The perineum, often overlooked, is an essential part of our anatomy. Located between the pubis and coccyx, it supports the pelvic organs and plays a crucial role in vital functions such as urination, defecation and sexuality. Despite its importance, the perineum is often neglected, which can lead to a variety of health problems, including bladder weakness, prolapse or chronic pain.

The aim of this article is to raise awareness of the importance of the perineum, understand its common problems and discover the appropriate care to maintain it in good health.

Anatomy and function of the perineum

The perineum is a musculo-tendinous structure located between the pubis and the coccyx. It forms the pelvic floor and consists of several muscles and ligaments that support pelvic organs such as the bladder, uterus and rectum. These muscles include the anus elevator muscle and the pubococcygeus muscle, among others.

The perineum fulfils several essential functions. It plays a crucial role in supporting the pelvic organs, preventing them from sinking or prolapsing. It also helps control urinary and fecal continence, thanks to the contraction of the perineal muscles. Finally, the perineum plays a significant role in sexuality, contributing to sensation and pleasure during intercourse.

Common perineal problems

Weakness of the perineum is a common problem that can occur for a variety of reasons, including pregnancy, childbirth and aging. During pregnancy grossesse and childbirth, the perineal muscles are under great pressure and can weaken, leading to problems such as urinary or fecal incontinence. 

Aging is also a major factor, as it leads to a reduction in muscle tone, affecting the perineum's ability to support the pelvic organs.

Urinary and faecal incontinence are frequent consequences of perineal weakness. The inability to control sphincters can significantly impact quality of life, leading to embarrassment, discomfort and social isolation. Those affected may be reluctant to take part in social activities or engage in physical exercise, which can lead to a deterioration in mental and physical health.

Pelvic organ prolapse is another disorder linked to weakness of the perineum. This is the abnormal descent of the bladder, uterus or rectum into the vaginal canal. Symptoms include a feeling of heaviness, pelvic pain and difficulty in urinating or defecating. Risk factors include the number of pregnancies, vaginal deliveries and aging.

Finally, perineal pain can result from trauma, surgery or medical conditions such as vulvodynia or chronic pelvic pain. Such pain can be disabling and requires appropriate medical management to improve patients' quality of life.

How to prevent and strengthen your perineum?

Kegel exercises: explanation and benefits

Kegel exercises are repeated contractions of the pelvic floor muscles, particularly effective for strengthening the perineum. They involve contracting the muscles as if you were trying to stop the flow of urine, then releasing them. Practised regularly, Kegel exercises can improve urinary continence, reduce the risk of prolapse and increase sexual pleasure by toning the perineal muscles.

The importance of posture and regular physical activity

Good posture and regular physical activity play a crucial role in perineal health. Maintaining correct posture reduces pressure on the pelvic floor and prevents muscle weakening. Activities such as yoga and Pilates are particularly beneficial, as they strengthen core and perineal muscles, while improving flexibility and balance.

Advice for pregnant women: preparing for childbirth and post-partum recovery

For pregnant women, preparing the perineum for childbirth is essential. Kegel exercises, combined with breathing and relaxation techniques, can help to soften and strengthen the perineum, making childbirth easier. After birth, it's crucial to continue these exercises to regain muscle tone and prevent continence problems. Consulting a physiotherapist specialized in perineal rehabilitation can also offer personalized support for optimal recovery.

Solutions and treatments for perineal problems

Perineal rehabilitation: methods and healthcare professionals involved

Perineal rehabilitation is essential to strengthen the pelvic floor muscles. It can include Kegel exercises, biofeedback and electrostimulation. Physiotherapists and midwives are usually the health professionals specializing in this type of rehabilitation.

Surgical procedures: types and indications

In cases of severe prolapse or persistent incontinence, surgical intervention may be considered. Common types include colposuspension and suburethral sling insertion. These procedures are generally recommended after conservative treatments have failed.

Use of medical devices: pessaries, special tampons

Specific pessaries and tampons are medical devices inserted into the vagina to support the pelvic organs and reduce the symptoms of prolapse. They offer a non-invasive solution and can be used in conjunction with perineal rehabilitation.

In short, perineal health is crucial to maintaining a good quality of life. Taking care of your perineum can help prevent problems such as incontinence and prolapse, and improve your sex life. It is strongly recommended that you consult a health professional for advice. tips tailored to your specific needs. Adopt preventive measures such as Kegel exercises and regular physical activity to keep your perineum healthy.