Pelvic Floor: What “Strong” Really Means

You’ve likely heard of the pelvic floor, but what do you really know about it? For instance, are you aware that having a weak pelvic floor isn’t the only issue? An overly tight one can cause problems, too. In this episode, we break down what the pelvic floor actually is, why it matters at every stage of life and how it affects more than just childbirth or aging. From bladder control and exercise to pain, prevention and simple daily habits, it’s time to demystify this commonly overlooked, but critically important, part of the body. 

Expert: Dr. Danielle Antosh, urogynecologist 

Notable topics covered: 

• Spoiler: The pelvic floor isn’t actually a flat “floor” 
• Why pelvic floor issues aren’t limited to pregnancy, childbirth or aging 
• Everyday activities that rely on the pelvic floor — often without you realizing it 
• How to know if your pelvic floor is healthy and strong 
• The difference between a weak pelvic floor and a tight one 
• Symptoms that may signal a pelvic floor problem, including pain and urine leakage 
• How menopause and aging can impact pelvic floor muscles 
• Practical guidance on Kegels: how to do them correctly — and common mistakes 
• The role of Pilates, yoga and other exercises in pelvic floor strength and flexibility 
• When pelvic floor physical therapy or other treatments may be needed 
• Why early awareness and prevention can make a long‑term difference

If you enjoy these kinds of conversations, be sure to subscribe. And for more topics like this, visit our blog at houstonmethodist.org/blog. 

Transcript

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ZACH MOORE: 0:07

Welcome to On Health with Houston Methodist. I'm Zach Moore, I'm a photographer and editor here, and I'm also a longtime podcaster.

KATIE MCCALLUM: 0:16

I'm Katie McCallum, former researcher turned health writer, mostly writing for our blogs.

ZACH: 0:20

And Katie, what do you know about the pelvic floor?

KATIE: 0:23

I know that I hear about it a lot more commonly these days than I feel like I used to, or that people used to. I do Pilates and basically every Pilates class we talk about the pelvic floor, we talk about doing pelvic tilts and they're always like,"We do these so we can build a strong pelvic floor." That's the beginning and end of everything I know. I know nothing else about it.

ZACH: 0:45

Well, I know we have a pelvis, I know that. And I know that it apparently has a floor. You know, it's one of these areas of your body that it's kind of out of sight, out of mind, right? Because, I mean, you go to the gym for leg day, that makes sense, right? KATIE: Yeah. You go to the gym for pelvic floor day, right? I mean, I don't know, that is kind of maybe why it's not at the top of our minds for exercise and health and that sort of thing.

KATIE: 1:07

Yeah, I mean, I think even those other, you know, quote, unquote "invisible" sort of bodily parts or organs like your heart or your lungs, or your digestive tract, like you know what they do.

ZACH: 1:17

Yeah.

KATIE: 1:18

You have a firm grasp on the importance of these things. ZACH: Yeah. I need my lungs to breathe.

ZACH: 1:23

Mm-hmm.

KATIE: 1:24

It is interesting, like, this thing is being brought up kind of a lot these days. Like, why are we hearing about it more and should we have always been talking about it? Like, where is it exactly? What is it exactly? A lot of questions there, for me.

ZACH: 1:35

A lot of questions, we're gonna get some answers today. And who did we talk to about this, Katie?

KATIE: 1:39

We talked to Dr. Danielle Antosh. She is a Urogynecologist here at Houston Methodist, so she is the perfect person to help us understand our pelvic floor. Thanks for being with us here today, Dr. Antosh.

DR. DANIELLE ANTOSH: 1:50

Thank you for having me.

KATIE: 1:51

I, you know, I think there's a lot of body parts that we have a pretty good grasp on, you know. We know what our heart does, you know, we know what our lungs do. If you asked me to explain the pelvic floor…[Laughing] I would say, "I know I have one," and that's probably all I could tell you. So, we're gonna dive into all that today. We're gonna figure out, you know, what this thing is, why it's important. I did wanna -- before we get started, I'm curious, what's the most common myth or misconception that you hear about pelvic health?

DR. ANTOSH: 2:22

There's quite a few, but I would say in relation to your pelvic floor, there's two common myths or misconceptions I hear a lot about. The first one is that you're only gonna have a pelvic floor issue if you've had vaginal childbirth. That is not true. Women can have a pelvic floor problem or issue if they've had C-sections, and I even see it sometimes in women that have never had a pregnancy or childbirth before. So, I would say all women, potentially, are at risk of having pelvic floor problems or pelvic floor disorders in their lifetime.

