Common toilet behaviours that can lead to pelvic floor dysfunction

Leaking urine and stool is an epidemic nobody talks about. Most pregnant women, new moms, and older women leak. So, do the men. 

I have come across children as well as young men and women suffering from urinary incontinence (the medical term for leaking urine) due to their diets, sedentary lifestyles, and toilet behaviours. 

These behaviours damage the ‘deep’ muscles in our bodies like the core and the pelvic floor which supports organs like the bowel, bladder, and vagina in our undercarriage.

Today, I want to talk about how your dysfunctional toilet behaviours may actually be damaging your pelvic floor muscles inadvertently and leading to pelvic floor problems causing pelvic pain, incontinence, prolapse of pelvic organs, and painful and unsatisfactory sex. 

And what I mean by toilet behaviour is what you do when you need to go to the loo and then what you do while you are inside it.

Here are a few common bathroom mistakes that are linked to weakening of your pelvic floor:

1.    Bad toileting posture 

The right toileting posture is one that doesn’t extend and hurt the pelvic floor muscles. But not many of us know that the design of our modern toilets is doing just that. 

You are sitting on a toilet seat now instead of squatting on it, as we did just a few decades back. 

This toileting posture has a great role to play in causing pelvic floor dysfunction because of our anatomy which is designed in such a way that if you squat to clear both your bowel and bladder, there is less impact on your pelvic floor.

What modern toilets do is not allow the pelvic floor muscles which are also responsible for urination or defaecation, to fully relax.  And you aggravate the stress on your pelvic floor by straining or pushing when you are unable to fully void. 

This pushing down on the pelvic floor can cause various problems like pelvic floor weakness which can lead to a pelvic organ relapse after childbirth or post-menopause and many other problems. 

One of the easiest things you can do to help your pelvic floor health is to use an Indian toilet while voiding. This will ensure that your pelvic floor is relaxed and doesn’t get damaged.

If using an Indian toilet is not an option, then you can lean forward with your elbows on your knees while sitting on the toilet. This will help to increase hip flexion, similar to a squat position. You can also elevate your feet by using a stool as this will be close to achieving a squatting position to relax the pelvic floor. 

Also, relax your belly and let it bulge out slightly while sitting on the toilet seat as this helps to lengthen the pelvic floor muscles.  

2.    Delaying it for long

Not going to the toilet for hours is bad for your pelvic floor health. This also predisposes you to UTIs. What happens when you hold –in urine for long is that you stretch the bladder because of the pee it has to store.

This leads to what is called an atonic bladder, a bladder that lacks tone. An atonic bladder is not able to store and empty the pee efficiently, and it also weakens your pelvic floor which has to work harder to support a heavier bladder.

Remember, a normal voiding schedule is every two to four hours so do try to accommodate a visit to the restroom after this time. And I can assure that your older self will thank me for this advice.

3. Not sitting down on the toilet seat but hovering over it 

This is such a common problem, especially when you are forced to use a public loo. The toilet seat is dirty and you take the easy way out and hover over the seat while you do the act.

But what this does is tightens your pelvic floor and increases chances of a dysfunction. Your pelvic floor should be relaxed while you are peeing or pooping and by hovering you are withholding adequate relaxation of pelvic floor muscles which means other muscle groups have to chip in to hold you up. 

A tight pelvic floor also means that your bladder and bowel don't fully empty which leads to a host of issues like urgency that means you almost always feel an urge to pee but can’t empty your bladder when you visit the restroom.

Similarly, if you can’t empty your bowels completely, there will be a faecal buildup in your colon which can cause many diseases including cancer as numerous studies have proved.  

4. Bearing or pushing down to initiate or complete urination 

Your pelvic floor muscles stretch and strain while you push down and strain on the toilet seat. And this weakens the pelvic floor.

So, take your time in the restroom and if you suffer from chronic constipation, remember, you are letting your pelvic floor down. Just do something about it.

5. Not allowing the stream of urine to stop

Allowing time for full bladder emptying is crucial if you want to avoid infections, urgency, incontinence and prolapse. 

6. Going to the toilet before you truly need to 

The “just-in-case” or preventive voiding really affects pelvic health. My mother used to do it a lot and she forced us to do it too. “C’mon- off you go to the toilet as there will be no clean toilets in the mall,” she would say. And, there we were straining and pushing on the toilet seat and hurting ourselves. 

This habit also trains your bladder to hold only small volumes of pee. This means that you will get the urge to urinate when the bladder is only filled with a small amount of urine- something called an overactive bladder. To avoid this, simply wait to use the bathroom until you truly need to!

Follow the above tips and enjoy pelvic floor health (almost) forever. All the best!