Can Birth Control Cause Pelvic Floor Dysfunction

The pelvic floor is a group of muscles and tissues that support the bladder, uterus, and rectum in women. These muscles play an important role in maintaining continence, sexual function, and overall pelvic health. However, various factors such as pregnancy, childbirth, and aging can weaken the pelvic floor muscles, leading to conditions such as urinary incontinence and pelvic organ prolapse.

One of the factors that can affect the pelvic floor muscles is the use of contraceptives. Contraceptives are medications or devices that prevent pregnancy by either inhibiting ovulation, blocking fertilization, or preventing implantation of a fertilized egg. While contraceptives are generally safe and effective, they can have various side effects, including those that affect the pelvic floor.

Hormonal contraceptives, such as the birth control pill, contain synthetic hormones that prevent ovulation by suppressing the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. These hormones are essential for the growth and maturation of ovarian follicles, which eventually lead to ovulation. By inhibiting ovulation, hormonal contraceptives prevent fertilization and pregnancy.

However, the synthetic hormones in hormonal contraceptives can also affect the pelvic floor muscles. Studies have shown that hormonal contraceptives can cause changes in the vaginal tissue, such as thinning of the epithelial lining and decreased vaginal lubrication. These changes can affect the elasticity and strength of the pelvic floor muscles, leading to pelvic floor dysfunction.

For example, hormonal contraceptives have been linked to an increased risk of urinary incontinence, which is the involuntary leakage of urine. A study published in the Journal of Urology found that women who used hormonal contraceptives were more likely to report urinary incontinence compared to those who did not use contraceptives. The study suggested that the hormonal changes caused by contraceptives may affect the urethral sphincter, a muscle that helps control the flow of urine from the bladder.

In addition to hormonal contraceptives, certain types of intrauterine devices (IUDs) can also affect the pelvic floor muscles. IUDs are small, T-shaped devices that are inserted into the uterus to prevent pregnancy. While IUDs are generally safe and effective, they can cause cramping and discomfort during insertion and removal.

Some women may also experience pelvic pain or discomfort with an IUD, which can be caused by the device pressing against the pelvic floor muscles or nerves. A case study published in the Journal of Women’s Health Physical Therapy found that women who used IUDs had higher levels of pelvic pain and muscle tenderness compared to those who did not use IUDs. The study suggested that the pressure and irritation caused by the IUD may contribute to pelvic floor dysfunction.

However, it’s important to note that not all contraceptives have negative effects on the pelvic floor. Barrier methods, such as condoms and diaphragms, do not contain hormones and do not affect the pelvic floor muscles. In fact, using a barrier method during sex can help strengthen the pelvic floor muscles by providing resistance and promoting blood flow to the area.

If you are experiencing unwanted side effects of contraceptives, Pelvic Floor Therapy can help! Pelvic Floor Therapy helps reduce pain in the pelvic floor muscles and nearby muscles. A Pelvic Floor therapist can help teach you how to appropriately relax and contract the muscles and how to coordinate these muscles with the deep core, hips, and low back. A Pelvic Floor Therapist should look at your entire body, including posture and gait, because distal joints play a role in how the pelvic floor is functioning. Pelvic Floor Therapy can help normalize any unwanted bladder and bowel symptoms including bladder leakage, overactive bladder, nocturia, Interstitial Cystitis, constipation, and fecal leakage.

Our clinic is conveniently located in Hoover, Alabama, near the Galleria. We have experienced clinicians with advanced training in the treatment of Pelvic Floor disorders. Contact us to schedule an appointment!

 


Champaneria R, D’Andrea RM, Latthe PM. Hormonal contraception and pelvic floor function: a systematic review. Int Urogynecol J. 2016 May;27(5):709-22. doi: 10.1007/s00192-015-2833-3. Epub 2015 Sep 25. PMID: 26407563.

Townswend MK, Curhan GC, Resnick NM, Grodstein F. Oral Contraceptive Use and Incident Urinary Incontinence in Premenopausal Women. Journal of Urology. 2009.01.040

Volpe ET. Intrauterine Devices, Pelvic Pain, and Physical Therapy: A Case Report. Journal of Women’s Health Physical Therapy, Volume 46, Number 4, October/December 2022, 183-189(7).

What is Lymphedema?

