sometimes get. I was getting a little bit worsening on my leaking urgency symptoms.
And so a lot of that is just like acceptance to have like, this is the phase I'm in. I'm sick. I'm coughing all the time. Yes, my pelvic floor is not happy right now, but this is temporary. Again, doing all the things Dayna mentioned pelvic floor relaxation strategies, if you can. But yes, also just reminding yourself, this will get better.
And yes, your pelvic floor will recover and will heal. No, yeah, for sure. I had a horrible cough. I am a public physio. I was leaking. It happens. It happens to all of us. I, I, I, on our graduation day, I always have these conversations with my clients. I give them these sort of situations and let them know that they are armed.
I hope they are. We've talked a lot about pelvic floor relaxation. I know when you're having symptoms, it can seem very like I'm leaking and you want me to relax tension. Um, but if you're, you know, just think about it again as your contracted bicep. If it's really tired, it doesn't really make sense to stack a whole bunch of.
Books on top of that and walk around like that or do bicep curls. It makes sense to sort of gently take that muscle through a range of motion, or maybe just let it dangle by your side. Again, your pelvic floor is no different. Um, the other thing I just want to mention too, and I mentioned it to all of my clients is I always get asked the question, do I have to keep doing these things forever?
So let's just say Kegels and reverse Kegels in, by themselves. And I often say, I would love it if you did, because, you know, we don't really think twice about going out for a walk or doing squats because we know the long term benefits of keeping these things in our lives. Your pelvic floor really, again, being like any other muscle group needs to be tuned up.
For some of us that strength for some of us it's relaxation for many of us it's a combination of both and certainly over time if you've got if you have symptoms flare up you've gone back to what you've done from your coaches or your pelvic physio or just your own knowledge and it hasn't settled maybe it's time for a reassessment we change across our lifespan so maybe we need to change those um you know proportions of kegels to reverse kegels or whatever But the important part is we want to keep them in there as best we can.
Life will happen. You'll ultimately go away from doing them, of course, but they're tools you can always come back to. And the more often we come back to things, the more likely they are to become a habit. Um, and that can help buffer some of these things from happening when they do happen as well. Yeah.
And I, and I will say, I will fully admit, um, as someone that does this for a living, I don't do deliberate, intentional Kegels because I, you know, remind clients of this all the time that strengthening, so whole body strengthening is pelvic floor strengthening. So as we rehab our body and learn about like the automaticity of those muscles or our pelvic floor.
Will do what it needs to do. Yes. In the beginning, or yes, if there are symptoms involved, we might need to do that deliberate Kegel training, pairing it with the breath, pairing it with movement. But yes, like I am relatively symptom free. Um, I strength train my body on a regular basis and I trust that my pelvic floor is doing a Kegel with every movement that it needs to do right.
And not intentionally thinking about it. Cause for me, that is what makes my symptoms worse. When I. overanalyze and I overthink like, what is my pelvic floor doing while I do this lift that tends to make my symptoms worse. So, but I, I will say I do intentionally do pelvic floor relaxation, um, hip mobility, breathing at the end of my workouts, because that is what my body struggles with.
And so intentionally doing reverse Kegels and breathing into my pelvic floor. Is what I need to do probably forever. For sure. Yeah, absolutely. And that's why it's kegels are not one size fits all. I think that's becoming more and more common, which is great. I'm going to go out on a limb and say most people should be relaxing their pelvic floors for every our public floors are contracting.
With whatever we do through the day. So we could all benefit. And even if it's just meditation to you, essentially, you're just releasing tension in your body. Yeah, absolutely. So I'll just review them all quickly. So this is a non exhaustive list. Of course, there might be other things we didn't touch on, but these are kind of the seven common ones that popped into our heads.
So. Seven reasons your pelvic floor symptoms may have changed recently. Number one, a change in your sleep pattern. Number two, a shift in your hormones. So a return of your cycle, for example, number three, an increase in stress and anxiety. Number four, a change in your breastfeeding schedule slash maybe if you're weaning number five, change in your bowel habits, something like constipation number six, change in your exercise routine, moving your body more or less.
And the last one sickness. Which is a big one right now. So just again, as that reassurance that don't blame yourself, if symptoms are increasing, there are many, many reasons that can explain that change. Absolutely.
We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review, or subscribe to anywhere that you listen to your podcasts. Thanks for being here.
