When we hear the word perineum, we usually think of the postpartum rehabilitation that women must undergo after giving birth. Or urinary incontinence which can occur with age. And often, we don’t know much more. This is what Sabrina Fajau, physiotherapist and osteopath, noted. “As is often the case with taboo health topics, there are few easily accessible reliable resources”, explains the one who decided to specialize in abdominopineal rehabilitation and launched the Instagram account
Princess Perineum “To talk about perineal prevention and women’s health in an uninhibited way”.
However, the perineum plays an important role in our daily life, from our sports practice to sexuality. So Sabrina Fajau takes the next step today and signs In perineum we trust* (First ed.), a book in which everyone can discover the keys to ensuring a healthy perineum.
Why are we so little informed about our perineum, and what consequences does this ignorance have?
Everyone has a perineum: women, children and men. But many are unaware of it, some do not even know what it is. It is a subject that touches on intimacy, sexuality, continence, the relationship to the body: so many taboo issues that we do not easily tackle. For a long time, the pudendal nerve, which innervates the perineum, was even called the “shameful nerve” in medical books. And since no one talks about it, we don’t take care of it. This leaves many patients in therapeutic wandering and caregivers who may lack training on this issue.
How to become aware of your perineum?
Most often, we are sitting on it! The external genitals are placed on the perineum, this is where urination and defecation take place. But it also plays an important role in sports practice, for both men and women: engaging your perineum and abdominal muscles well allows you to increase strength, whether for pushing in a rugby scrum, for doing squats. with load or for climbing.
And what are the worst habits we have on a daily basis that damage our perineum?
This happens in particular in the toilets. We sometimes hear that to become aware of your perineum, you have to stop while urinating. Well the stop pee, it’s forbidden, it’s very bad. When you block urination, the muscle does not know how to react, this can lead to reflux of urine and cause infections. Holding back for hours is not good either: the perineum is never relaxed. It causes pain, and more rarely, can lead to infections reaching up to the kidneys.
We also avoid peeing in a high squat, when we do not sit down for fear that the toilet seat is dirty: in this position where we have the buttocks contracted, the perineum is not relaxed, we force with the abs, and that disrupts the bladder. In the same way, we must also avoid the “safety pee”, the one that we force ourselves to do because we have three hours of road to do with the children: we push when we should not, and we do not let go. not the bladder relax when it can hold up to half a liter of fluid.
And it’s the same with defecation: many people tend to force themselves to go to the toilet and push too much, thinking that this will prevent them from going at a less convenient time. However, this has deleterious effects on their perineum. Physiologically, the anal sphincter is supposed to open, not descend. But if you don’t let it open properly and push too hard, over time, the pressure on the perineum can cause prolapse, it’s organ descent.
How to take care of your perineum?
This involves prevention and information. Learning to use the toilet properly should be part of learning continence from childhood: don’t push yourself, don’t push too hard. And since our toilets are generally too high, a simple and effective thing to do is to place a step in front of our toilet, to have a more squatting position that facilitates defecation without putting too much strain on the perineum.
A perineum that is going well is a perineum that we do not take care of. But like the rest of the body, physical activity is recommended for a healthy perineum.
What role does the perineum play in sexuality?
It has effects, whether you are a man or a woman. In men, this improves sexual ease, better control their pelvis and their erection.
And for women, it is at least as important. If it is healthy, it also improves sexual ease. It is important to realize that it is not normal to have pain during sexual intercourse: it is an area that reacts to psycho-emotional stimuli, and in the same way as when we are stressed, we tighten the muscles. teeth, we also tighten the perineum.
How do you know if you have a perineum problem and you should consult?
The first thing to know is that only one drop has escaped, it is already a urine leak and it is not normal. Then, if we have pelvic pain, that we suffer from chronic constipation, that we can not retain gas or other materials, it is because we need to consult. Fortunately, more and more patients are taking this step and benefiting from rehabilitation adapted to their pathology.
You devote an entire chapter of your book to “body positive”. Why address this theme in a book on the perineum?
Perineal pathologies are taboo, they affect sexuality, and are associated with the idea that when you are no longer a continent, you are old. All this hits you, with the idea that our body lets go of us, that it is less desirable.
There are perineal pathologies due to psycho-emotional life episodes that will impact the perineum. And conversely, perineal pathologies that will impact self-esteem: someone who likes to run and who has continence disorders, if we tell him – through ignorance – that he must put on diapers, the psychological impact is devastating. However, we do not re-educate only perineums, but people, which implies a global and benevolent approach. Once you have re-educated your perineum, you have to restore the patients’ confidence and that they no longer feel degraded.
* In perineum we trust. Sport, sexuality, motherhood: transform your life with a healthy perineum, by Sabrina Fajou, Editions First, in bookstores since September 30, 16.95 euros.