Anne Hathaway Is Right: Women Should Learn About Their Pelvic Floor Way Earlier
As if we needed another reason to love Anne Hathaway, in a recent interview with Fandango while promoting her new film Verity, she was asked what book she would write. Her answer, according to Fit&Well, was pelvic floor health
“I would want to interview every single expert I could find and write a bible that would actually really help women,” she said. And about her own experience: “As I’ve aged and discovered it, my life has improved, my energy has improved, my strength has improved.”
She also mentioned that there was “so much information not available to [her] as a young woman”. And she’s absolutely right. This information is not widely accessible and the first time a woman often hears about it is after something has gone wrong - and sometimes not even then! By then, we as pelvic floor physical therapists are treating an issue when we could have potentially prevented it in the first place. A lot of women who I treat say that they wished they had known sooner.
What if we treated the pelvic floor like our teeth or our heart?
We all go to the dentist twice a year for preventative care, we wouldn’t wait until we got a cavity to go, right? And we try to eat healthy, exercise, and stay fit for our heart and lungs, we wouldn’t wait until we had a heart attack to start caring right? I believe we should treat our pelvic floor in the same way.
Before or during pregnancy, every woman should have a baseline pelvic floor assessment that tells her where she’s starting from: strength, coordination, and whether her pelvic floor tends toward weakness or tightness. You can get one from a pelvic floor physical therapist, or through the self-assessments inside Amie.
Why baselines matter:
Knowing where you started means you can more easily track changes when they occur. For example, If at your baseline doing 20 squats was easy and then all of a sudden it becomes a little harder, or you start to feel back pain at squat number 10, it’s easy to catch that something is happening and we can more easily nip it in the bud.
You can also prepare your body better for pregnancy, postpartum, and beyond by starting earlier rather than starting from zero after you’ve had the baby.
And most importantly, you know what your normal is - not a generic standard.
What should you pay attention to at each stage of life?
Pelvic floor before pregnancy
What to watch for: chronic pelvic pain (like endometriosis, vaginismus, or vulvodynia), chronic UTIs, PMOS (formerly known as PCOS), any pelvic pressure or leaking (especially if you’re a high-intensity athlete or exerciser), and GI issues like chronic constipation or IBS.
Why it matters: getting these checked early means you know your normal going into the next stages of life.
Pelvic floor during pregnancy
What to watch for: urinary leaking, core and glute weakness, and constipation or changes in bowel habits.
What’s changing: a lot of extra pressure on your pelvic floor and core, temporary changes in posture and center of gravity, and hormonal changes.
Postpartum pelvic floor
What to watch for: pelvic pressure, urinary or fecal leakage, core and glute weakness, posture changes, pain at C-section or perineal tear scars, pain with intercourse, and vaginal dryness.
What’s changing: your body is readjusting to a new normal. Weakness in some muscles leads to postural compensations, and lack of sleep, hormonal shifts, and lactation (which lowers estrogen and can cause vaginal dryness) all play a part.
The in-between years
What to watch for: many of the same symptoms as postpartum, except now they may have been there for years. Think leaking when you run or jump, pelvic pressure, lingering core weakness, or pain with intercourse.
What’s changing: you’re after kids but before perimenopause. You’re getting back to the workouts you love, your schedule is packed, and your own needs slide to the bottom of the list. Issues that started early postpartum can become chronic.
Pelvic floor in perimenopause and menopause
What to watch for: vaginal dryness, UTIs, urinary leakage, pelvic pressure, and pain with intercourse.
What’s changing: hormone levels (low estrogen again), bone density, tissue elasticity, mood, and even brain changes
What to do now, no matter what stage you’re in
Learn to connect your pelvic floor and core to your breath. As you inhale, your pelvic floor gently lowers; as you exhale, it returns to rest. It’s the foundation for everything else.
Figure out if your pelvic floor tends to be on the weaker side or the tighter side. This matters, because the right exercises for one can make the other worse. That’s exactly what a baseline assessment shows you.
Know what to look out for, so that if something does change, you can start addressing it right away.
This is why we built Amie
Until Anne Hathaway writes her bible, we’re here to help. Amie gives you support that grows with you: start with a baseline assessment that shows where your pelvic floor is today, then follow a personalized plan that adapts as your body changes, through pregnancy, postpartum, and every stage after. No waiting for something to go wrong.
Dr. Anna McMaster, PT, DPT, PRPC, is a women’s health and pelvic floor physical therapist and co-founder of Amie.