KATIE: 2:56

So, we should all be listening.

DR. ANTOSH: 2:57

Definitely. This is very important in my opinion. I mean, I do see this all day every day, but it is a common problem. About one in four women suffer from a pelvic floor issue in their lifetime, and you know, one in five women will have a surgery for either bladder incontinence or prolapse in their lifetime. So extremely common. Very important. And then I would say the other misconception is, or kind of myth, that I hear a lot about and I remember hearing this kind of growing up too is to do a Kegel you should be stopping your urine flow, like when you're peeing. And I would say although that is the correct muscle to Kegel, it's probably not good to do when you're peeing and urinating just because it's interfering with what your bladder's trying to do. KATIE: Okay. So, to just generally not do that.

KATIE: 3:46

Okay.[Laughing] You know, I'm not surprised Kegels have already come up. DR. ANTOSH: Mm-hmm. We're gonna touch on them some more but I think that's the other thing I would say if you asked me to talk about pelvic health would be something about Kegels. DR. ANTOSH: Yes. Can't tell you how to do 'em but I can tell you I've heard about 'em. Okay so, obviously we need to set some foundation here, probably, first. I wanna start with a really simple question -- Well, simple in that it's only a few words, the question is, what is the pelvic floor?

DR. ANTOSH: 4:15

That is a great question, and I would love to show anyone watching a model here if I can grab this.

KATIE: 4:21

Yeah. So, for our listeners, Dr. Antosh actually has a model of the pelvis and we're gonna look at it.

DR. ANTOSH: 4:27

Yes so, everybody has this similar anatomy except for, obviously women, we have different organs inside the pelvis, but everybody has a pelvic bone and a pelvic floor. And so, our pelvis has several pelvic bones that basically support our hips, the rest of our bodies, and these are -- Also, important to the pelvis is the pelvic floor muscles, and that's really what's considered the pelvic floor. So, basically you can see below this is kind of looking to the front of someone's body here and our hips, our hip bones here, this is where our legs would come out and here, you can see below, is part of the pelvic floor. KATIE: That's a lot of muscle. It is a lot of muscle, and it's very important for not only our, you know, control of some of our bodily functions such as bladder and bowel, it's important for other daily activities, but it supports the organs in our pelvis. KATIE: Yeah. It supports the bladder, it supports our rectum, and as you can see from the other side, you know our bladder here, the uterus is here, and then the rectum comes through here. Just opening up the pelvic floor you can see here is the pelvic floor muscles are almost like a bowl of muscles that wrap around these organs in our pelvis and help to support them so they don't fall down and out and be -- also that they function correctly when we need to hold our bladder, when we need to hold our bowels. They're all important for that. So it's a very, you know, big group of muscles, different muscles, that go inside our pelvic bones to support those organs. And specifically for women, as you can see here, there's a vital part to support the bladder, the uterus, and the rectum.

KATIE: 6:18

Okay.

DR. ANTOSH: 6:19

And so that's what the pelvic floor is, it's a group of muscles that help support those organs and also help us with our, you know, bodily functions.

KATIE: 6:30

Is that, you know, I guess -- So, that's super helpful because I would not have thought -- I liked your analogy that it's like a bowl, kind of holding something. I don't -- That's already really helpful. I mean, do we have many muscle groups that are like a bowl like that? Or like a net, or a hammock kind of thing?

DR. ANTOSH: 6:46

It's pretty much a very unique part of our bodies and especially since, you know, we spend a lot of time upright and standing it, with gravity, it's a very important structure.

KATIE: 6:57

Okay.

DR. ANTOSH: 6:58

To help keep things where they should be.

KATIE: 7:00

Okay. Interesting, thank you.

DR. ANTOSH: 7:02

And of course, you know, certain things like childbirth can cause some trauma there or things to change and other things as well.

KATIE: 7:08

Yeah, absolutely. You know, to that end you mentioned it's important with some daily activities. What are kind of, you know, if I'm going about my -- Today's -- you know, if I'm going about my day today, when was I using my pelvic floor that I might not have even realized?

