There are countless myths and misconceptions about pelvic anatomy and physiology, and these falsehoods get passed down generation to generation. Unfortunately, these cultural misconceptions can damage our self-perception and negatively influence how we care for this part of our body. This article is an opportunity to unlearn those harmful myths and begin a new relationship with your pelvic floor. Remember, these are just body parts! Anatomy and physiology is just that—anatomy and physiology. Any cultural taboo, meaning, or stigma is constructed by people, not biology.
Anatomy and Physiology of the Pelvic Floor
The pelvic floor is a group of muscles and other tissues that rests at the bottom (or the floor) of your pelvis. It plays a key role in bladder, bowel, and sexual health. In typical female anatomy, the pelvis is the bony structure at the base of the spine that contains the three internal female pelvic organs. These organs are the bladder, the uterus, and the rectum. These organs are supported by a set of muscles, fascia, and ligaments. Collectively, these structures are known as the pelvic floor.
What Does the Pelvic Floor Do?
The pelvic floor has four main jobs:
Provide support for the internal organs
Manage pressure changes and postural changes inside your body
Maintain bowel and bladder control
Support reproductive function
Although the internal pelvic organs are suspended by their own support tissues like ligaments, they need additional support from below from the pelvic floor. Think of your pelvic floor like the bottom slice of bread on your favorite sandwich. When you pick up your sandwich, that bottom slice keeps all of your ingredients from slipping out.
This is especially important with added pressure like coughing, lifting, or pregnancy. In a typically functioning body, the pelvic floor contracts (squeezes, engages) and relaxes at the appropriate times in order to support the internal organs during such pressure changes. For instance, when you sneeze, your pelvic floor muscles should automatically engage to provide support for your internal organs as they withstand the force generated by sneezing. On average, a sneeze exerts about 90 lbs. of force (Adams, 2014). That’s a lot! If your pelvic floor is not able support your internal organs as it should, activities like sneezing can cause symptoms like incontinence and a sense of heaviness or bulging in the vagina.
Numerous activities increase pressure in our abdomen including coughing, laughing, jumping, and lifting, to name a few. The pelvic floor helps to manage this pressure by contracting and lifting upwards, away from your feet. In this way, your pelvic floor acts very similarly to other muscles that stabilize your body, like your deep abdominal and back muscles. For this reason, pelvic floor physical therapists like myself think of these muscles as part of your core, supporting changes in your posture as you move throughout the day.
As mentioned above, if the pelvic floor is working optimally, it prevents incontinence. Contracting the pelvic floor closes the urethral and anal openings and sends a message to your body to retain urine/stool. Usually, this contraction happens automatically to prevent leaks. In order to urinate or have a bowel movement, the pelvic floor has to completely relax.
Finally, the pelvic floor muscles are critical for optimal sexual function. They have to be relaxed to allow penetration. They also have to relax and stretch to allow a baby to exit the birth canal. They contract to produce an orgasm.
References:
Adams J, Schmid J, Parker RD, Coast JR, Cheng D, Killian AD, McCray S, Strauss D, McLeroy Dejong S, Berbarie R. Comparison of force exerted on the sternum during a sneeze versus during low-, moderate-, and high-intensity bench press resistance exercise with and without the valsalva maneuver in healthy volunteers. Am J Cardiol. 2014 Mar 15;113(6):1045-8. doi: 10.1016/j.amjcard.2013.11.064. Epub 2013 Dec 25. PMID: 24440333. ↩︎
