Pelvic Floor and Osteoporosis

Is Your Pelvic Floor Increasing Your Risk of Osteoporosis?

bladder prolapse bone denisty bone health exercises for incontinence organ prolapse osteopenia osteoporosis pelvic floor pelvic health Nov 26, 2022

What Is Osteoporosis?

Osteoporosis is a skeletal disease characterized by low bone mass and deterioration of bone tissue.  Bone is a living tissue that is constantly being broken down and replaced, but when the breakdown is faster than the rebuild, osteoporosis is the result and leaves you at increased risk of fracture. In the early stages, before full-blown osteoporosis, the loss of bone mineral density is called osteopenia.

What Are The Symptoms Of Osteoporosis?

This disease is often called the 'silent disease' because there are no immediate sensations in the body, and it isn't until a fracture that people learn they have low bone mineral density. Symptoms of bone loss are back pain, loss of height over time, a stooped posture, and bones that break easily.

How Do I Know If I Have Osteoporosis or Osteopenia?

The current gold standard for measuring the density of the bones is a DEXA scan (dual x-ray absorptiometry) which will check your overall bone density as well as the lumbar spine and the femur necks of both hips.  You will get what is called a T Score which represents the difference in your bone density compared to the average bone density of young, healthy adults. A T Score of between -1 to -2.5 is considered osteopenia, and a score greater than -2.5 is considered osteoporosis. I recently had a Body Composition and DEXA scan and was happy that my scores showed that I am above average for my age in terms of my bone density.

What is The Pelvic Floor?

The pelvic floor is a group of muscles that attach to the pubic joint, the tailbone and the sitz bones. They close off the base of the pelvis and have some very important jobs. These muscles contribute to pelvic and spinal stability, support our internal organs, manage our continence, and they contribute to sexual response. Optimal function is closely tied to the hips, so both the musculature of the hip and the bone mineral density in the hips can influence the pelvic floor and its ability to do all of its jobs.

What Increases The Risk of Osteoporosis?

Common contributors to osteoporosis are:

  • low calcium and vitamin d intake
  • certain medication use
  • smoking
  • alcohol intake
  • abnormal amenorrhea
  • loss of or low estrogen in women and low testosterone in men
  • age
  • family history
  • low physical activity

It is also important to note that moderate to severe Pelvic Organ Prolapse (POP) is an independent and negative predictor of whole-body bone loss in patients over age 60. In postmenopausal women, moderate to severe POP can be a risk factor for hip fractures. Women with low bone quality have increased odds of urinary incontinence as well. One study looking at Korean women over the age of 50 years found that the prevalence of osteoporosis was higher in the POP group compared to the non-POP group.

How Can I Reduce The Risk of Osteoporosis?

There are modifiable and non-modifiable risks for osteoporosis. Family history, being female, having a small frame, being over 50 years of age and having an endocrine disorder are considered non-modifiable.  That means that the other risk factors are ones we can address and make changes to help reduce the risk and even improve our bone density. Eating calcium-rich foods is an important way to reduce the risk. Getting adequate vitamin D through diet, sun, and supplementation is essential. Avoiding cigarette smoking and avoiding or limiting alcohol is very important. Possibly the most important way to reduce the risk of developing osteoporosis is physical activity. 

The challenge is that many women avoid physical activity because they experience bothersome symptoms such as leaking urine, urgency, heaviness from prolapse and back pain. Some avoid exercise because they don't want to experience the symptoms. Others avoid exercise because they are afraid of making their problem worse.  There are also many women who have been told to avoid high-impact activity and resistance training - 2 keys to maintaining our bone health. There is also some evidence to support the use of collagen supplementation for both the prevention and treatment of individuals with osteoporosis. It is important to use a collagen that is bio-available, meaning it is easily absorbed. I also believe there may be benefits to the pelvic floor as well, which I wrote about here. I also share links to the collagen I take that is supported by research. 

What Exercise Is Pelvic Floor Safe That Helps Build Bone?

I am always asked which exercises are 'safe' for prolapse or incontinence or overall pelvic health, and the truth is, there really isn't a 'good' or 'bad' list.  It boils down to the execution of an exercise by an individual.  When I first began learning about pelvic health back in 2007, it was very much a conservative approach with a long list of exercises to avoid if you had some form of pelvic floor dysfunction. While it seemed like the right thing at the time, limiting ranges of motion or impact or entire exercises was, in turn, creating other challenges. 

One big challenge was the risk of bone mineral density loss because of the advice to avoid lifting weights and impact activity. We lose muscle mass, and bone density as we age, and women can lose up to 10% of their bone mass within the first five years post-menopause. By removing weight lifting and weight-bearing activity, we were increasing women's risk of bone loss. Thankfully with evolving research and people willing to challenge commonly held beliefs, there is now a lot less restriction, but the general population still remains fearful of worsening their condition. 

Something to consider is that there is no cure for osteoporosis. There are many solutions for pelvic floor dysfunction and pelvic health management; some are even cures.  Walking is one of the best weight-bearing activities and is good for our overall health as well. Yoga, resistance training, and balance work are all good options to help build and maintain our bone health. I recommend optimizing your pelvic health as a first step. 

My Buff Muff Challenge takes a whole-body approach to strengthen the pelvic floor with movement. As a progression from the challenge, I offer a monthly membership that provides a whole host of workouts designed to add progressive resistance to our pelvic floor and entire body that will benefit our muscles, our brains and our bones.

Will Supplements Help My Bones?

It is important to address diet (eat adequate amounts of protein and calcium-rich foods) and exercise (weight-bearing and resistance training) first and then add supplements. The following supplements are often recommended to support bone health

Collagen (as mentioned above). For those interested in trying the collagens I use, there are different links depending on whether you are in Canada, the USA, or the UK.

There are so many collagen supplements on the market which can make it hard to know which form is best. I have tried a lot and never really noticed much and was always researching new ones because I wanted the best. Then I heard about Verisol® and the associated research (some listed above) and set out to find a product with it because it makes sense to use the one backed by research. The ones I found and now use are Beauty Focus Collagen+ by NuSkin (liquid form) and Totally Derma (powder form). I am also currently trying the ones from Sparkle (see below). 

For those interested in trying the NuSkin collagen I use, there are different links depending on whether you are in Canada or the USA or the UK.  The pricing is retail and is pricey.  Message me directly so I can get you my members only pricing ([email protected]).

For people living in Canada Canadians click here

For people living in the USA  Americans click here

For people living in the UK UK folk click here 


For those interested in trying the Totally Derma Collagen



Below are the coupon codes to get a discount 

VAGINACOACH10 – for 10% discount on 30 day supply

VAGINACOACH15 – for 10% discount on 90 day supply


One other one that I am currently trying and like is Sparkle Wellness.  They have Verisol as well as other patented and researched forms of collagen for bones and joints and skin.  I am trying the skin and the bone ones.  When I asked about which is best if I want ALL the benefits, they suggested starting with the one type you want to focus on.  (I am starting with the bone one...I had a dexa scan recently so can see the improvement with another test).  They also said that all forms of collagen will benefit all parts of the body but specific peptides are more formulated for certain things.

Do you take collagen?  What changes have you noticed in your body?  After you try the ones listed above please share your feedback with me.

Photo by Otto Norin on Unsplash