DR. ANTOSH: 7:24

Yeah so, I think, just, some of the really important vital activities that we're not even really thinking we're using them for is when we urinate. So, first of all they're important when they're contracted to hold it in. KATIE: Okay. When it's full you wanna hold it to the bathroom, but also they intentionally relax when you're urinating, also when you have a bowel movement, when you need to hold it to go to the bathroom. So, bladder and bowel control, it's very important. And with our reflexes and our brain telling us,"Okay, now it's okay to do these bodily functions in the bathroom," It's important for those to relax. So those are two very important things. The other, you know, important thing is with sex. So, these muscles are very important for sex and so, really, they're important -- They are very important in the sexual response and also during orgasm to increase pleasure. So it's very important that we have healthy and strong muscles. And it's also just important in just day-to-day activities.

KATIE: 8:27

Right.

DR. ANTOSH: 8:28

Jumping, bending over, when you're exercising, when -- Even your breathing. Your pelvic floor is dynamic, it's moving, it's contracting as your diaphragm moves as well. So even just the act of breathing, your pelvic floor muscles are ready, they're contracting, they're like…

KATIE: 8:45

Like coordinating things?

DR. ANTOSH: 8:46

They're coordinating with your breathing so… KATIE: That's interesting. It's important for breathing, it's important for urination, it's important for bowel movements, it's important for sex, it's important when you're, you know, jumping around and doing exercises that it provides that support. It almost reflexively contracts. So, pretty much almost everything.

KATIE: 9:07

Yeah, I mean, you kind of answered another question I had which was who should care about their pelvic floor health. And I mean, maybe "who" is not the right -- You started off with this myth that you don't really need to care unless you've had a vaginal birth.

DR. ANTOSH: 9:20

Mm-hmm.

KATIE: 9:21

I think generally I've also kind of heard that you really only need to care until later in life or as you mentioned after vaginal birth. You know, it sounds like maybe that's not the case, you've already said that's a myth so I guess I would say is the question, when should someone start caring? Or, how would you answer that? DR. ANTOSH: Yes. I think everyone should be aware of what it is and be actively aware in preventing, maybe, issues down the road. Since, like I said, we're all potentially at risk of these issues later. And you know, there may be certain things like pregnancy and childbirth where you wanna pay even more attention to the pelvic floor, or after childbirth maybe do some extra therapy or exercises. But in my opinion, everybody should know what a pelvic floor muscle exercise is and we should be working out -- working it out like any other important muscle of our body. I know there's a lot out there right now about, you know, strength training, keeping our muscles strong especially as we age. Well, the pelvic floor muscles should be part of that. Okay.

DR. ANTOSH: It's very important. KATIE: 10:24

Yeah. It's, you know, I'm glad you brought it up like that because I wanted to talk about how when I think of strength training, you know, I think my calves, my biceps. Like, those are muscles I can point to and say, like,"Oh, I see this getting bigger." Like, my efforts are working. Or, "Woah, I overdid it in the gym, like, this is what hurts." I think the pelvic floor, it's invisible, well I mean it's -- We can't see it, so it's hard to imagine as much. So, I mean, what tips would you say if someone kind of doesn't even know if their pelvic floor is in, I guess, maybe good shape, is what I would say?

DR. ANTOSH: 10:59

Yes, I mean, so, I guess if you're not actively noticing it, meaning having a pelvic floor problem such as bladder, bowel control issues, or the other problem we sometimes see is pain, vaginal and pelvic pain. KATIE: Okay. Then maybe you do have a healthy pelvic floor, meaning you shouldn't be aware of it functioning all day every day. KATIE: Mm-hmm. If it's a healthy pelvic floor, you're not necessarily gonna feel it as it's contracting and doing these normal things, it's kind of just, part of routine life. KATIE: Yeah. But at the same time, we don't wanna forget about it, right. You still wanna work it out so that it doesn't get weak because -- I don't know if you're gonna get to this, but you know, with one of the big changes in a woman's life in menopause, well what happens to our muscles and our bodies, what those kind of decreasing hormone levels as our muscles or our collagen changes, but our muscles tend to atrophy too, and that includes the muscles of the pelvic floor. These are voluntary muscles, they're not muscles that just will naturally contract on our own. We have to purposely also contract them to keep them strong, like do some strength training with them. KATIE: Yeah. And sometimes natural exercises that we do can do that, but if not you should be doing pelvic floor muscle exercises, or Kegels, Kegels, however you wanna pronounce it. To keep those muscles strong as we age, especially into and after menopause.

