GETTING TO KNOW Your Pelvic Health

Elaine Barry | WOMEN’S HEALTH PHySIO SPECIALIST

Often as women we may go through life dipping in and out of our connection with our pelvic health. It may start with menstruation, continue on through to our sexual health and possibly then into childbearing years. Many women may go through life never really deepening their connection to this part of their body and may only awaken to it as symptoms occur of declining pelvic health, potentially during the peri-menopausal/menopausal years.

Building your awareness and understanding of the basic functions of your pelvic floor, will help grow this connection to your pelvic health that ultimately, could be the missing link in improving the foundation of your basic womanly needs and overall health. 

The Pelvic Floor

A beautiful dome - shaped set of structures which spans out within the bowl of our pelvis, the pelvic floor separates the pelvic cavity above from the perineal region below. The levator ani muscles make up the main body of the pelvic floor,  combining with the coccygeus muscles and deeper hip muscles to contribute to the provide the multiple basic functions functions of the pelvic floor.

⇒ Organ Support

The pelvic floor provides support for our uterus, rectum and bladder as well as other abdominal organs. It is one of the Core Four; making up the floor of our abdominal canister with the abdominals at the front, the diaphragm at the top and the back muscles and gluteals at the back. It is integral with our respiratory system therefore, working in tandem with our diaphragm helping to resist rises in intra-abdominal pressure that occur naturally with functions such as coughing, sneezing, movement and lifting. 

⇒ Sphincteric Control

The support that our pelvic floor provides for our organs leads to a natural closing and opening control of the exit points of our bladder, the urethra, where urine comes out and the bowel, the rectum where faeces comes out. It allows us to expel waste products from the body and should be functioning well enough to prevent leakage but similarly allow us to release with ease. We should be able to go about our daily functions and activities without concern of losing control of our bladder or bowel.

⇒ Sexual & Reproductive Health

Pleasurable and pain-free sexual intercourse is inextricably linked with sensation and mobility of our pelvic floor. We can certainly hold onto trauma and even daily emotional stresses which can be reflected then in our ability to have and enjoy sex. Our sexual hormones particularly oestrogen influence how healthy our vaginal tissue is, the ability of the bladder to process information as it fills with urine and of course our bowel plays a vital role in ridding our body of excess oestrogen. Our pelvic floor plays a vital role in supporting a growing baby, delivering a baby through childbirth. It stretches amazingly during these processes and has the ability to recover and restore remarkably afterwards.

⇒ Lymphatic Drainage

With its natural pumping action is aids fluid and lymphatic drainage within the body and pelvis. 

stay in tune

Regular awareness through observing what is normal for us and then any changes to these normal functions can help us identify if our pelvic health may be beginning to change and possibly coming less than optimal. Even small, consistent changes to our daily habits may bring about symptom relief.

⇒ Vulvar and Vaginal Health
Increased sensitivity, skin changes or unexplained bleeding in the area of the vulva and vagina can be related to a number of general health changes in the body and a good gauge of not only hormonal health but overall health and may be a pointer towards more early detection of more serious complaints. 
Knowing the normal condition of your skin in the vulvar region and normal pattern to discharge and of course bleeding is essential so you can note subtle changes that your body may be going through. Skin irritation, itch and/or painful sensitivity which may be aggravated by relatively normal activities such as washing, wearing certain items of clothing, using a tampon or a menstrual cup and furthermore intimacy is always worth following up with your medical practitioner or pelvic health specialist physiotherapist.

⇒ Urination
Observing our urinary habits such as frequency. Six to eight times a day is ideal although this may vary with fluid intake. Irritants such as caffeinated drinks may interrupt the natural frequency of urine output and contribute to overactive bladder. The bladder should be able to hold up to one and a half  to two cups (300-400ml) during the day and at night up to 800ml. This should be reflected in the length of time we can hold our urine (3-4 hours) and how much comes out when we go. If we consistently see an increase in our need to urinate and how urgently we need to go we may need seek help to regulate this.
Leakage of urine bladder can happen in one third of women and this is not isolated to those who have had a baby. It may be associated with an overwhelming urge and not getting to the toilet quickly enough (urge incontinence) or with more dynamic activities like movement, exercise, coughing, sneezing or laughing (stress incontinence). 

