World Continence Week runs annually in late June, to raise awareness and to help eradicate the unnecessary stigma that surrounds incontinence and pelvic floor health. Many people, especially those who’ve given birth, suffer from varying degrees of incontinence. We laugh about peeing when we sneeze, but many of us have come to believe it’s inevitable. We wanted to find out just how common incontinence is and if it can be fixed, so we chatted with the vagina coach (yes, that’s her title!), Kim Vopni.
What exactly is our pelvic floor and what’s its role in the body?
The pelvic floor is a group of muscles that close off the base of our pelvis and are the foundation of our core. These muscles support organs, play a role in sexual response and help stabilize our spine and pelvis. They also manage our openings—the urethra, the vagina and anus—and help maintain continence.
What is incontinence and is it normal?
Incontinence is the involuntary loss of urine, and no, it’s not normal. Women’s media, movies and feminine hygiene companies have tried to convince us that incontinence is part of being a woman. This is not true. Incontinence is common, many women suffer from it—especially during pregnancy, postpartum and into menopause—but it is treatable. I am passionate about normalizing the conversation around how common these issues are and letting women know they can be fixed.
How common is incontinence?
Incontinence is unfortunately a common condition. Close to 40 percent of women and an estimated 400 million people worldwide suffer from it. And those are just reported cases; I believe there are many more that go unreported. While incontinence is largely considered something that happens to older women, it can affect anyone including young athletes, CrossFit enthusiasts and men.
Is incontinence a challenge only for women who’ve given birth vaginally?
Incontinence can happen to anyone. Giving birth vaginally puts a woman at an increased risk for pelvic floor weakness but people who have C-sections have still carried an increased load on the pelvic floor and had the posture and hormone changes that come with pregnancy. In addition, a C-section involves multiple incisions through the core which in turn influences the pelvic floor. Postpartum recovery is often overlooked and common struggles like incontinence can carry over into menopause if not resolved. Constipation and low back pain can also be signs of pelvic floor dysfunction. No one is immune to pelvic floor issues.
Are there any known cures for incontinence or just ways to manage it?
Incontinence can be cured or greatly improved for most people. Simple, regular exercises can decrease and even eliminate incontinence and dramatically change people’s lives. Lifestyle, diet, exercise and pelvic floor therapy can also improve or even cure the issue. An important consideration is that pelvic floor exercise is not just a quick fix but rather an on-going strategy to maintain optimal function.
A lot of people are told that surgery is the only fix but then they have the problem return. Surgery treats the symptom, not the problem. Another reason for a high recurrence rate after surgery is poor preparation and lack of rehabilitation.
Vaginal rejuvenation options such as laser therapies and the BTL Emsella chair can work for some but outsourcing pelvic floor exercise is an expensive shortcut that rarely addresses the true problem.
What are some non-surgical methods to improve continence strengthen the pelvic floor?
Kegels, habits, lifestyle, diet, movement and much more you can do easily from home. I work with clients to learn what parts of their lifestyle, habits or behaviours may be contributors to their incontinence issues and then develop strategies for change. I share lots of exercises and movement as I like my training to reflect real life.
Who is a good candidate to visit a pelvic floor physio?
I recommend all women have their pelvic floor evaluated by a pelvic floor physiotherapist, ideally once a year. It’s the best way understand your personal situation as every body is different. Unfortunately, physio isn’t available to everyone due to location, costs, medical coverage, comfort, etc. At home, women can do a basic evaluate of their own pelvic floor by putting a finger or two inside the vagina to see if they can feel the contract, lift and let go of a Kegel. I have a 28-day challenge through my app, Buff Muff, which is at-home pelvic floor training and resources. When conversations around incontinence are more common, women have the vocabulary and the confidence to ask the right questions, find a care provider and seek treatment.
What exactly is a Kegel and what does it do?
A Kegel is a pelvic floor exercise which, when done correctly, will strengthen your pelvic floor muscles. They’re basically the same as a workout you’d do on any other muscle in the body to make it stronger.
How do you know if you’re doing a Kegel correctly?
Many women, especially when pregnant are told to “Do your Kegels!” but few are told or shown how to do them properly. The interpretation is often that it’s a squeeze. I see people tensing their core or their thighs and butt cheeks, holding their breath but that’s not correct. It involves an upward, lifting motion, as well as a squeeze and then a relaxation. Here are some visualizations I recommend, to guide the movement:
- Imagine lifting your perineum up towards the crown of your head
- Imagine picking up a blueberry with your vagina and your anus
- Imagine sipping a milkshake through a straw with your vagina
- Imagine preventing a tampon from slipping out
- Imagine pulling your partner’s penis/finger deeper into you (this one you can try in real life if you have a partner or can use your own finger or a pelvic floor device)
Anyone can take the Kegel Quiz on my website which walks you through a Kegel and helps determine what shape your pelvic floor is in. Kegels are effective when done correctly and consistently. My coaching takes it one step further and coordinates Kegels with movement, to mimic lifestyle and train your body to respond.
Is it ever too late to improve incontinence?
It’s never too late. The earlier you can begin strengthening the pelvic floor—ideally long before pregnancy—the better, but there’s no bad time to learn about your health and improve it! After menopause, around age 51, the pelvic floor muscles can further weaken when we no longer have circulating estrogen. The tissues in the vagina and around the bladder start to thin and become dry, which can contribute to pain and incontinence. If the pelvic floor never recovered after pregnancy, the risks are higher in menopause. Beginning Kegels at any age can prepare for the stages ahead and improve any current challenges. I encourage woman at any age to educate themselves and seek help. No one has to suffer incontinence. There is treatment and support available.
Kim Vopni is a pelvic floor specialist, popularly known as the Vagina Coach. Kim became passionate about spreading information on pelvic health after the birth of her first child. She is a self-professed Kegel maven, and a certified fitness trainer specializing in the pre- and post-natal stages, perimenopause and menopause. She is a women’s health educator and speaker, an author, and the founder of Pelvienne Wellness Inc. Kim is also the creator of Kegels & Cocktails, health events designed to empower and educate women on the importance of pelvic health. Kim strives to normalize discussions about vaginas, Kegels and menopause—especially when her teenage sons are in ear shot. Learn more at www.vaginacoach.com and follow @vaginacoach.