KATIE: 12:21

Yeah. I like the proactivity kind of direction we're going here 'cause I'm very, you know, I write about health problems all day so it's very top of mind for me that, you know, the best way to kind of not, perhaps need to read something that I write all day is to, like, get ahead of some of this stuff. So, you've mentioned exercises a few times. I know when I'm in my Pilates class, almost every Pilates class, they say, like,"We're doing something with our pelvic floor," we're titling it or something, and I never quite know if I'm doing it right or things like that. Like, what are these exercises we should be doing? Is it easy to mess 'em up? Is it Kegels? What are those tips you have for someone?

DR. ANTOSH: 12:58

Yeah so, pelvic floor muscle exercises, also known as Kegel exercises, are when basically you purposely draw them in and contract the muscles of your pelvic floor. And there are certain things you can think about to kind of engage those muscles, most commonly is thinking about not peeing, or holding your pee, or your urine. So kind of, it's almost like a lift and a squeeze. And the other thing that might help people to engage their pelvic floor is also thinking about not passing gas. So, if you feel like you're thinking about,"Okay I don't wanna pee and I'm trying to squeeze." If you don't feel those pelvic floor muscles moving, and one way you can tell is just gently, you know, placing your fingers, you know, over your underwear on the outer part to see if you feel, like, a lift there. You can also, if you feel comfortable with it, gently, you know, put your finger just inside the vaginal opening to see if you can feel a squeeze around your finger, because that is the pelvic floor muscles. But, if you're not getting that sense or movement, sometimes thinking about the gas, like trying to hold in gas, can recruit some of those same muscles. And sometimes I feel like people squeeze them a little more effectively, especially when I, you know, check patients and their pelvic floor. Sometimes if I give them that cue, like, I tell them, "Okay, imagine you're walking into, you know, a crowded elevator and you feel like you might accidentally pass gas. So, squeezing those muscles, those are engaging your pelvic floor. KATIE: Okay. And so just that thought of doing that and thinking about that can engage your pelvic floor if you need more, kind of, mental cues to help yourself. And I think the best thing to do is to try to -- And everyone has different, like, strengths and weaknesses of their pelvic floor. Some people may only -- can only hold it for like a second. KATIE: Mm-hmm.'Cause it's so weak. But you wanna try to hold and squeeze for anywhere between 3-10 seconds depending on how long you can hold it.

KATIE: 14:51

Okay.

DR. ANTOSH: 14:52

And then you probably wanna give yourself a little rest to relax for 5-10 seconds. And you wanna try to do 30 to 40 squeezes a day.

KATIE: 14:59

Okay.

DR. ANTOSH: 15:00

It really doesn't take that long to do, it's just a matter of remembering to do it either incorporating it into your, like, daily routine, like,"I'm gonna do it." Some people think, "I'm gonna do it at every stoplight I stop at in the car," or, "When I'm brushing my teeth in the morning." Sometimes multitasking and doing other things at the same time is a little challenging for people that are starting off, so either doing it sitting down or lying in bed trying to squeeze those muscles, or maybe at the end of a workout. Laying on a mat and doing it. The good thing about it is no one can tell that you're doing a pelvic floor muscle exercise. You shouldn't be lifting your buttock off the floor or making a grimacing face or anything, it really is something that you can do anywhere, anytime and no one should be able to tell that you're doing it. So, that's a good thing with it.

KATIE: 15:44

I feel like some of the videos I've seen they kinda want you to, like, tilt… DR. ANTOSH: Mm-hmm. While you're doing that. And maybe, like, your belly is filling with air. So is that none of -- That's not necessarily needed?'Cause when I have tried those sorts of things, it's too much going on and I cannot figure it out.

DR. ANTOSH: 15:59

Yeah, I would just try to focus on the pelvic floor and not think about the other things. Like, it shouldn't be a lot of grimacing or, like, squeezing your buttock muscles, or your ab muscles. Although, some of those muscles may engage a bit. It really, you know, just to focus on the pelvic floor. But, if -- The other thing is if you have difficulty remembering to do that or it's hard for you to do that, I think there's two options. There's certain exercises, you mentioned one of them, Pilates. Pilates and yoga, and actually there was one study on barre. KATIE: Okay. Exercises and classes have been shown to be really good for the pelvic floor and your core pelvic muscles to strengthen them. So, if you feel like, "Hey, I'm not gonna remember to do these every day, like, maybe try to engage in one of those kind of group activities, you know, on a weekly basis to keep your pelvic floor muscles strong. Doing yoga.

KATIE: 16:50

Okay, so I might already be ahead of the curve here if I do Pilates and yoga every week.