⇒ Bowel Motions
Bowel motions certainly can vary between us, but aiming for a daily bowel motion without straining is the ultimate goal to protect our pelvic  floor integrity. Our bowel movements influence how our bladder behaves as these organs are so closely connected within the pelvic cavity. Chronic strain on the pelvic floor can occur while managing our bowels can lead to other issues of pain and discomfort in this area so getting this right is vital. 

Complaints of leakage of urine and possible wind/ faeces are more common than you think. It is always worth seeking help within the early stages as it is often indicative of underlying weakness or dysfunction of the pelvic floor. Pelvic floor physiotherapists are experts in this area and with a course of pelvic floor awareness training and exercise, research has shown great change possible and often full resolution of symptoms where this line of action is appropriate.

The pelvic floor is an adaptable, dynamic structure working in tandem with our breath and should be mobile like every other muscle. It adapts to the demands of daily living : shortening, tightening and weakening with sedentary living. It stays alive through sexual pleasure, exercise specific to its structures and also with the stretch and other movements we may choose with our exercise routine. Good bladder and bowel habits aswell as breath awareness and stress management all play a vital role in keeping your pelvic floor healthy.

Breathe deep and feel the love |

Your pelvic floor and diaphragm work in tandem with one another. As you breathe in your diaphragm descends and the pelvic floor should be able to lightly descend also. This helps to maintain a normal and functional mobility in the pelvic floor.

⟹ Try a breath awareness sequence such as this:

• Close your eyes, resting in a comfortable position and place one hand on chest, one hand on belly.

• Observe which is moving more

• Draw your awareness to the belly rising and falling

• Now draw attention to the your tailbone. As you breathe in imagine the tailbone floating downwards. As you breathe out, allow it rest back to starting position.

• Now send your attention to your sit bones. Imagine these two bones spreading away from one another, creating space across the pelvic bowl and pelvic floor.

• Finally come to rest awareness at the back passage opening, the anus. As you breathe in feel this area open, maybe visualising a flower in your minds eye. Don’t force or strain.

• Repeat each of these steps up to 10 times.

• Feel more relaxed in your pelvic region.

Respecting your pelvic health:

Growing your awareness, knowledge and attention to this area has the power to really change how we feel as women, drastically change our quality of life and really empower us. Start now by getting to know your body parts inside and out. Know how to name them, find them, where they are and how to use them to your benefit. Becoming atuned to any small shifts or changes and in particular catching them early will ultimately lead to better future health. Try not to ignore or put up with discomfort, pain, itch, dryness, leakage of any kind or a bladder or bowel that seems to rule your life. Like anything in our health repertoire its about being proactive and your pelvic health deserves this as much as any other part of your body.

- ELAINE BARRY | WOMEN’S HEALTH PHYSIO SPECIALIST

BOOSTING YOUR LIBIDO with Chinese medicine

Chinese Medicine & Low Libido

Defining sexual dysfunction is tricky, because we are all individual and have different feelings and expectations regarding what’s ‘normal’ for us, ranging from being highly sexual to rarely interested. However, issues may occur when your own level of sexual interest and function changes, or isn’t aligned with that of your partner. To a certain extent, it’s normal for sexual desire to wax and wane and a low sex drive is often the result of major life changes such as illness, having a baby, menopause or ironically from the pressure of trying to have a baby. When the solution is pills for men, an anti-depressant or injection for women, all with side effects, lets look at a more natural approach, that, yes, will take more time, but it will be so worth it with long lasting results.

In traditional Chinese medicine (TCM), low libido and poor sexual function are often seen as an imbalance of Yin (female energies) and Yang (male energies)

In particular, as they relate to the Kidney organ-meridian system (which in TCM includes not only the kidneys themselves, but also the sexual organs and hormones). When the functioning of the Kidney organ-meridian, Kidney Yin and Kidney Yang are healthy and in balance, sexual vitality and performance are also likely to be strong. However, deficiency of Kidney Yang may dampen sex drive, and low levels of Kidney Yin may decrease stamina and performance (even if the desire for sex remains). Kidney Yin and Kidney Yang perpetually influence each other. All imbalances have different diagnoses in Chinese medicine and are treated with different combinations of herbs and regular acupuncture treatments.