Lymphedema is a chronic condition that results from an accumulation of lymphatic fluid in the tissues, leading to swelling and discomfort. It is caused by damage or obstruction of the lymphatic system, which is responsible for draining fluids from the body’s tissues and transporting them back into the bloodstream. Lymphedema can occur in any part of the body, but it most commonly affects the limbs, especially the arms and legs.

There are two types of lymphedema: primary and secondary. Primary lymphedema is a rare, inherited condition that usually presents in childhood or adolescence. It occurs when there is a congenital abnormality in the lymphatic system, causing lymphatic fluid to accumulate in the tissues. Secondary lymphedema, on the other hand, is much more common and occurs as a result of damage to the lymphatic system. This can happen due to surgery, radiation therapy, infection, injury, or other medical conditions.

Symptoms of lymphedema can vary depending on the severity of the condition, but generally include:

  • Swelling in the affected area, which may be mild or severe
  • A feeling of heaviness or tightness in the affected limb
  • Limited range of motion or flexibility in the affected limb
  • Recurring infections in the affected area
  • Thickening or hardening of the skin in the affected area

If left untreated, lymphedema can lead to complications such as chronic infections, skin ulcers, and lymphangiosarcoma (a rare form of cancer that develops in the lymphatic vessels).

Treatment for lymphedema typically involves a combination of lifestyle changes, physical therapy, and medication. Some lifestyle changes that may help alleviate symptoms of lymphedema include:

  • Maintaining a healthy weight and diet
  • Practicing good hygiene to prevent infections
  • Elevating the affected limb when possible
  • Wearing compression garments to improve lymphatic flow

Physical therapy for lymphedema may include exercises to promote lymphatic drainage, massage techniques, and the use of pneumatic compression devices. Medications such as diuretics may also be prescribed to help reduce swelling.

In some cases, surgical intervention may be necessary to remove excess tissue or repair damaged lymphatic vessels. This is generally considered a last resort and is reserved for severe cases of lymphedema that have not responded to other forms of treatment.

In conclusion, lymphedema is a chronic condition that can cause significant discomfort and complications if left untreated. If you are experiencing symptoms of lymphedema, it is important to speak with your healthcare provider to determine the best course of treatment for your individual needs. With proper management, many people with lymphedema are able to lead normal, active lives.

Complete decongestive therapy (CDT) is a specialized therapy designed to manage lymphedema, a condition characterized by the accumulation of lymphatic fluid in the tissues, resulting in swelling and discomfort. CDT involves a combination of four components: manual lymphatic drainage (MLD), compression therapy, exercise, and skin care. CDT is considered the Gold Standard treatment for Lymphedema. 

Manual lymphatic drainage is a type of massage that aims to stimulate the lymphatic system to promote the flow of lymphatic fluid. During an MLD session, a trained therapist uses light, rhythmic strokes to gently push the lymphatic fluid towards the lymph nodes, where it can be filtered and eliminated from the body. MLD is a gentle and non-invasive therapy that can be performed on any part of the body affected by lymphedema.

Compression therapy involves the use of compression garments or bandages to support the tissues and prevent the accumulation of lymphatic fluid. Compression garments can be worn on a daily basis to maintain the progress made during MLD sessions. The type and degree of compression needed will depend on the severity of the lymphedema and the individual’s needs.

Exercise is an important component of CDT as it helps promote lymphatic flow and improve overall health and fitness. A therapist can design a personalized exercise plan that is safe and effective for individuals with lymphedema. Exercise can include activities such as walking, swimming, or gentle stretching.

Skin care is an essential part of CDT as individuals with lymphedema are at a higher risk of developing skin infections. A therapist can provide guidance on proper skin care techniques, such as washing and moisturizing the skin daily and avoiding cuts and scratches that can lead to infections.

CDT is typically administered over the course of several weeks or months, depending on the severity of the lymphedema. The therapy should be performed by a Certified Lymphedema Therapist (CLT). At-home self-care techniques can also be taught to help individuals manage their lymphedema on their own.

Overall, CDT is the gold standard treatment for managing lymphedema and improving quality of life. It is a holistic approach that addresses multiple aspects of the condition, including lymphatic flow, tissue support, exercise, and skin care. With proper treatment and self-care, individuals with lymphedema can lead active and fulfilling lives. 

Jennifer Spencer is a Doctor of Physical Therapy and Certified Lymphedema Therapist. She can be found at Magic City Physical Therapy in Hoover, AL. 

Why Am I Getting Up In The Middle of the Night to Pee?

