One afternoon when I was a freshman at Gettysburg College, my roommate closed our dorm door, glared at me nervously, and whispered “I have an embarrassing favor to ask.” This was gonna be good.
After a long pause, she admitted a deep dark secret: She didn’t know her parts of speech—noun, adjective, adverb, that kind of the stuff, the stuff you learn in 5th grade. She wanted me to tutor her without anyone knowing.
Not exactly the juicy tidbit I had expected, but still surprising. Sure, she had made it to college with a huge linguistic gap, but she could obviously write and read and was smart enough to gain admittance, so I didn’t understand why this would be so embarrassing.
I asked her how the grammar oversight had occurred. Her teachers had, well, overlooked it. She hadn’t thought anything of it until she got to college and realized people just casually toss around parts of speech like they are common knowledge.
Is it really common knowledge?
Cut to twelve years later (I have a point, really). A female relative asked for some advice about exercise. As I showed her a simple wall push-up, I added, “Be sure to contract your pelvic floor as you breathe out.” She nodded, then paused, then whispered, “What is my pelvic floor?”
I was stunned. How could she not know? But, of course, how would she know? Especially for her generation, women’s private parts stayed private, even to themselves.
Indeed, many woman make, bake, and birth babies without knowing how many holes they have down there (3 btw). Unlike my college roommate who had suddenly realized she was not in the know, this relative didn’t even know she should know.
Those two incidents have stuck in my head. Gaps in knowledge happen. We can’t know what we aren’t taught.
Say Hello To Your Pelvic Floor
Therefore, say hello to your pelvic floor. It wants to meet you.
Put your hand on your crotch. This is the floor’s bottom. The top is your diaphragm, but we will just focus on the pelvis.
The pelvis is made up of 4 bones—two ilium bones, the sacrum, and the coccyx.
The pelvis contains the bladder, uterus, and rectum. The pelvic floor muscles (along with tendons and ligaments) support these organs. These muscles are really important.
Both the deep and superficial pelvic floor muscles control your urethra and anal sphincters, your rectum muscles, and your vagina (again, the THREE holes are the urethra, vagina, and anus). They span from the pubic bone (in front) to the coccyx (in back) and from side to side.
The superficial muscles create a figure 8, with the center of the 8 in the middle of your perineum (the perineum is the area between your anus and your vulva). The muscles cross over each other and surround the urethra, vagina, and anus.
The deeper muscles (levator ani and coccygeus muscles) are located above the superficial muscles and create a kind of hammock to hold your pelvic organs in place.
All your muscles are important, but the levator ani muscles are extra important in supporting the internal organs. You also want your tendons and ligaments to be doing their jobs.
Consequences of Childbirth
Sometimes childbirth compromises different parts of your pelvic floor, especially if the central tendon in the perineum is not repaired properly after a tear. Indeed, the urogenital hiatus—the junction of the urethra and vagina—is prone to weakness because the insertion of the levator ani muscles creates an indentation.
A look at the organs
The bladder sits at the front of the pelvic bowl, next in line is the uterus, and holding up the rear is the rectum (sorry, couldn’t stop the pun). The rectum rests against the coccyx and the back of the levator ani. The uterus rests against the bladder, and the bladder rests against the vagina. When in the proper position, this connectivity between the organs helps create stability. However, if one organ changes position, the rest can as well.
Pelvic organ prolapse is the “slouching” of one or more of these organs. This can be the case if connective tissue or tendons are compromised during childbirth or if the pelvic floor muscles become too weak.
If you have weak pelvic floor muscles, tight pelvic floor muscles, slouching organs, or compromised support structures, what should you do? You have options. The first step is actually knowing you have a pelvic floor. You can’t fix what you didn’t know you had.
Read Next: Is Your Vagina Falling Out?
Much of the information in this post was adapted from Blandine Calais-Germain’s The Female Pelvis (Seattle, Eastland Press, 2003). You can buy it HERE.