SO WHAT CAN WE DO:

1. Movement

Women can often hold tension and repressed emotions in the pelvic area which can lead to stagnant sexual desire. Repressed emotions don’t disappear, instead, they reveal themselves in unhealthy ways and disrupt harmony in the body. The liver, in Chinese medicine, is believed to play the primary role in regulating and ventilating the flow of qi, blood, and fluids in the body's circulatory systems. The liver meridians regulate the menstrual cycle and circulate blood and hormones to and from the the uterus, ovaries, and sex organs. The Chinese medicine mindful movement Qi Gong, is an amazing movement to bring into your daily routine as there are many styles of qigong that are specifically targeted for circulation in these channels and to get the energy moving. It can help you restore your libido if you practise regularly. This qigong style is unique in that the sexual qi is quickly charged as you do the exercises, which involve shaking and vibrating the sexual organs. If your low libido comes from a place of deficiency rather than stagnation, there are numerous routines and sequences to slowly start building back up your energy and therefore build back up your sexual energy and desire. Overtraining your body can result in depleting already depleted reserves.

2. nourishing nutrition

Healthy sexuality depends on the healthy energy that you put into it, so all the attention we pay to sexuality revolves around good management of Qi (energy). You can’t put pour from an empty cup. In Chinese medicine when we look at treating low libido, we look at nutrition that will strengthen our kidney energy. This is where the real long term solutions come into play. Foods that strengthen kidney yin are red dates, black sesame seeds, seaweed, grains like barley & millet, walnuts, black beans, kidney beans, and veggies like string bean, sweet potato, tomato, water chestnut, yam, zucchini.

Herbs:
Maca is a root plant native to South America that is said to nourish the endocrine glands which produce and release sex hormones, so improving vaginal sensitivity as well as stimulating the hypothalamus, pituitary and adrenal glands, which in turn support and balance hormones and so boost flagging desire. Add a teaspoonful of the powder to a smoothie or hot drink daily.
If depression and fatigue are responsible for low libido, tonic herbs like ginseng and ashwagandha help build stamina and energy, regulate metabolic rate and protect against mental and emotional stress.

There are also some foods that are known as natural aphrodisiacs. Figs, bananas and avocados are considered libido-boosting and also provide important vitamins and minerals that can increase blood flow to the genitals and promote a health sex life.

As a general rule eat ‘food of love’ - A vibrant, energising, balanced diet plays a major role in delivering the same benefits in the bedroom, while heavy, fatty foods will make you feel sluggish. We all know that food affects your mood, behaviours and most importantly your relationship and sex drive.

3. Treatments

Acupuncture |

Acupuncture is increasingly an applied treatment for numerous sexual health conditions, it has become a popular, natural treatment for improving libido without side effects. Taking a whole body approach to issues like low libido, acupuncturists understand that challenges with libido can be an indication of a deeper, underlying issue. Acupuncture works to restore optimal health rather than suppressing or masking a particular symptom and essentially encouraging your body to do its normal job and functioning - equilibrium.

Acupuncture increases your sex drive by:

• Improving circulation - Acupuncture promotes blood flow along the pathways that surround the reproductive and other organs that affect sex drive

• Balancing hormones—Acupuncture helps stimulate hormonal glands

• Relieving stress—Acupuncture can restore emotional balance and help you relax

• Your practitioner can also work with you on a range of individual dietary and lifestyle choices that may be preventing your body from being in its optimal sexual health status

Herbal Medicine |

Herbal medicine can be a wonderful way to support your body as your herbalist can combine herbs to make formulas and tonics specific to your individual needs. For example, formulas can be created to nourish your blood in combination with herbs to improve circulation which is vital for hormonal and sexual health. For women, herbs that help to regulate the menstrual cycle and support healthy female reproductive function include white Peony root and Dong Quai.

