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What Women Should Know About Their Pelvic Floor as They Age

As women age, we experience numerous changes throughout our bodies. With hormones beginning to fluctuate, decreasing estrogen levels and muscles that aren’t as active as they once were, we are sent on a path to navigate our bodies once again.

As part of these changes to the overall body, come changes to the pelvic floor. Specifically, hormonal changes which cause the pelvic floor to weaken and often lead to connective tissues becoming rigid and offering less support.

In fact, close to 30% of women will develop a pelvic floor disorder as they age, which is why it becomes increasingly important for women to be on the lookout for symptoms that could indicate larger issues and know how to manage these conditions. 

What Are Some Symptoms You Should Be Aware of?

There are several signs women can closely monitor which serve as good indicators that it’s time to visit a pelvic floor specialist for an evaluation.

The first and most obvious symptom is incontinence, where you’re unable to control your bladder when active, causing unexpected leakage. Incontinence is also paired with the urgency to urinate and inability to hold in your bowel movements until you get to a restroom, which is another type of incontinence common among older women. 

Although common, incontinence is not normal and can have numerous causes, including vaginal infections or irritation, UTIs and constipation. However, in older women, incontinence most likely occurs due to weakened bladder muscles, weak pelvic floor muscles, damage from diseases that control the bladder, such as diabetes and multiple sclerosis, and even diseases that make it hard to get to the bathroom in time, like arthritis. 

Women can also suffer from what’s called pelvic organ prolapse, which occurs when organs including the bladder, rectum, vagina or uterus are not properly supported and sit lower than they normally should. If not treated, any of these organs can show outside of the vaginal opening. If a woman lives past the age of 80, she will have an 11% chance of needing an operation for this condition. 

Pain is another symptom that can be an indicator of pelvic floor dysfunction. It’s important for women to look out for pelvic pain or rectal pain, which can oftentimes be mistaken for bladder pain.

Lower back pain is also not to be overlooked as pelvic floor muscles also work to support the spine and pelvis. When these muscles are strained, chances of lower back pain increase. Painful intercourse and any other signs of sexual dysfunction are another red flag that you should get your pelvic floor checked out. 

What Should You Do to Maintain Good Urological Health?

There are many ways women can maintain good urological health, especially as they age.

Water Intake

Something as simple as drinking water regularly has proven to be extremely beneficial to your urological health as it prevents urinary tract infections (UTI’s) and other irritations in the urethra. However, the amount of water you drink is key.

Typically, it’s recommended to drink half your body weight in ounces every day in order to truly improve your urological health. Further, drinking the correct amount throughout the day is very important, in that you should be spreading your water intake throughout the day and avoid drinking water at least two hours before your bedtime. 


In addition to drinking enough water, your bladder health also greatly relies on your diet. The types of foods and liquids you consume daily is a key component in how your bladder functions and may even increase your risk of incontinence.

Consuming too much of a specific type of food/liquid can cause bladder irritation, leading the bladder to spasm and creating a strong urge to go.

In order to prevent these instances of incontinence, it’s important to limit your intake of coffee (both caffeinated and decaf), tea, carbonated beverages, alcohol, citrus fruits (grapefruit, lemon, limes, orange), tomato based products (yes, even ketchup), and certain spices.


Exercise is another important part of maintaining a strong pelvic floor. There are exercises you can do on your own in order to strengthen your pelvic floor muscles like Kegels and bridges, which are known to help strengthen your pelvic floor muscles.

However, sometimes these at-home exercises aren’t enough and seeing a pelvic floor therapist becomes necessary to improve pelvic floor function. Unlike an OBGYN, pelvic floor therapists specialize in caring for the muscles in the pelvis and have an in-depth understanding of how the pelvic floor operates.

Through repeat sessions, they will be able to provide specific treatment plans that will target any pelvic floor issues you may be experiencing, which can range from muscle/connective tissue tension, weakness, poor habits and/or scar tissue to name a few.

Hormone Therapy

Vulvovaginal hormone therapy is an additional way women can improve their urological health. There are hormone receptors in the lower urinary tract and applying localized hormone therapy can greatly improve the microbiome of the genitourinary system, balancing the pH and therefore minimizing the risk of urinary and vulvovaginal infections.

The Golden Rule

Lastly, the golden rule – if you have to go, go! Holding it in for a prolonged amount of time when you have to go to the bathroom can cause serious cases of UTI’s, kidney failure and bladder muscle weakness which can ultimately lead to incontinence.

Seeing as a healthy bladder can hold 400 to 500 mL before voiding on itself, it’s important to feel the need to urinate at least 2-3 times a day – any more or any less can indicate an issue, whether it be dehydration or an overactive bladder.

Maintenance Is Key!

Aging is a normal part of life and comes with many expected changes to the body. It also means paying attention to your body more so than when you were younger, and for women, that means paying attention to their pelvic floor and urological health.

By looking out for the various symptoms listed above and using best practices to maintain good urological health, you can avoid and even treat changes that may occur to your pelvic floor.

Have you experienced any symptoms of incontinence? Have you seen a professional and what was their advice? How do you manage your symptoms on a daily basis? Let’s have a conversation!

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The Author

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF is a Medical Advisor to Aeroflow Urology. She is a provider of comprehensive sexual and reproductive health, basic urologic care, and gynecological care for Western North Carolina and the Southeast and has opened up her own private practice in June 2020, Fosnight Center for Sexual Health, in Asheville, NC.

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