Perineum: everything they don't tell you

The perineum is like the second heart of our body. If it is not in "good health" it is our whole body, our daily life and especially our health that feels it. Also called our pelvic floor, it is composed of a set of muscles and ligaments that extend from the pubis to the coccyx. 

Often compared to a hammock because of its shape, it actually fulfils the same function as a trampoline: it supports the organs of the small pelvis with each movement, thebladder, uterus, rectum… and maintains them. It is usually (and unfortunately) only during pregnancy that women hear about it for the first time. 

As you will have understood, the main function of the perineum is to maintain your genitals. It is also one of the main actors in the smooth running of your toilet trips. During urination certain muscles in the perineum relax to let the urine pass and contract again when you are finished. It's the same with bowel movements. But that's not all, your perineum allows you to avoid health problems such as organ descent or incontinence for example, it also helps you to improve your daily life!

You may not have known it but the perineum is one of the muscles of love, if it is toned you can have more fulfilling sexual experiences.

But in order for it to continue to perform all of its functions properly, it must be cared for and kept toned throughout your life.

Not sure if your perineum needs toning? Listen to your body! When your perineum becomes slack, there are several warning signs.

Here are the symptoms that may alert you to the problem: 

• You have bladder weakness (and yes, a few drops count too)
• You feel pain or a lack of feeling during sex
• You feel like it is an emergency when you have to go to the toilet and you can't stop yourself
• You feel a vaginal heaviness (this is one of the first signs of organ descent)

Do you recognize any of these? Then don't wait any longer and go and consult a health professional who can help you diagnose and manage the condition.

In addition to these symptoms, it is important to know that many factors influence the tone of the perineum. But as the perineum is a set of invisible muscles, this is one of the reasons why women are so unaware of it. One of the best known risk factors and the one that has the greatest impact on the perineum is pregnancy.

For 9 months the weight of the baby will create a pressure which increases, both on the perineum and the bladder. For those of you who have been pregnant before, you will remember that very strong and urgent urge to go to the toilet, no matter how hydrated you are. Not to mention the drips that get in your panties and could be a part of your daily routine. 

Whether it is a caesarean or vaginal delivery, a pregnant woman's body secretes hormones and in particular relaxin. This hormone acts on the joints and ligaments to relax and soften the tissues to prepare the body for childbirth. It is therefore only natural that the pelvic floor muscles will relax from the moment you become pregnant. 

At the time of delivery, the baby's passage can also weaken the perineum. In order to get the baby's head out more easily during pushing, you may also have an episiotomy. This is an incision about 2.5cm to 5cm long that is made in the lower vagina to increase the opening and facilitate the passage of the baby. However, it should be remembered that an episiotomy is like taking antibiotics, it is not automatic and is not always necessary! This practice should therefore not be systematic and should only concern 10% of deliveries. 

Doctor Martin Winkler is reassuring:
“spontaneous tears are often smaller and more superficial than episiotomies. They are easier to repair and heal faster...”
To limit the risks, from the 8th month of pregnancy, you can use a neutral oil or a special oil to massage the perineum, massage your perineum to "soften" it and prevent a possible tear. 

Don't panic, if your perineum is in distress, there are many methods to take care of it. The most effective method is unsurprisingly to tone your perineum regularly throughout life. A bit like an abs session, you don't just do 10 sessions and then stop, otherwise, bye bye the effects of training. It's exactly the same for the perineum, it's a set of muscles that must be maintained, not just after giving birth.

The perineum is toned by prevention and is rehabilitated as a matter of obligation, no matter what happens after a pregnancy. And yes, no matter how you give birth, the perineum is very much in demand during pregnancy, even in the case of a Caesarean section. But before you start your rehabilitation of the perineum, give your body time to recover.

Wait 6 to 8 weeks postpartum before you start your rehabilitation sessions. You can then consult your midwife or a physiotherapist to make an initial assessment and to begin to re-educate your perineum. The objective of the sessions: strengthen your perineum so that it regains its tone so that you can say goodbye to leaks and hello to a fulfilled sexuality! 

There are different rehabilitation methods that are adapted to the needs of each individual. 

They include: 
• Electrostimulation: these are electric currents that will make your perineum react and stimulate it. You are passive, it is the electrical stimulation that stimulates your perineum.
• Biofeedback: you are active, You become aware of your perineum by contracting and releasing it yourself. You get feedback in real time of your contractions directly on a screen. This allows you to monitor and adjust the intensity of your contractions to the exercise required.

For this, there is the Emy perineal probe, developed by the start-up company Fizimed. It is a clinically proven medical device that allows you to re-educate your perineum at home. You can train anywhere you want, whenever you want and at your pace ! This saves you time so that you can fully enjoy your baby and avoid having to travel. 

The Emy solution consists of a vaginal probe coupled with a mobile application allowing you to visualise your contractions through medical games, like those used by health professionals. It is an innovative French solution that revolutionises home perineal rehabilitation.

The Emy solution has been designed so that perineal rehabilitation is no longer a chore but a moment of pleasure. playful, fun, motivating and above all easy to use. And because our health is not a game, Fizimed also carried out a clinical trial that proved the effectiveness of the Emy probe. The first effects on the perineum appear after 3 weeks of use only: better tone, less bladder leakage, improved sensations during sex... Try it yourself!

In the course of a woman's life, it is not only pregnancy and childbirth that will weaken and damage the perineum. From many factors play a role and end up impacting directly or indirectly on the pelvic muscles.

Examples include: 
• age: tissues naturally slacken with time and hormonal decline
• sports: especially high-impact sports
• carrying heavy loads: this increases abdominal pressure and can stress the perineum
• Overweight: excessive pressure on the perineum can weaken it
• constipation: repeated bouts of constipation can lead to weakening of the perineum
• smoking: chronic coughing in smokers overtaxes the perineum

So no matter how old you are, you may face problems with your perineum. It is a set of muscles, just like any other muscle in our body, that must be cared for throughout our lives !


Would you like more information or resources on the subject?
We recommend the following Instagram accounts:

@princessepérinée
@périnée_bienaimé






Article written in collaboration with Fizimed.