DR. ANTOSH: 16:54

Yes, it's great for your pelvic floor.

KATIE: 16:56

Okay.

DR. ANTOSH: 16:56

And the nice thing about Pilates and yoga, it strengthens but it also stretches at the same time. It teaches those muscles to kind of also stretch, which is important, and then strengthen them too.

KATIE: 17:07

So, you know, you mentioned that earlier and I wanted to ask about it, so now seems like a good time. It -- The pelvic floor, you know, needs to tense up and relax, strengthen and stretch, like, what does that mean, I guess? And what is that important for?

DR. ANTOSH: 17:21

Well, I think there are two kind of dysfunctions, opposite ends of the spectrum with your pelvic floor. There are what we most commonly think about when people have pelvic floor, pelvic floor muscle issues are really weak pelvic floors which is more common after childbirth and as we age. But there's also women and men that can have really tight pelvic floors, and that can be a dysfunction too. It can cause pain.

KATIE: 17:44

Okay.

DR. ANTOSH: 17:45

Pain with sex, trouble emptying your bladder and your bowels, constipation. And so, we don't wanna be at far ends of the spectrum on either one of those and, you know, sometimes it's difficult to determine why people have really tight pelvic floors but you do see it more in really strenuous athletes.

KATIE: 18:04

Yeah.

DR. ANTOSH: 18:05

Maybe in someone that has had some pelvic trauma either from, you know, some kind of accident or surgery in the past. Or they have some other type of pain process going on in their abdomen and your pelvic floor muscles just react by getting all tense and tight. That can also cause dysfunction. So, one thing I would say too is that if you're having a lot of pelvic pain and pain with sex, it may not be a good idea to just go do a ton of Kegel exercises. Maybe get checked out by, you know, a specialist first or your, you know, your gynecologist, or even see a pelvic floor physical therapist. We have physical therapists that deal with pelvic floor issues too, if you are having any of those problems.

KATIE: 18:48

Okay. Yeah, I think, you know, I think we'd need probably a whole episode on -- to go through the different pelvic health conditions and treatments and things, but could you give us sort of a broad umbrella overview of, you know, what are, kind of the symptoms when something's going, you know? If a listener right now is like,"Oh hey, I see myself in this conversation." Like, what should be that sign that, "Hey, it's time to come in" and here's the list of things that we might wanna rule out?

DR. ANTOSH: 19:17

So, again, the two main dysfunctions: having a very weak pelvic floor or having a very tight, too tight, non-relaxing pelvic floor. And so, if it's very weak, women may start experiencing, and men, difficulty with their bladder control. So you might start seeing some incontinence. Urinary leakage with cough, laugh, sneeze, exercise. Sometimes more of an overactive bladder in terms of, like, "I can't make it to the bathroom, I start leaking on the way to the bathroom, I can't hold it in." Or a lot of urgency, frequency to rush to the bathroom a lot. And then sometimes with really weak pelvic floors women may notice prolapse, which is when the vaginal walls can start dropping down and feeling a bulge coming out vaginally. So, obviously, if that -- If you feel or notice something there, that's another reason to get checked out. And then -- And people that have really tight pelvic floors, I would say it could be more pain related. So, again, chronic lower pelvic or vaginal pain, bladder pain, feeling like you have a bladder infection when there isn't one there, and then, you know, really a lot of difficulty peeing. Like, you know, you can't empty your bladder that sort of thing. And sometimes just even the bowel dysfunction. I mean, I know constipation's really common but if it's not getting better with the things your doctor is telling you, maybe it's a pelvic floor issue.

KATIE: 20:43

Gotcha. I mean, this might be difficult to sort of answer, but when we say pelvic pain are we thinking, like, sharp pains or just dull ache, feels like you're bloated, or -- I mean, I hear about bloating a lot. Is bloating different than the pain you're talking about here?

DR. ANTOSH: 20:59

Yeah. Probably not as much bloating as just a lot of -- I mean, the pain can -- And the way people describe the pain can really vary. KATIE: Okay. So it's not just one type of pain but a pressure like pain or a pulling, or a cramping, or dull like ache or pain is common for people to describe it when they have, really, pelvic pain where their pelvic floor muscles are in spasm. And like I said, if you're having like a pain process going on in the belly, even if it's not related to pelvic floor, the pelvic floor then tightens up and then that can cause more pain. KATIE: I see. Okay. Also, just a tight pelvic floor can cause pain on its own. So, I would say if you're having pelvic pain and it's persistent and not getting better to get checked out by a specialist to see what's going on. What's causing it and then to see if your pelvic floor is, you know, part of the problem.

