The perineum is a hammock-like set of muscles that extends from the pubis to the coccyx, and closes off the lower pelvis. These muscles support the viscera, bladder,
uterus and rectum. They also ensure urinary and anal continence and a fulfilling sexuality. The perineum must be sufficiently strong and coordinated to fulfill its various roles automatically and reflexively.
The risk factors for bladder weakness are varied. In the case of stress urinary incontinence, the main ones are :
In the case of urinary incontinence due to urgency, the aggravating factors are :
There are two types of bladder weakness.
Stress urinary leaks, i.e. leaks that occur during abdominal effort, such as coughing, sneezing, laughing, jumping or carrying a load.
In these circumstances, the abdominal muscles contract very hard, resulting in increased pressure in the abdominal cavity and on the perineum, which must react in a coordinated fashion.
If the perineal resistance is less than the abdominal pressure…then there’s a leak!
Urge leakage is leakage due to overactivity of the muscle surrounding the bladder, the detrusor.
As the bladder fills, tension sensors in the detrusor send information to the brain about the rate at which the bladder is filling, triggering the urge to urinate.
If these sensors are out of whack, cravings become urgent or even irrepressible even though the bladder is not full… it’s then impossible to hold back, and leakage occurs!
Factors that promote or aggravate imperiousness include caffeine, theine, white wine and champagne, as well as soft drinks and energy drinks.
This sense of urgency can also be heightened by stress, contact with water, the cold or even the doormat syndrome… the closer you get to home, the more uncontrollable the urge becomes!
Bladder weakness is neither inevitable nor normal, and solutions do exist.
Of course, you need to make the right diagnosis and then put in place the tools to resolve your incontinence.
Perineal reeducation can help you deal with these leakage problems. It involves becoming aware of your perineum, learning to contract it to strengthen it. It also involves postural work, with effective abdominal strapping, so that the perineum, abs and posture work together to keep you dry.
Sometimes all it takes is changing a few bad habits to dramatically improve symptoms!
Perineal problems affect women AND men, but in different proportions and under different conditions.
Women suffer much more than men, because the female anatomy and hormones are risk factors for urinary or anal leakage and organ descent.
However, men also have a perineum that loosens with age, which can lead to urinary and/or fecal incontinence or sexual problems.
Chronic constipation with repeated pushing can weaken the perineum, and certain surgeries, especially of the prostate, can create lesions.
Organ descent” is the colloquial term for prolapse.
In women, this is the downward sliding of one or more organs located in the pelvis. The bladder, uterus and/or rectum descend and push against the vaginal wall, forming a ball that can be felt or seen if it is externalized beyond the vulva.
A cystocele is when the bladder descends, a hysterocele when the uterus descends, or a rectocele when the rectum descends.
The organs are held in place by a ligamentous system that suspends them and a muscular support system formed by the perineum and pelvic floor.
With age, pregnancy, vaginal delivery and menopause, support and suspension systems become less effective, and the risk of prolapse increases.
The first principle of perineal rehabilitation is to diagnose the problem correctly, so as to offer the right rehabilitation for the right problem.
There’s no such thing as one type of perineal reeducation, but rather the reeducation that’s right for everyone!
In simple terms, it’s a toolbox for solving urinary leakage problems, anorectal leakage problems, post-partum problems and organ descent problems.
Awareness of the perineum is the keystone of perineal rehabilitation – becoming aware of the area, its state of contraction or relaxation…
The aim is to regain a perineum that contracts at the right time and with the right strength, so that you no longer have to suffer from bladder weakness.
THERE IS NO NOTION OF PAIN IN PERINEAL REEDUCATION, IT’S A LIMIT NEVER TO BE CROSSED.
Perineal rehabilitation lasts as long as necessary, with the aim of eliminating symptoms.
The Oh my Péry! treatment paths are designed for 10 weeks of accompanied autonomy, and remain accessible for a further 10 weeks if you need more time to complete the process.
The important thing is to follow its course with regularity to become aware of your perineum, its place and its function!
The length of the session depends on how much time each person can devote to it, but ideally you should consider sessions of 20 to 30 minutes twice a week to achieve results.
It’s a time for you to connect with your body. Don’t neglect it…
Perineal reeducation sessions can be carried out in a doctor’s office, but sometimes access to care is complicated. A well-managed online solution can help you solve your perineal problems.
In perineal rehabilitation, the most important thing is your motivation and regularity in practicing the exercises.