Nocturia, or the need to urinate frequently at night, can have a significant impact on quality of life. It can interrupt sleep and leave you feeling tired and sluggish during the day. Pelvic floor therapists can play a crucial role in helping to manage and reduce nocturia. In this blog post, we’ll explore some ways that a pelvic floor therapist can help decrease nocturia.

  1. Pelvic floor muscle exercises: Pelvic floor muscle exercises, also known as Kegels, can help improve bladder control and reduce nocturia. It’s not just about kegels! These muscles need to be able to contract and relax just like any other muscle in the body. These muscles should be coordinated with your deep abdominal muscles, spinal muscles, hip muscles, and work of breathing. A pelvic floor therapist can work with you to develop an exercise program that is tailored to your specific needs and goals. 
  2. Bladder retraining: Bladder retraining involves gradually increasing the amount of time between urinations, which can help train the bladder to hold more urine and reduce the need to urinate at night. A pelvic floor therapist can help guide you through this process and provide support and encouragement along the way.
  3. Behavioral modifications: Making certain behavioral modifications, such as reducing fluid intake before bedtime and avoiding bladder irritants, can help reduce nocturia. A pelvic floor therapist can provide guidance on making these modifications and help you develop a plan to implement them into your daily routine.
  4. Manual therapy: Manual therapy techniques, such as visceral mobilization, joint manipulation, scar tissue mobilization, and trigger point release, can help reduce muscle tension and improve bladder function. A pelvic floor therapist can use these techniques to help alleviate symptoms of nocturia.
  5. Education: A pelvic floor therapist can provide education on proper bladder habits and techniques to reduce the need to urinate at night. This may include information on proper fluid intake, voiding techniques, and how to recognize and manage bladder irritants.

Nocturia can be a challenging condition to manage, but a pelvic floor therapist can provide valuable support and guidance. By working with a pelvic floor therapist, you can learn techniques to improve bladder control and reduce the need to urinate at night, allowing you to get the restful, restorative sleep you need to feel your best.

There are several strategies that can be used to decrease nighttime urination (nocturia), including:

  1. Reduce fluid intake before bedtime: Limiting fluid intake before going to bed can help reduce the amount of urine produced at night and decrease the need to urinate.
  2. Avoid bladder irritants, especially in the afternoon and evening. They can irritate the bladder and increase urine production, so avoiding these substances before bedtime may help reduce nocturia. Bladder irritants include caffeine, seltzer water, alcohol, spicy foods, acidic foods, artificial sweetener, chocolate, and certain medications such as diuretics and antihistamines. 
  3. Practice habits to improve your quality of sleep: magnesium supplementation, sleep in a cool, dark room, use a sound machine, get 10-15 minutes of morning sunlight to help your body produce melatonin naturally, and exercise daily.

There are several habits or behaviors that can make nocturia worse. Some of these include:

  1. Consuming fluids before bedtime: Drinking a large amount of fluids before going to bed can increase the production of urine and cause the need to urinate more frequently at night.
  2. Consuming caffeine, alcohol or spicy foods: These substances can irritate the bladder and increase urine production, leading to nocturia.
  3. Taking diuretic medications: Diuretics are medications that increase urine production and can lead to nocturia.
  4. Lack of physical activity: A sedentary lifestyle can contribute to fluid retention in the body, leading to increased urine production and nocturia.
  5. Smoking: Smoking has been linked to bladder irritation and can contribute to nocturia.
  6. Poor sleep habits: Poor sleep habits, such as not getting enough sleep or having disrupted sleep, can disrupt the normal functioning of the body and contribute to nocturia.
  7. Underlying medical conditions: Certain medical conditions, such as diabetes or heart failure, can cause nocturia.

Nocturia, or the need to urinate frequently at night, can be related to stress for several reasons. Stress can have a direct impact on the body’s urinary system, leading to an increase in urinary frequency and urgency.

One way that stress can impact the urinary system is by activating the sympathetic nervous system, which is responsible for the body’s “fight or flight” response. When the sympathetic nervous system is activated, it can cause the bladder to contract, leading to the need to urinate more frequently. Stress can also increase the production of certain hormones, such as cortisol, which can lead to an increase in urine production and contribute to nocturia.

In addition to these physiological factors, stress can also impact sleep quality, which can contribute to nocturia. When we are under stress, it can be difficult to relax and fall asleep, and we may wake up frequently throughout the night. This can interrupt the normal sleep cycle and lead to an increase in nighttime urination.

