Kim (00:04.91)
All right, so let's dive into collagen. Basically, I'm asked, will collagen help my pelvic floor? So it's usually people who have prolapse who are asking me this question, but I do get it from some people who are experiencing continence as well. So will collagen help strengthen my pelvic floor? Short answer, it's not gonna do your exercise for you, but.
The pelvic floor is an often overlooked part of the body and with regards to preventive health, it's one of the most thought about parts of the body for those suffering from common conditions such as incontinence and organ prolapse. And I speak from both personal and professional experience, having experienced stress urinary incontinence after the birth of my second child, a stage two uterine prolapse, a stage two rectocele that slowly progressed and I lived with for nine years.
Even though I knew a few things about prevention and childbirth, I had overlooked the recovery component and I also developed chronic constipation due to the hormonal upheaval of perimenopause and an autoimmune response with my thyroid. So I still develop pelvic floor dysfunction even though I had known a few things going into childbirth. And I know that physical, the physical and emotional toll that pelvic floor dysfunction can take. And I also know that so many things are...
treatable and figure -outable to quote Marie Forleo with the right amount of information, the right information and the right regimen in place. So the pelvic floor is a group of muscles responsible for maintaining our continence, our pelvic and spinal control and stability plays a role in our sexual response and our organ support. And there are three layers of pelvic floor muscles in the pelvis as well as ligaments and tendons and a huge vascular network.
And we need strong pelvic floor muscles, ligaments and tendons, as well as good blood flow and circulation for optimal function. Many women give birth to babies to become pregnant and every woman who reaches midlife will go through menopause. And those are two pivotal times in our life for our pelvic floor. I would say menstruation is also another time. Our first sexual experiences are also another time.
Kim (02:22.862)
But even women who have never given birth can experience challenges with their pelvic floor. So it's important to note that. It's also important to note that as we age, we lose muscle mass. In particular, we lose more type two muscle fibers. We lose hyaluronic acid and we lose collagen. And this, all of these can have a direct influence on the functioning of the pelvic floor muscles or our sense of the area, the pelvis.
It's also common for people with existing pelvic floor challenges to stop exercising. And that can be because of their pelvic floor, because of fear, can be from lots of different reasons, but stopping exercising can also inhibit blood flow. And that can also further decrease the muscle mass and the strength and all the losses we were talking about. So strengthening the pelvic floor muscles is a key part of improving and maintaining function. However,
could we possibly get some benefit from supplementing with things like collagen or hyaluronic acid in addition to doing pelvic floor exercise? So this is a question, as I mentioned, I get asked all the time and I wanted to look deeper into the research. I also get asked about it from a diastasis recti position. So diastasis recti is where the two straps of muscle on the outer abdomen, like the outer most abdominals,
They're known as the rectus abdominis. They're the six pack muscles. There's a band of connective tissue called the linea alba, which is a meshwork of connective tissue that holds the two rectus muscles in place at the midline. During pregnancy in particular, this connective tissue stretches and it can contribute to the two straps of the rectus moving away from the midline and creating a larger than normal gap. We haven't ever really decided what is quote unquote normal.
And to be clear, there's always a gap between the rectus. They're never fused together. So it's often people learn about it after they've given birth when they, you know, they have a measurement of a gap, but not very many people have done that same test before they were pregnant to know what their gap was there. So we're not always comparing apples to apples. So the muscles are never fused together. And it used to be thought that the size of the gap was an indicator of function. However, we're now becoming.
Kim (04:44.814)
more clear on the fact that the size of the gap is not the most important indicator of function. It's more the integrity of that connective tissue. So that's the diastasis piece. And we've talked about what the pelvic floor is. Now we're thinking what's connective tissue. So connective tissue is the tissue in the body that supports and protects us, that gives structure to the organs and the tissues in the body.
Connective tissue is made up of cells and fibers and gel -like substances that can help move nutrients between tissues and can help repair damaged tissues as well. So connective tissue can be categorized into three subgroups, loose, dense, and specialized. Loose connective tissue helps hold organs in place and is made up of extracellular matrix and collagenous, elastic, and reticular fibers.
Dense connective tissue is associated with tendons and ligaments with a higher density of collagen fibers. Adipose tissue, cartilage, blood, and lymph are examples of specialized connective tissue. Connective tissue contains a lot of type 1 collagen, which is the most abundant collagen in the body. Now we're moving on to what is collagen. It is, as we just said, the most abundant.
protein in the body and provides structural support to what is known as the extracellular matrix of connective tissues. Collagen is what contributes to our skin's firmness and resiliency and is often thought of as the glue that holds everything together. While it is mainly thought of as a skin supporting supplement, collagen is also found in muscles, bones, tendons, ligaments, and blood vessels. As we age, we produce less collagen, as I mentioned, about 1 % less each year starting around
the age of 20, and this can lead to less buoyancy and resiliency in our tissues as well as drier, thinner skin. So how does collagen relate to the pelvic floor and diastasis recti? There are many different types of collagen with the most common types being type 1 through 4. Type 1 collagen compromises over 90 % of the collagen in the human body. And with regards to the pelvic floor, we find types 1 and 3.
