Holistic Pelvic Care

Secrets to Improving Pelvic Health at Any Age by Dr. Anna Cabeca

As a gynecologist I talk to thousands of women about the health of their lady parts. In particular, I talk about the importance of prevention relating to women’s vaginal health concerns. Today I want to focus on what you should know about your pelvic health. This is also something men should think about, by the way, as their pelvic health is important as well.

Pelvic health is important to all women physically, mentally and sexually

Pelvic health is important to all women physically, mentally and sexually

Pelvic health is important starting in your 20’s

I’m guessing some of the younger women out there are about to click off the page as they are likely thinking, “I’m too young to worry about my pelvic health. That sounds like an older woman’s problem to me!”

But you’d be wrong! Pelvic health is important at any age. Women should be thinking about their pelvic muscles starting in their 20’s as that is when several key hormones like estrogen and DHEA actually start to decline. And if you’ve had a pregnancy you’ve already put some wear and tear on your pelvic muscles and should be exercising them to help them recover.

Lifestyle considerations can add to your risk for pelvic health issues

There are a lot of additional lifestyle considerations that can impact your pelvic health at any age. Poor posture or even sitting all day long at work every day can impact your pelvic muscles. 

If you are overweight, all that weight pushes down on your abdomen and further exhausts your pelvic floor muscles. If you have diabetes or another chronic disease there can be impact. 
A poor diet, having food intolerances or digestive issues can affect your musculature. Anything that makes you strain can only make the downward stress worse on your pelvic muscles.

As women’s sexual hormones decline further in their 30’s, this starts to affect the muscles and tissues around the pelvic area, vagina, uterus, rectum and bladder. And while initially a woman in her 30’s may not experience any obvious symptoms…the symptoms will typically worsen over time if nothing preventative is done.

By 40, most women will have weakened pelvic muscles

In my experience most women have weakened pelvic muscles starting at age 40.

By this time many women have started to have slight urinary leakage (stress urinary incontinence is the medical term). 

You know what I’m talking about: that tiny bit of uncontrolled pee that happens when you laugh or cough. Or the trickle of urine that occurs every time you exercise. It may be so slight at first you ignore it. And then, maybe you start wearing a thin panty-liner. No problem, right? Just wear a daily panty-liner.

Did you know that it is estimated that 70% of women use period-specific products – such as panty-liners – for incontinence purposes?

And while statistics vary, stress urinary incontinence has been estimated to affect over 50% of women between the ages of 20 to 80 years. Some estimates are even higher. They Mayo Clinic, for example, uses 85% as their estimate.

I hate to tell you but it is likely to get worse if you don’t exercise your pelvic muscles. Not only will the urinary leakage get worse, but as your pelvic muscles weaken, all the organs that those muscles normally help to stay up start to fall down through your vagina, a problem called pelvic prolapse (an issue that can eventually require surgery).

See the graphic? Your pelvic muscles are like a strong sling that holds everything else up. Now imagine that sling slowly falling and weakening.

Your pelvic muscles are like a supportive hammock

Your pelvic muscles are like a supportive hammock

And the issue just isn’t about leaking!

Although I personally think that issue alone makes me want to do my pelvic strengthening exercises faithfully, weak pelvic muscles can also affect your ability to enjoy sexual intimacy.

And the reason for this is two-fold. First, weak pelvic muscles don’t provide as good of blood flow and nerve supply to surrounding tissues (needed for optimal sensation). Exercising these muscles may improve your orgasms!

Weak muscles can cause leaking, a decrease in both sensation and libido

Weak muscles can cause leaking, a decrease in both sensation and libido

Second, if you are leaking…maybe you just won’t feel very sexy. I can tell you there is a lot of recent research that says that weak pelvic muscles, incontinence, and other vaginal symptoms affect us ladies beyond just the physical symptoms! It embarrasses us. It impacts our relationships. It makes us stop doing things we love to do, like bike-riding, jogging, a favorite sport or…even our making love.

But pelvic health isn’t just about sex

Even if you aren’t having sex your pelvic health is vital to you not developing severe incontinence issues and/or needing to have surgery due to pelvic prolapse.

The number one reason older women end up in a convalescent home is that they have incontinence. So it really is an issue that spans a woman’s entire life.

So what’s a woman to do? 

First, relax when sitting on the toilet!

Yes, it’s true. So many of us are in too great of hurry, so what do we do? We try and force out the pee or poop as we really need to get back to the kids or work. Think about it, when was the last time you really relaxed while on the toilet? It makes a difference. All of the forcing and pushing further stretches – and stresses - your pelvic muscles.

