Written by the Smart Solutions Education Team

Although we pay them scant attention, pelvic floor muscles play an active role in pregnancy, birth, optimal bladder and bowel function – and for sexual pleasure. In other words, the pelvic floor muscles are critical for a woman’s physical, social, and sexual well-being from puberty to menopause.

What are pelvic floor muscles?

The pelvic floor muscles are like a hammock of muscle and tissues that stretch from the tailbone to the pubic bone.  The vagina, the urethra (urine tube) and the rectum (back passage) all pass through this structure. Healthy pelvic floor muscles help to support and control the bladder, uterus and bowel.

Pelvic floor problems

Issues with pelvic floor muscles include constipation, pressure or pain in the pelvic region or rectum, discomfort during sexual intercourse, as well as urinary, flatus (wind) and fecal incontinence. Genital or pelvic organ prolapse (POP) can also occur, which involves pelvic floor weakening that allows the uterus, urethra, bladder, or rectum to sink into the vagina.

Pelvic floor dysfunction often begins during pregnancy or delivery and impacts approximately one quarter of new mothers. With attentive care, including medical guidance, physiotherapy, pelvic floor exercises and healthful nutrition, many women recover within six months of delivery. Even after full recovery, however, problems can return at menopause. By age 80, 50% of women suffer from some symptoms of pelvic floor dysfunction.

What’s happening?

Researchers have explored why many women experience pelvic floor dysfunction while others do not.  Studies suggest a link between decreased collagen levels with incontinence and POP. Pelvic floor issues often have a genetic component and typically arise from nutritional deficiencies that affect the manufacture, assembly and metabolism of collagen.

Collagen is the most abundant protein in connective tissues and provides strength and structure to bones, muscles, skin, and tendons. Researchers suggest that the excessive stretching of the vaginal wall during pregnancy and delivery may trigger the degradation of collagen and other constituents of the vaginal wall, such as elastin that provides elasticity. One study found that women under age 53 with POP had a 30% lower collagen concentration in the cervix than similarly-aged women without POP.

Pelvic floor symptoms that return at menopause may result from estrogen depletion and the subsequent decrease of collagen production.  In the first five years after menopause, in fact, women lose approximately 30% of skin collagen, and levels continue to decline at 2.1% annually over 20 years. Collagen depletion reveals itself as tiny lines, wrinkles and sagging skin. If you can see these skin changes in the mirror, you can assume that there has been collagen depletion in your other connective tissues!

Diet and exercise

Pelvic floor muscles benefit from exercise throughout your life, and can improve continence, prolapse and sex. Daily, sit comfortably and squeeze the muscles you would use to stop urine flow for several seconds without holding your breath or contracting other muscles. Rest between squeezes, then repeat with back passage muscles.

To help with connective tissue repair and life-time maintenance, be sure to eat adequate amino acids and collagen-rich (animal) foods no matter what your life-stage. Encourage collagen creation by providing key building blocks. Silicon is an essential nutrient for collagen production, but it is difficult to absorb this nutrient from food, herbs and colloidal (gel) supplements. Choose a supplement in orthosilicic acid form, which your body can more easily use to create collagen.

You may also consider taking collagen directly. For example, marine collagen is comprised of enzymatically hydrolyzed collagen tissues of marine fish, including skin, bone and scales.  Marine collagen provides collagen and elastin polypeptides in the ratio that is naturally found in human skin. Be sure your diet includes Vitamin C, which is a necessary co-factor for collagen production. Round out your menu with healthy essential fats to allow for maximum absorption of these vital nutrients. As a bonus, you should see improvements in skin, hair and nail health, too!

If you are pregnant, talk to your health care providers before taking collagen supplements. 

Selected references:

Han, L., Wang, L., Wang, Q., Li, H., & Zang, H. (2014). Association between pelvic organ prolapse and stress urinary incontinence with collagen. Experimental and therapeutic medicine, 7(5), 1337–1341. doi:10.3892/etm.2014.1563

Nygaard I, Barber MD, Burgio KL, et al. (2008). Prevalence of symptomatic pelvic floor disorders in US women. JAMA.300:1311–1316. 

Memon, H. U., & Handa, V. L. (2013). Vaginal childbirth and pelvic floor disorders. Women's health (London, England), 9(3), 265–277. doi:10.2217/whe.13.17

Romano, M., Cacciatore, A., Giordano, R., & La Rosa, B. (2010). Postpartum period: three distinct but continuous phases. Journal of prenatal medicine, 4(2), 22–25.