Finally, stress can also contribute to other conditions that can cause nocturia, such as anxiety and overactive bladder syndrome. These conditions are often related to stress and can lead to an increase in urinary frequency, urgency, and incontinence.

Waking up at nighttime to urinate can actually be caused by habit.  When we regularly wake up to use the bathroom at a certain time each night, it can train the bladder to signal the need to urinate at that time, even if the bladder is not full. One way to diminish the routine urge at night is to try to ignore the urge to break the habit. Ways to help ignore urinary urges at night include deep breathing, counting backwards from 100, singing a song in your head, and simply telling yourself that your bladder is not actually full. 

Our clinic is conveniently located in Hoover, Alabama, near the Galleria. We have experienced clinicians with advanced training in the treatment of Pelvic Floor disorders. Contact us to schedule an appointment!

Can Pelvic Floor Dysfunction Cause UTIs

Pelvic floor therapy is a type of physical therapy that focuses on the muscles, ligaments, and connective tissue that support the pelvic organs, including the bladder, uterus, and rectum. The goal of pelvic floor therapy is to improve awareness and coordination of pelvic floor muscles and improve the function of these muscles and tissues, which can help to alleviate a variety of symptoms, including those related to urinary tract infections (UTIs).

UTIs are a common problem that affect millions of people each year. They occur when bacteria enter the urinary tract and multiply, causing inflammation and infection. Women are more prone to UTIs than men, in part because of the proximity of the urethra to the anus, which makes it easier for bacteria to enter the urinary tract.

Pelvic floor therapy can be an effective way to prevent and treat UTIs, as it can help to improve bladder function, reduce inflammation, and improve coordination of muscles that support the pelvic organs. Also, tight pelvic floor muscles can often mimic the signs and symptoms associated with UTIs. If you find yourself having frequent UTI symptoms but negative urine tests, the Pelvic Floor muscles are to blame and Pelvic Floor Therapy can help. Here are some ways that pelvic floor therapy can help with UTIs:

  1. Pelvic floor muscle coordination: Pelvic floor muscles are an important part of the urinary system, as they help to control the flow of urine and prevent leakage. Uncoordinated pelvic floor muscles can contribute to urinary incontinence and other bladder problems, which can increase the risk of UTIs. Pelvic floor therapy can help to lengthen and strengthen these muscles through a variety of exercises, not just Kegels, that can improve bladder control and reduce the risk of UTIs.
  2. Improving bladder function: The bladder is an important part of the urinary system, and problems with bladder function can contribute to UTIs. Pelvic floor therapy can help to improve bladder function by teaching patients how to properly empty their bladder, reducing the risk of residual urine that can lead to infection. Additionally, pelvic floor therapy can help to reduce the frequency of urinary urgency and incontinence, which can further reduce the risk of UTIs.
  3. Reducing inflammation: Inflammation is a common problem with UTIs, and it can cause pain and discomfort in the pelvic area. Pelvic floor therapy can help to reduce inflammation by improving blood flow to the area and reducing muscle tension. This can help to alleviate pain and discomfort associated with UTIs and reduce the risk of future infections. A Pelvic Floor Therapist can also discuss nutrition to assist in reducing overall inflammation to improve your bladder and pelvic health.
  4. Addressing underlying conditions: Pelvic floor therapy can also be helpful in addressing underlying conditions that can contribute to UTIs, such as constipation or pelvic organ prolapse. By addressing these underlying conditions, patients can reduce their risk of developing UTIs and improve their overall pelvic health.

In addition to these benefits, pelvic floor therapy can also be helpful for those who have already experienced UTIs. For example, patients who have experienced recurrent UTIs may benefit from pelvic floor therapy as part of a comprehensive treatment plan. By improving bladder function and lengthening & strengthening pelvic floor muscles, patients may be able to reduce the frequency of UTIs and improve their quality of life.

In summary, pelvic floor therapy can be a valuable tool for preventing and treating UTIs. By improving bladder function, reducing inflammation, and improving pelvic floor muscle coordination, patients may be able to reduce their risk of UTIs and improve their overall pelvic health. 

Our clinic is conveniently located in Hoover, Alabama, near the Galleria. We have experienced clinicians with advanced training in the treatment of Pelvic Floor disorders. Contact us to schedule an appointment!