Second, try to be more aware of your pelvic muscles. It is likely you never think about them (until you start to tinkle more and more). Once they have your attention, the best exercise for them is something called Kegels. You’ve probably heard of them, but I have found most women don’t do them regularly. And for those that do, many do them incorrectly!

Here’s how to do the perfect Kegel for the best results.

It is easy to do the perfect Kegel

It is easy to do the perfect Kegel

In this short video you will learn how to do Kegel exercises as well as how to test to see if you are doing them properly. There are 3 simple steps.

Pay particular attention to the breathing! When we cough and laugh we do those things on the exhale…so it is important that we are able to contract (and keep that pee in) on the exhale as well.

Step 1: Focusing on the area between your vagina and anus (called the perineal body), pull up on the exhale. Contract those pelvic floor muscles.

Step 2: Hold this contraction for a count of three. Then relax. You’ll eventually want to increase this count, up to eight.

Step 3: While you are holding this contraction, try and breathe normally and relax.

These steps should be repeated. Do three sets of eight lifts, three to five times per week.

And by the way, men can do Kegels, too!

Do you have hyperactive muscles? A small number of women have the opposite issue of pelvic floor muscle weakness; they may have tense or hyperactive muscles. You can discuss your own pelvic health status with your doctor or there is a self-test you can do. 

Try and stop your urine midstream when you are peeing. If you can’t stop your urine stream, your pelvic floor muscles are likely not as strong as they should be. This isn’t a test you should repeat too often (and definitely don’t do this as an exercise routine!). Just do it to initially self-test yourself… and maybe repeat in a month if you implement Kegels. And then do the self-test infrequently after that.

A feminine cream containing DHEA may also help

DHEA is a natural hormone in our body that is important to the integrity of skin, muscle, and bone and also has a role in maintaining libido. Like other hormones it decreases over time beginning in a woman’s 30’s. Many people take oral DHEA to improve energy level and mental alertness, but here I am talking about a cream that is applied topically around the vulva.

DHEA applied locally at the vagina can improve the musculature of the deeper layers of the vagina (decreasing symptoms of urinary leakage and pelvic prolapse), as well as improving vaginal dryness and irritation, vaginal and vulva discomfort, and even libido.

That’s why I used DHEA in my new feminine restorative cream, Julva®

You can get a free 7-night trial of Julva here, just pay $4.95 shipping and handling. 

For international shipping, there's this special link for International Julva trial packs. It runs about $13-18 for USPS first class, it just takes awhile to get there. 

So no matter what your age, take care of your important pelvic muscles! And share this information with all of the ladies in your life.


Found this interesting?

Dr. Anna Cabeca is an Emory University trained and board certified Gynecologist and Obstetrician.  In addition, she is board certified in Anti-Aging and Regenerative Medicine and an expert in Functional Medicine and Women’s Health.  She specializes in bioidentical hormone replacement therapy and natural alternatives, successful menopause and age management medicine.  

Dr. Cabeca is the creator of the highly acclaimed virtual transformational programs: WomensRestorativeHealth.com, SexualCPR.com, and MagicMenopause.com. She is also the creator of the superfoods drink Mighty Maca™ and the new feminine anti-aging cream, Julva™.

Dr. Cabeca is passionate about supporting women (and the men that love them) in creating health and hormone balance for themselves as well as many generations to come.

To connect with her:


Addressing Pelvic Pain and Infertility with Dr. Jennifer Mercier

Dr. Jennifer Mercier is a triple threat: naturopath, massage therapist and midwife.  I kind of fall in love with her work on the episode, as you'll hear!  

It was Jennifer's own experience with stage 4 endometriosis, coupled with her medical training, that helped her develop the Mercier Therapy.

Mercier Therapy is her own system of abdominal therapy that works with the ligaments and organs to move them into alignment with the goals of restoring function and /or reducing pain.

For women, it can help us have a smoother cycle, recover from surgeries, improve our fertility and heal trauma.

I find so many have strange sensations in their abdomens that they worry about. And many have complications form C section or even a natural birth, and feel there are no options to heal.  Still other have unexplained infertility, that can potentially respond to a new approach.

Jennifer works locally in St. Charles, IL, but also trains practitioners in other states and countries.  That means if this type of work speaks to you, you may be able to fidn a practitioner in your area.  And if you are practitioner, training is available.  

Her clinic

Her training program

Find a practitioner

The Mercier Movie

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