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Caring for your pelvic’s health


Routine Kegel exercises are a must for all women particularly of child bearing age throughout their lives.

The exercises are named after Dr Arnold Kegel, the gynaecologist who first described them to strengthen the pelvic floor muscles.

The pelvic floor in women supports the uterus, bladder and bowel and prevents a common condition known as pelvic organ prolapse affecting half the women who have had children.

According to Urogynaecologist Dr Johnstone Miheso, there are many ‘silent sufferers’ who are too embarrassed to seek medical help about some of the pelvic floor disorders yet the conditions can be prevented by practicing daily kegel exercises.

He defines Kegel exercise as a type of physiotherapy which consists of repeatedly contracting and relaxing the muscles that form the pelvic floor.

“This practice is similar to a lady pretending she has to urinate and then holding it in,” he says.

Dr Miheso describes pelvic organ prolapse as the descending, or drooping of any of the pelvic floor organs including the bladder, uterus, vagina and rectum into, or outside of the vaginal canal.

He says this a common condition among women who have had vaginal delivery and attributes age (above 40), multiple deliveries and menopause as the main risk factors. Other causes are obesity, chronic constipation and cough and previous pelvic operations such as hysterectomy.

 “Patients may present with a dysfunction of one of the organs bladder, bowel or recurrent vaginal discharge and problems when having sexual intercourse. They may also have urinary incontinence, or describe a feeling of a ‘bulge’ from beneath or a sensation of ‘sitting on a ball,” he says.

  In most cases, pelvic organ prolapse appears during menopause since it is during this time that pelvic tissues damaged during childbearing, age and lose strength.

However, about 50 per cent of women do not show any symptoms and those who do are sometimes vague because of embarrassment.

“A keen gynaecologist should be able to identify this problem through a careful history, physical examination, or when conducting a pap smear test,” Dr Miheso says.

In terms of prevention, Kegel exercises are the best way to keep this occurrence at bay.

Doctors also advice keeping constipation at bay because the straining it causes increases pressure from the bowel on the vaginal wall which weakens and damages the connective tissue and muscles in the pelvis.

Surgery comes in once the condition has been identified and is always as a last resort.

“Patients can seek help from general hospitals and a majority do not need specialised treatment. By reporting the condition early women can avoid social problems commonly associated with pelvic organ prolapse,” he says.