Above all, you’ll need time, a mat, a small ball, possibly a connected probe AND professional support to carry out quality rehabilitation!
There isn’t really any particular sport that’s best for building up your perineum. The perineum has to do its work on a daily basis, as an autonomous part of your daily life.
The most important thing is to practice a sport that you enjoy.
If, during your sporting activities, you notice urinary or anal leakage or a feeling of heaviness, then I urge you to consult a specialist to diagnose and understand why these symptoms are occurring. It will certainly be necessary to adapt your practice and re-educate your perineum so that sport can be done in good conditions, without leaks.
For 9 months, your uterus will grow with your baby and weigh on your perineum. You’re going to gain weight, lose muscle, your center of gravity will change, the ligaments will relax a little… all this has an impact on your perineum.
This can lead to perineal pain, joint pain (particularly around the symphysis pubis and pelvic joints), relaxation of the perineal muscles and abdominal girdle…
But it doesn’t have to be that way: you’ll recover, because there are solutions to help your body get back to its pre-pregnancy shape!
Organ descent is the sliding of the uterus, bladder or rectum into the vagina, forming a ball that can be felt or seen if it comes out. The patient then describes a sensation of heaviness in the perineal area.
This organ descent is encouraged by muscle relaxation and ligament distension. This situation is particularly common in the immediate post-partum period. This prolapse is often transitory, and things return to normal with hormonal rebalancing and well-managed perineal re-education.
Post-delivery perineal re-education is recommended if the young mother presents symptoms of urinary and/or anorectal leakage 3 months after giving birth.
There is no obligation and no deadline to start your post-partum perineal reeducation… it’s never too late to do it right!
There’s no need to start post-partum perineal rehabilitation too soon. Give your body time to recover, take time to enjoy your baby and rest…
It’s never too late to do your rehabilitation, so whenever you want!
If there are no medical contraindications to resuming your sexuality… treat yourself!
The golden rule is that it’s your choice and your desire. If you experience pain, especially during intromission, you can overuse lubricants, especially if you’re breast-feeding – as you may be suffering from vaginal dryness. And as the body remembers pain, it may set up a protective mechanism, notably by contracting.
And if it’s reassuring to start perineal rehabilitation before resuming your sexuality, that’s fine too: there’s no good time like the one you’ve chosen!
In order to make the right choice of program, I encourage you to start with the assessment consultation, which allows us to get to know each other and make a diagnosis. During this privileged moment, I’ll share my advice with you and guide you towards the right treatment path.
You can also take the online mini-questionnaire to identify any problems and choose the program that’s right for you.
If in doubt, don’t hesitate to contact me and I’ll answer your questions.
The programs run for 10 weeks, during which time you will have access to all the information and videos created to support you in your intimate well-being.
If you wish, you can be part of the “Oh my Péry!” community throughout the tour.
It’s a closed, secure group where I can keep in touch with you to give you advice or launch small challenges. You can also ask questions.
And every month I invite you to take part in our videoconference meetings: each meeting has its own theme, and there’s plenty of time for good-natured discussion.
You have private and secure access to your program. It’s designed to feel like you’re in the office with me.
In addition to the course, if you wish, you can join a community where all questions are welcome, and where the experiences of some can be of benefit to others. This closed, secure group allows me to keep in touch with you. You can ask me questions, ask for clarification on certain exercises… I’m here with you, for you!
The course is worth €290 incl. VAT.
It’s scheduled to run for 10 weeks, and will remain available for a further 10 weeks, so you’ll have plenty of time to implement all the solutions I’ve put at your disposal.
I’ve worked for over a year to offer you a reliable and professional protocol, in which you feel confident and supported every step of the way.
For less than €15 per week, you’ll regain control of your perineum, get back to your life before leaks and regain your self-confidence!
The program is designed in stages – each week brings a new challenge.
The secrets of success: REGULARITY, PERSEVERANCE, SELF-CONFIDENCE AND GROUP ENERGY.
Your treatment journey takes place over 10 weeks, during which you can access new videos, new tips, new best practices…
These 10 weeks will change your life! Your commitment is important… but you’re not alone, I’m here to support you. Trust yourself to find your rhythm and establish your “perineum” routine.
At the end of the 10-week self-guided program, all content remains accessible for a further 10 weeks to give you time to finish off at your leisure.
I also invite you to join “Oh my Péry! the sequel” if you want to stay connected to the group, keep learning about pelvic health and women’s health in general.