Tao Hong Si Wu Tang is a popular blood nourishing formula. They are often taken with female reproductive tonics traditionally used to tone and preserve the Yin (such as Rehmannia, Chinese Licorice and Ginger) and promote the flow of Qi (energy) and Blood to the ovaries, uterus and pelvis (such as tangkuei and Chinese Angelica root). Chinese medicine has a long tradition of using safe, gentle aphrodisiacs and may be all you need to get your sex life back on track.

At-Home Acupressure |

Acupressure can be a really lovely way to stimulate circulatory points but to also connect with your partner with touch. Touching is a powerful thing, especially in areas that relate to a holistic view of your partner and research shows that the act of physically touching your partner helps create intimacy and relieve stress. So get your favourite oils ready.

• Give a foot massage & incorporate these points

KIDNEY 1
On the sole, in the depression when the foot is in plantar flexion, approximately at the anterior third and the posterior two thirds of the line from the web between the 2nd and 3rd toes to the back of the heel.

SPLEEN 4
On the medial/inside aspect of the foot, in the depression distal and inferior to the base of the first metatarsal bone.

Gently massage Kidney 1 (KI1) and Spleen 4 (SP4), which are both located on the feet. These are considered very powerful points for balancing the subtle energies in the body while simultaneously promoting an increase in blood flow to the core of the body. Both of these points are directly and intimately connected to both the male and female reproductive organs. A foot massage will also give a quick boost of circulation and warmth to the feet, Chinese medicine maintains that cold feet means poor circulation and poor circulation makes it harder to orgasm. This may also give you a pass to continue wearing socks during sex!!

• Massage Stomach 30

Level with the superior edge of the pubic bone, 2 cun (roughly 2 finger- breaths) lateral to the mid-line. It can also be found halfway from the midline to the lateral border of the rectus abdominis muscle at that level. Stomach 30 (ST30) is right near a main artery, which again, helps to increase blood flow in the body. Slowly press on this pressure point for a few seconds, hold, and release.

4. Self Care

Join Forces |
In ancient Chinese medicine philosophy, yin and yang (night/day, hot/cold) is a concept of dualism, describing how seemingly opposite or contrary forces may actually be complementary, interconnected, and interdependent in the natural world, and how they may give rise to each other as they interrelate to one another. These interactions require a mutual interdependence and connection. Poor sexual health and low libido can often have roots in a lack of connection with your partner. This can happen for a variety of reasons, lack of time, stress, busy schedules with children etc. Make time for date night or allow space where intimacy and connection can happen.
From a Chinese medicine perspective, sex, in the context of a supportive relationship, is important. The Taoist sages would say that having sex connects us energetically to our partners. This is known as He Qi, which literally means “joining energy.” It refers to the way that in a good sexual relationship, both partners contribute energy to each other. By doing this, the Taoists believed that it was possible to use sex to increase lifespan and heal the body.

Sleep & Time |
Many of us have a hectic lifestyle that can lead to sleep deprivation. Being busy also makes it difficult to make time for sex and intimacy. People who balance work with caring for aging parents or young children are often left exhausted, which can lead to a reduced sex drive. It is like during from an empty cup. At times we all need to reflect where we can cut down on unnecessary stress or rushing around. Try and prioritise what needs to be done in the week, you may have more time than you think on your hands.

Stress Management |
No matter how healthy you are, being stressed out can affect your sex drive and decrease your kidney Qi (energy). Women are particularly susceptible to the effects that stress can have on one’s sex life, according to research. Try to manage the stress in your life with rituals and practices that resonate with you, such as mindful movement (yoga, Qi Gong), meditation, time for you. This also allows time for connection with yourself, as if this is lost than connection with others can be hard.

The Golden healthcare system for 2021

COVID-19 has cast a pitiless spotlight on the importance of preventative lifestyle approaches, and how our future health will depend on a new alignment between wellness and healthcare. In the past, these health models have been seen as two separate areas of health and well-being. Western healthcare standing as the clinical, cold face of sick based medicine and wellness as the warmer, very often trend led daily healthcare. So does this mean, finally, an exciting movement towards the convergence of healthcare and wellness.