KATIE: 21:50

Okay, gotcha. You mentioned one in, I think one in five women will need surgery for this in their lifetime. You know, so that that sounds like one of the treatments. What's, you know, what are the other kind of treatments? Is it common to kind of go straight to surgery or are there other things people can try first?

DR. ANTOSH: 22:06

Yes, there's many conservative things that they can do, that's why I think talking about this is so important since we know this could be a problem to be proactive with keeping our pelvic floor strong and active and healthy. But, in someone that's already suffering from some of these issues, or a weak pelvic floor, we have, definitely, exercise and also some bladder retraining methods. Very conservative treatment options we can offer. We have physical therapists that are very specialized in this area that can help patients work through how to get their pelvic floor muscles going. Some people they try to do Kegels and they just can't get the sense of where they are or how to do it. And there's even, like, more, kind of, wearable devices that can help you determine where your pelvic floor is and how to get it stronger.

KATIE: 22:52

Yeah.

DR. ANTOSH: 22:53

There's a lot coming out with that.

KATIE: 22:55

I've seen, yeah, I've seen some of those where they'll -- It's like virtual, I think they called it, like, virtual pelvic physical therapy or something.

DR. ANTOSH: 23:02

Yes. KATIE: I've seen ads for them. So, are those. DR. ANTOSH: Yes.

KATIE: 23:06

Yeah, that sounds interesting.

DR. ANTOSH: 23:07

So, there's many different ones out there. I can't say one is necessarily better than the other, it's just a matter of, like, what's gonna help you pay attention to pelvic floor and get it stronger. If you feel like you would be more on top of things to have, you know, something that you can put there and monitor your strength and remind you to do it. There's also, like just, apps on your phone that can help you with your pelvic floor that you can download that can kind of remind you on what to do, how often to do them. So, it just -- I think it just varies based on, like, what's gonna work for you in your day-to-day.

KATIE: 23:40

You know, to wrap up here another question for you, sort of like what we asked at the beginning of myths and misconceptions, I'm curious, do you have -- Is there one thing you kinda wish people knew earlier about their pelvic health?

DR. ANTOSH: 23:54

I hear it almost every day that when women come to see me that have a pelvic floor issue they said -- they usually say,"I just don't know why more people aren't talking about this. That I didn't hear about it earlier." I will say in and around things like childbirth, which can be a big risk factor for this, there's a lot of other things going on. You know, you're dealing with a newborn and you're like,"Oh, this is probably normal that, you know, I'm leaking and that sort of thing," and you kind of put things on the back burner a little bit to take care of your child. But I really think you should focus on that and, you know, if it's a persistent issue, you know, get help for it. Because these are the same issues that will creep back up later in life. KATIE: Yeah. And so, I think being aware of it, and conscious of your pelvic floor, like, I think, like, knowledge is key. Knowing your anatomy, knowing these are issues that can happen later in life will just help us as women, like, seek care when we need it when we're bothered.'Cause that's what it really comes down to is when you have an issue and you're bothered, seeking treatment. There are specialists for this. But also, the preventative strategies. Other preventative strategies, avoiding constipation, avoiding a lot of weight gain is a big one, and then just keeping your pelvic floor muscles strong.

KATIE: 25:10

Gotcha. I love that you brought the diagram, and I would encourage our listeners who didn't get to see it to either try to go watch this and look at it or go look online. DR. ANTOSH: Mm-hmm. I've watched a lot of videos about, like, how to do Kegels, and they've never just shown me that it's like a bowl-like muscle that I feel like has kind of connected all the dots for me. I've been thinking of it like a piece of paper or something.

DR. ANTOSH: 25:30

Like it's like a flat structure.

KATIE: 25:32

Yeah, like somewhere in my body. Whereas, like, now I kinda, I don't know, just, that, like, unlocked a whole new kind of, like, understanding for me. So, thank you for the knowing your anatomy tip, I think. Exactly what I needed at least.

DR. ANTOSH: 25:41

Yes, and it's like -- It's really -- our bodies are amazing. It's like an amazing structure on what it does.

KATIE: 25:47

Yeah.

DR. ANTOSH: 25:47

It's like, that it functions all the time and, you know, I think --

KATIE: 25:51

There is a lot going on in this model.

