By Cora Tomowich, MSc PT Hons BKin
Do you suffer from regular yeast infections, urinary tract infections (UTIs), or chronic pelvic pain? Have you ever had an incident of urinary or bowel incontinence? Well… it doesn’t have to be that way!
Welcome to my discussion about self-care for ‘down there’. If you’ve ever wondered what to do to help promote bladder, bowel, and vaginal health, then you are in the right place. In this article, you will learn about a few simple practices that help you listen to what your body is saying ‘south of the border’.
Understand Proper Fluid Intake
Improper fluid intake can lead to regular UTIs, increased urgency and frequency of urination, constipation, and incontinence.
Many people with urinary incontinence will decrease their fluid intake in the hopes of preventing accidental leakage or the need to urinate as often. But less fluid consumed means less volume of urine in the bladder, making it more concentrated and irritating to the bladder lining. This will ultimately make urgency worse and cause you to go more frequently. Reduced fluid intake can also encourage the growth of urethral bacteria, increasing your risk of getting a UTI; and make stool harder and more difficult to pass. Thus, causing constipation and significant strain of the pelvic floor muscles.
When it comes to daily liquids, we must be sure not to under- or over-hydrate. As a general rule, fluid intake should be approximately a half ounce of non-alcoholic or non-caffeinated liquid per pound of body weight. In managing fluid intake, I often advise my patients to:
- Monitor fluid intake in comparison to urinary output
- Avoid drinking large amounts all at once and instead sip throughout the day
- Use urine colour and odor to guide daily hydration
- Urine should be light yellow in colour and have no odour
- Dark or odourous urine is a possible sign of under-hydration; clear urine is a possible sign of over-hydration and overworked kidneys
Some vitamins can change urine colour and odour; and the first void of the day is normally darker as the urine has been sitting overnight. Small changes to daily fluid intake can make a big difference in how the bladder is allowed to operate; so be sure to sip throughout the day and keep your body consistently hydrated
Avoid Bladder Irritants
Irritation of the bladder lining can be caused by the regular consumption of certain acidic foods and dehydrating liquids, which can ultimately lead to frequent UTIs, yeast infections, and urinary leakage.
In my practice, I see many patients with increased urinary urgency, frequency, and incontinence. As part of treatment, I will discuss daily habits that can increase the risk of these bladder issues; part of which being food and fluid intake. Although there is no exact diet to cure incontinence, there are some foods and beverages that contribute to bladder irritability and leakage. If you experience incontinence or regular UTIs, you may wish to decrease or eliminate the following bladder irritants:
- Alcoholic beverages
- Caffeinated beverages
- I.e., coffee and tea (regular and decaf)
- Carbonated beverages / soda water
- Spicy foods
- Artificial sweeteners
- Tomato-based products
- Food colourings and flavourings
I understand how difficult it is to give up these things, however, slowly implementing small changes to your diet might provide insight into what causes your bladder control issues and help initiate recovery.
Pay Attention to Bowel Urge
Ignoring the need to evacuate the bowels can be risky as the urge to empty stool only comes once every few hours. If we miss our ‘window of opportunity’, we can become constipated or worse.
Although constipation is largely related to diet and exercise habits, there is also a behavioural component to consider. Regularly ignoring the urge to evacuate the bowels causes stool that is already in the colon to become dehydrated, hardened, and more difficult to pass. If stool is difficult to pass, we are more likely to strain the muscles of the pelvic floor and cause a rectal prolapse during a bowel movement. Long term constipation can irritate the lining of the colon, which can lead to the formation of polyps, disease, and/or other cancerous growths. So, for patients who experience this issue, I make the following suggestions:
- Go when you feel the urge to do so; don’t hold it!
