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Covid, alongside its friend’s influenza, the common cold, RSV etc., have shown an increase in the number of women presenting to the clinic with symptoms of both:
- SUI (Stress Urinary Incontinence): ‘the complaint of any involuntary loss of urine on effort or physical exertion (e.g sporting activities) or on sneezing or coughing’ (International Continence Society). I.e leaking when the bladder is under a high pressure
- Prolapse: ‘the descent of one or more of the anterior or posterior vaginal wall or uterus/apex of the vagina’ (International Continence Society) which is also associated with feeling or seeing a bulge inside or outside of the vagina. This could also present as a feeling of heaviness or dragging within the vagina or lower back.
To understand why this occurs, we need to zoom out for a moment and look at the torso as a cylinder. The diaphragm (base of the lungs) is the roof of the cylinder, the sides are created by your abdominal muscles and spine, and the base of the cylinder is the pelvic floor. For a cough, sneeze or nose blow to occur, we need to create a lot more pressure inside the cylinder. If either the pelvic ligaments and fascia are weak, or the pelvic floor muscles are weak or not functioning optimally, we see an excessive stress placed on the base of the cylinder from this.
What can you do to help manage this at home?
- Do “the knack”. We have an Instagram post on this, but essentially what it involves is a voluntary squeeze and lift of the pelvic floor muscles prior to a sneeze/cough. This is to help reinforce the support at the base of the cylinder.
- Ensure you keep drinking enough and eating enough “bowel friendly foods”. Constipation puts extra strain on the pelvic floor, and can occur when you’re sick. Try to be on the front foot with looking after your bowels when you’re unwell, and if you’re worried, telehealth your GP for assistance with managing this further.
What we can do to help with your pelvic floor care before or after you are unwell:
- Assess you for prolapse. If we know you have one, or if you develop symptoms as a result of being unwell, we can give you specific strategies to help you manage your prolapse during periods of sickness in the future.
- Assess your pelvic floor muscle coordination. How strong is it? How fast can you contract it? How well can you keep it on through movement? Do you bear down effectively? All things that are important for helping you keep the happiest pelvic floor possible during times of illness.
- Constipation management strategies.
Pelvic floor strain not only occurs in women with acute conditions such as a Covid, it also occurs in women with chronic respiratory conditions such as:
- Cystic fibrosis
- Bronchiectasis
- Asthma
- Hayfever and Allergies
In these populations, pelvic floor symptoms are common, but not well known. We treat women of all ages, with a variety of pelvic floor conditions that occur for numerous reasons. If you are worried, please reach out, we would love to help you make periods of illness, just a little less stressful.