DR. ANTOSH: 25:53

There's a lot going on.

KATIE: 25:54

Can't see when it got brought in the room I was like,"Woah, what's that?" DR. ANTOSH: The body is amazing. Yeah, the body is truly amazing. Any last thoughts or anything else you wanna leave listeners with here today? I know we really appreciated having you on.

DR. ANTOSH: 26:06

Yeah, I think the only other thing I would say is it's not wrong to say, you know, do your Kegels, Kegel exercises to treat this, but I do want you all to know that if that doesn't work and you're bothered by an issue, there are more treatment options out there. It's not the only option to help these pelvic or this pelvic -- These pelvic floor issues that men and women have. There are certainly specialists that can help. Physical therapists, conservative treatments. There are, like, more aggressive treatments too and they're minimally invasive, but there's plenty of options out there. But it's a good place to start. KATIE: Okay, awesome. Well this has been really great. I have definitely learned a lot. Thank you so much for coming on the show today. You're welcome, thank you for having me.

ZACH: 26:49

So Katie, pelvic floor… name is kinda misleading right?'Cause I think floor, I think 2-dimensional, flat, right? But that's not what the pelvic floor is.

KATIE: 26:58

No, it is a bowl shape.[Laughing] Which I agree with you, is not what I think of when I think of a floor. Yeah, I think all of our listeners probably heard me kind of lose my mind just when she pulled out, you know, the model. ZACH: Right. And yeah, it's a bowl of muscles, essentially. That is not where my mind was going when we were talking about what the pelvic floor is. For people just listening, we also do have a video version of this, guys, and I do think you should go try to watch at least when she brings out the model. It definitely made it way more clear why it's so important when I saw it. ZACH: Right. You know, I mentioned out of sight out of mind, well now in sight, in mind. I really was able to wrap my mind around, like, what's going on down there, right? Yeah, absolutely. Absolutely. And I think too -- I'm also glad she brought up, you know, you can physically see why it matters through the model. But I'm glad that she brought up and we kind of dealt with this right away, it's a misconception that this is only something to think about if you're, you know, pregnant or have just been pregnant or you're much older. ZACH: Mm-hmm. Your pelvic floor is important throughout your life and it's probably something we actually don't talk about enough.

ZACH: 28:02

Right, no, it's a men issue, it's a women issue.

KATIE: 28:04

Mm-hmm.

ZACH: 28:04

Like, it's universal, everybody has a pelvic floor. And in -- Look, I understand that it's kind of a -- It's a private area down there, right? I mean, Dr. Antosh listed off all of its functions and its importance, and those were things that, you know, we're not really comfortable talking about a lot or especially in public places. And they're like, "Oh, do I really wanna go talk to my doctor about this?" Unless you have a clear and present problem.

KATIE: 28:26

Mm-hmm.

ZACH: 28:26

But as she pointed out, like, look most of the people that come in here they wish they would have come in sooner. So don't be afraid to do that.

KATIE: 28:31

Yeah, absolutely, absolutely. And, you know, she gave us some pretty practical, easy tips for, you know, keeping a strong pelvic floor. You know, Kegels, I know we've probably all heard of them.[Chuckling] ZACH: Yeah. I loved her cue, her mental cue for how to do those correctly. I've heard a lot of weird, sort of, things you should do to do a Kegel. It's never stuff that, like, is a common action that you do. Hers was great. It was pretend you're in an elevator and you don't want to pass gas in front of a bunch of strangers. Like, that's a very, kind of like, obvious mental cue that we've all be in that situation.

ZACH: 29:03

All been there. KATIE: Yeah. And she was like, do it at a stoplight, do it for 30 seconds at a stoplight couple times a day. No, I'm absolutely gonna do that 'cause, you know, you hear about -- Here's a part of your body that you haven't been thinking about but you should be exercising it and maintaining it. I'm like, "That's intimidating," but the stoplight thing? I can totally do that. 30 seconds every now and then at a stoplight. So, don't be intimidated by all this new knowledge about those body parts you have. There are simple and easy ways to maintain it, keep it healthy, and then again always see your primary care physician and they can inform you further. KATIE: Absolutely. Totally agree. All right, that's gonna do it for us this time on, On Health with Houston Methodist. Be sure to share, like, and subscribe wherever you get your podcasts. We drop episodes Tuesday mornings. So, until next time, stay tuned and stay healthy.♪ ♪