- Get into a regular habit with your bowel movements
- I.e., everyday approximately 30 minutes after the first meal of the day
- Eat well and optimize your fluid / fibre intake
- See your doctor or nutritionist for your specific dietary needs
- Maintain a regular exercise program
- Daily 30-minute walks can help to move the bowels, making stool easier to pass
- Sit properly on the toilet
- Bowels move best in a squat-like position, which is simulated by putting both feet on a small footstool (8-12 inches tall) and leaning forward
- Try the AIRBAG technique as described here by Shelly Prosko.
Give Yourself the Proper Sleep
Sleep is an incredibly powerful construct designed to allow our bodies repair and heal. Without proper sleep, this healing process is inhibited and pelvic floor dysfunction and pain become worse.
Sleep is a huge contributor to overall health. In my practice, I see many people who experience pelvic pain due to pregnancy, labour, injury, tissue abnormalities, etc. Almost all of these patients also report that sleep is often not restful and frequently interrupted. This is a problem because without proper sleep, the body cannot optimally continue its self-healing process and persistent pelvic discomfort becomes worse.
Instead of advising patients to get a certain number of hours of sleep per night, I will coach on matters of sleep efficiency, which I discuss in my previous article Understanding Common Sleep Problems and their Solutions. I also advise patients to make the following changes to their bedroom and/or daily routine to help optimize sleep drive, sleep quality, and regulate circadian rhythm:
- Have a consistent bedtime and wake-up time, even on weekends and holidays
- Eliminate electronics from the bedroom
- Use the bed for sleep and sex only; no reading or working in bed
- Avoid napping for more than 20-30 minutes during the day
- Stop all fluid intake 2-3 hours before going to bed, to avoid having to wake up and pee at night
- Consider taking magnesium, vitamin D, and/or potassium supplements
- Can help combat symptoms of chronic insomnia, fatigue, and stress
- See your doctor and/or naturopath for details
With the proper amount of efficient sleep, we are equipped to promote the body’s natural defenses against illness, tissue injury, and persistent pain. Sleep should always be addressed when building a self-management and treatment plan, with emphasis on keeping a steady routine for bedtime habits.
Follow a Proper Vulva Hygiene Routine
Poor vulva skin hygiene can lead to chronic infections, persistent pain, and pelvic floor dysfunction.
There are many pelvic conditions that closely relate to or can be treated by implementing simple changes to vulva hygiene. One such condition is Clitoral Phimosis, whereby the clitoral hood (aka prepuce) adheres to the glans of the clitoris; causing pain, impaired sensitivity, and the inability to orgasm. Other conditions include Vulvodynia, chronic UTIs, and chronic yeast infections; all of which have symptoms that can be better managed by proper washing of and care for the skin of the vulva. In fact, it is a good idea for all of us to follow some simple vulva skincare techniques, as follows:
- Gently wash the vulva with water only; no soap or cream unless otherwise prescribed
- Avoid using harsh detergents for clothing that sits against the vulva
- Always pee after having sex
- Wear white cotton panties (no thongs) during the day, and go bare at night
- Always wipe the vulva from front to back
When combined with the correct manual and/or medicinal therapies, proper vulva hygiene can hugely improve the severity, frequency, and duration of any pelvic floor issue. In case you missed it, check out my previously published article 10 Tips for Vulvar Skin Health.
See a Pelvic Floor Physiotherapist
Regular check-ups with a pelvic floor physiotherapist can help solve pelvic floor dysfunction and ensure you remain on the right track.
Studies have repeatedly shown that pelvic floor physiotherapy can help patients regain control of their bladder and bowel functioning to prevent issues such as urgency, incontinence, and prolapse. But what if you don’t have these issues? Well, many experts have said that it’s never a bad idea to have the pelvic floor checked anyway; thus ensuring that the aforementioned issues never come to pass. It is my personal belief that checking the pelvic floor and refreshing our home exercise programs on an annual basis can promote optimal deep core functioning and overall body health.
Book an appointment with Cora to see how she can help you support your pelvic health.
Contact us: 416.214.9251, firstname.lastname@example.org
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