At the Global Wellness Summit, 2020, experts discussed how the pandemic has provided painful, incontrovertible evidence that “we need to shift our healthcare system away from profiting from sickness and gear it towards preventing it” – forecasting that we will see a combination of functional and conventional medicine across community and economic lines, with telemedicine (and tele-wellness) playing a much bigger role. So, perhaps 2021 will be the year we start to shift the language and the focus of medicines towards an empowered preventative approach to healthcare.

Moving towards an Empowered Lifestyle Medicine:

Aaron Antonovsky, a professor of medical sociology, theories reject the "traditional medical-model division of separating health and illness". He described the relationship as a continuous variable, what he called the "health-ease versus dis-ease continuum. He coined the term Salutogenesis, which is a medical approach focusing on factors that support human health and well-being, rather than on factors that cause disease (pathogenesis). The word "salutogenesis" comes from the Latin salus = health and the Greek genesis = origin. Antonovsky developed the term from his studies of "how people manage stress and stay well". More specifically, the "salutogenic model" is concerned with the relationship between health, stress, and coping. In his 1979 book, Health, Stress and Coping, Antonovsky described a variety of influences that led him to the question of how people survive, adapt, and overcome in the face of even the most punishing life-stress experiences. Therefore, a shift in attention to the attributes or behaviours that support us through inevitable stresses rather than the treatment of the end result of stress - disease. Considering scientists have started to track that 95% of most illness are derived from stress, this appears a sensible empowering move.

An Empowered Structure for Lifestyle Medicine

When myself and Emilia set up Escapada, we had one absolute focus and passion, it is within your ability to create your own empowered natural toolbox that will support you throughout your life. We both come from a strong background of Western medicine and have the utmost respect for its diagnostics and acute medicine. But at the risk of becoming painfully repetitive, the gold lies in the integration of Western medicine and natural medicine, and the greatest gold lies in the concept that your daily lifestyle is your medicine.

Bruce Lipton, developmental biologist, whose pioneering research on cloned human stem cells presaged today’s revolutionary new field of epigenetics. Epigenetics is a new type of science that is growing in popularity and promise in the scientific world. It is the study of cellular and physiological traits, or the external and environmental factors, that turn our genes on and off, and in turn, define how our cells actually read those genes. So effectively the interplay of our bodies and imbalances, and the influence of external environment and more importantly lifestyle factors. So slowly but surely, science has started to track and provide a scientific language for the long standing health sciences and philosophies of Chinese Medicine and Ayurveda. The further we move forward with our careers, the more we gain respect for the long standing and solid nature of Chinese Medicine and Ayurveda. They don’t chop and change information, they live on solid principles and when adopted give individuals a life long individualised health and self care system with a preventative approach at its core.

moving Forward:

Let us make 2021 the year we start to reframe how we talk about health, how we think about health and start having meaningful conversations moving away from a sick based healthcare model to an empowered preventative healthcare model. Examine as individuals how we view our health, what it means to you and how empowered do you feel and trust that you can make informed decisions in times of imbalance. We urge you to feel empowered in starting to build your own empowered individualised healthcare system. We invite you to start using lifestyle and natural medicine as a first port of call, and only when needed, Western medicine. Start inviting other methods of treating imbalance into your life, for example, use acupuncture instead of antibiotics for your sinusitis, get your seasonal tune ups, adjust your eating habits as we move through the year.

Girr, at the Global Wellness Summit, predicted that while healthcare has been quite sterile, and “wellness has become the cool kid on the block,” that the future is an unprecedented convergence, where innovative, new models that bring health and wellness together symbiotically “becoming the global cultural north star.” She argued that new integrations will give healthcare the pleasurable, aspirational qualities of wellness while wellness will increasingly get the science-backed credibility of the medical industry–and the players and brands that execute on this (and it’s already happening) will “win big.” Having many years of experience of both medicines, Chinese medicine and Ayurveda have been winning big for many, many years, we are just waking up to it.

We hope you enjoy and feel empowered, as we continue to bring you the wisdom but simplicity of Chinese Medicine and Ayurveda, it is the sum of all of these small adjustments that bring you the biggest strength and resilience.