How to do pelvic floor exercises after hysterectomy?

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Want to know how to do pelvic floor exercises after hysterectomy? After a hysterectomy, protecting your pelvic floor muscles is especially important as they hold your pelvic organs securely in place. 

A hysterectomy can increase your risk of weakened pelvic floor muscles and prolapse. Why does this happen? 

pelvic floor exercises after hysterectomy
  1. The descending uterine artery supplies the uterosacral ligaments(the hammock-like structures supporting internal pelvic organs). Cutting this blood supply during a hysterectomy may cause atrophy and weakening of these ligaments. 
  2. It is not rare for tissue and nerve damage to happen when they separate these muscles during the procedure.
  3. A space is created by removing the uterus and cervix, which the other pelvic organs can sag into.
  4. Moreover, if they remove the ovaries, you will also undergo a hormonal change and experience the first signs of menopause. The loss of estrogen will bring about a gradual weakening of your pelvic floor muscles. 

And what happens when pelvic floor muscles weaken? When these muscles lose their strength, you may experience problems associated with bowel or bladder function.

For one, you may get a prolapse when one or more organs drop from their normal position or press on another organ. This can happen when the bladder descends from its normal position and pushes against the urethra. As a result, you may experience stress urinary incontinence, and specific activities like coughing, running, or sneezing make you lose urine unintentionally

How soon can one start pelvic floor exercises after hysterectomy?

When you have approval from your surgeon, you can slowly start exercising these muscles. Usually, this is after they take out the catheter, and you can urinate independently. Always begin with what feels comfortable and then steadily increase to at least three times a day.

It would help if you practiced quick contractions together with more prolonged contractions:

  • Quick contractions are when you squeeze your pelvic floor muscles for a second and then rest.
  • Prolonged contractions are when you squeeze your pelvic floor muscles, keep them tight for several seconds, and then rest.

How do you locate the pelvic floor muscles? Imagine that you need to hold your urine or hold yourself from passing wind. A note of warning: doing this exercise on the toilet and stopping your urine flow is not a good idea. It is something that may affect your bladder function in the long run. Another way to locate these muscles is by putting a finger in the vagina and tightening the muscles. When done correctly, you should feel it squeeze around your finger.

How to strengthen my pelvic floor after a hysterectomy?

Pelvic floor exercises, also named Kegels, can strengthen your muscles and help prevent different types of prolapse after hysterectomy. They are not exercises you only do during the recovery period of a hysterectomy. It should be a daily exercise routine for the rest of your life. Many women find it tough to do these exercises faithfully every day. But you can combine it with other daily habits like while in the shower or doing them when you do the dishes. Or, when you already have another daily exercise, include some Kegel exercises in this routine.

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How to do Kegel exercises?

  • In the beginning, when the pelvic muscles are weak, it may be easier to do them lying down as it is easier to activate these muscles more effectively. 
  • To separate the muscles, begin to squeeze the muscles around your anus. Then proceed to squeeze the ones around the vagina and urethra. Hold them tight as if you want to hold something in your vagina. Try not to tighten your buttocks at the same time. You’ll want to hold it for two seconds, then release and relax for two seconds. Repeat this ten times if you can.
  • Build this up to the point where you can hold those muscles tightened for 3 to 8 seconds, or longer if possible. And then relax for 8 seconds. When you feel your muscles get stronger, try to do three sets a day. Keep repeating this process, contract and lift and then loosen. 
  •  You must rest entirely between every contraction and not hold your breath. Relax your muscles as long or longer as you squeeze them.
  • When you already have some issues with light bladder leakage after your hysterectomy, try to squeeze for two seconds each time you feel the need to sneeze, laugh, or cough. 

Benefits of pelvic floor exercise after hysterectomy

Even if you had a hysterectomy several years ago, it is never too late to start with pelvic floor exercises. Here are the benefits of doing daily Kegel exercises following your hysterectomy.

  • It gives better bladder control and can considerably reduce incontinence
  • Increases blood flow to the pelvic organs
  • Improves vaginal health
  • Enhances sexual satisfaction

How to protect your pelvic floor?

The infographic below shows you what to do to prevent pelvic floor muscle damage and how to keep those muscles strong and healthy.

how to protect your pelvic floor

Reminder apps and toner devices can be effective

Despite all your good intentions to begin pelvic floor exercises, it’s easy to forget to do them or not do them correctly. So a lot of women like to get some help with that.

You can find several apps that remind and show women how to do pelvic floor muscles exercises. For instance, the NHS pelvic floor exercises app with a very suitable name: Squeezy. It is easy to use, discreet, and features guides to assist your exercise program, and records how many exercises you have completed. Check out the preview of how the Squeezy app works.

Women can also use pelvic muscle toners. These are devices that can help with strengthening their muscles.

Pelvic floor toners come in several different types.

kegel exercise balls

For one, you have the Kegel balls, which have been around for centuries to increase the strength of the pelvic floor muscles. They usually sell them in sets with a few balls of different weights and sizes to slowly build up your muscle strength with ease.

How does it work? You have to insert a vaginal cone which you need to hold in place by squeezing the pelvic floor muscles. Beware, keeping them in for too long can produce muscle tension rather than sort out the issue.

Brands to try out: 1). Adorime Kegel Exercise Weights 2). Bodyotics Delux Kegel Weights 3). Intimate Rose Kegel Exercise Weights

Electronic pelvic floor toners are modern devices that assist in toning the pelvic muscles. Does a machine that uses vibration to tone the pelvic floor truly work? In terms of home devices, there is little research. Still, a 2011 review found that women who received verbal cues or biofeedback for their pelvic floor exercises experienced significantly better results than those who did Kegels without it.

Women with weak pelvic floor muscles who find it challenging to locate and tighten them correctly can benefit from electrical stimulation. You may sense a tingling around the vaginal muscle area when using electrical stimulation, but it should never be painful. 

Generally, these devices connect via Bluetooth to an App on your phone. They have a program that delivers gentle electrostimulation for different lengths of time. What’s more, it lets you track your progress. 

Brands to try out: 1). Elvie Award Winning Smart Kegel Trainer 2). Yarlap Kegel Trainer 3). K Goal Kegel Exerciser

Whether you need assistance reminding you to do the exercises or reassurance you’re doing the exercises right and effectively, some of these pelvic floor trainers could be beneficial to you.

In a nutshell

With pelvic floor exercises after a hysterectomy, you can help support your internal organs, ensure your bladder and bowel work properly and keep your risk of prolapsing to a minimum.

After a hysterectomy, those muscles may be feeble, and exercising the pelvic floor muscles can be particularly tough. Don’t be disheartened. You will inevitably start seeing the results by taking the time to build up your muscle strength. However, when you experience severe issues like pelvic pain and urinary or bowel incontinence, finding a pelvic floor physiotherapist to help rehabilitate your pelvic floor muscles is recommended.


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