Kim (07:02.862)
Collagen is one of the most important parts of the extracellular matrix and plays a support role in the pelvic floor. A study by Norton et al. showed that women with joint hypermobility have a significantly higher prevalence of pelvic organ prolapse, from which we can infer that connective tissue integrity plays a role. Fibrous connective tissue and the pelvic floor muscles support the vaginal walls, with collagen types 1 and 3 playing a significant role in tissue tensile strength.
One study found conclusively that women younger than 53 years of age with pelvic organ prolapse have 30 % lower collagen concentration compared to age match controls, which indicates a constitutional tissue weakness contributing to prolapse development. Another study wanted to see if there was a correlation between the clinical stage of pelvic organ prolapse, histological structure and results of immunohistochemical study of the vaginal wall.
There were 60 post -menopausal women who had undergone some type of pelvic surgery during which a biopsy of the vaginal tissue was taken. There were three groups in the study. Group one was women with stage one or two prolapse. The second group was women with a stage three or four prolapse. And the third group was women with no prolapse. They found a significant difference in the connective tissue of group two, namely degradation of collagen fibers.
with a decrease in connective tissue strength and elasticity. They found that women with pelvic organ prolapse had a low ratio of type one compared to type three collagen. Analysis of the collagen content in the vaginal wall in patients with mild pelvic organ prolapse of stage one and two revealed a significant increase in the level of collagen type one and a decrease in the content of type three compared to patients with more severe pelvic organ prolapse of stage three and four.
We also have some evidence to show that pelvic organ prolapse and other collagen associated disorders may have a common etiology originating at the molecular level of the collagens. A gynecologist and a molecular biologist completed a rodent study and were able to demonstrate that prolapse is caused by a combination of loss of elasticity and a breakdown of proteins in the vaginal walls. Chen et al. looked at...
Kim (09:25.07)
collagen metabolism and turnover in women with stress urinary incontinence and found increased collagen breakdown as a pathologic etiology of incontinence. A similar study found a reduced expression of types one and three collagen in the anterior vaginal wall tissues, which may play an important role in the onset of pelvic organ prolapse. When looking at connective tissue at the midline of the body, so for diastasis,
One study compared women with and without diastasis and they found that both type one and type three collagen were less abundant in the women with diastasis recti than in those without the condition. And the difference was statistically significant. Another study looked at collagen turnover in urogenital tissue in women with stress urinary incontinence and in urologically healthy women.
The study concluded that the low tissue collagen marker levels in women with stress urinary incontinence suggest a reduced collagen turnover, which may negatively affect tissue strength and elasticity. Another small study set out to determine whether there was a difference in collagen metabolism between comparable urinary stress incontinence and continent women. And the research suggests that women with urinary...
in stress urinary incontinence have an altered connective tissue metabolism causing decreased collagen production, which may result in insufficient support of the urogenital tract. I'm also going to link to another article that helps further understand what we know about collagen and the types in the pelvic floor, as well as possible links to pelvic organ prolapse and other disorders. So does collagen supplementation help?
We currently have no evidence specific to collagen supplementation and the pelvic floor or diastasis recti. We don't have anything yet, hopefully one day. Until we have that research, we can look at how collagen supplementation helps with other factors in the body such as skin, muscles, bones, hair, and nails. One study used a specific collagen that is more easily absorbed. It was a bioactive collagen peptide. And in the study, they wanted to determine the effectiveness of the...
Kim (11:40.012)
bioactive collagen peptide on eye wrinkle formation and stimulation of pro -collagen one, elastin and fibrillin or fibrillin, I don't know how to say that, biosynthesis. Elastin, like collagen, is also a key extracellular matrix protein. Fibrillin is a glycoprotein that gets secreted into the extracellular matrix by fibroblasts and is thought to provide a scaffolding for the deposition of elastin.
They found that ingestion of the specific bioactive collagen peptide promoted a statistically significant reduction of eye wrinkle volume in comparison to the placebo group after four and eight weeks. Moreover, a positive long -lasting effect was observed four weeks after the last bioactive collagen peptide administration. Additionally, after eight weeks of intake, a statistically significant higher content of pro -collagen type 1,
Andy Lasten in the bioactive collagen peptide treated volunteers compared to the placebo treated patients was detected. For fibrillin, a 6 % increase could be determined after bioactive collagen peptide treatment compared to the placebo, but it was not statistically significant. Their findings demonstrate that oral intake of the specific bioactive collagen peptide, in this case it was varisol, reduced skin wrinkles and had positive effects on dermal matrix synthesis.
Knowing that the pelvic floor and the abdominal wall have type one collagen, we can speculate that oral intake of this specific bioactive collagen peptide may also influence those tissues. With no known risks or adverse reactions to collagen, it seems like a very low risk option. So as I said earlier, I get asked about it in relation more specifically to prolapse. So people ask, will this help?
it is not going to cure your prolapse or your incontinence or your diastasis. We have no data on the use of collagen supplementation as it pertains to prolapse, incontinence or diastasis, but we also don't have data to show that it doesn't. And while I know people with early grade prolapse or urinary incontinence or diastasis, some people have seen or felt improvements in their symptoms after using collagen, collagen will not cure these conditions outright.
Kim (14:03.182)
The specific bioactive collagen compound used in the above study shows wonderful results for the skin and knowing that we lose collagen as we age and that it was mainly type 1 collagen, which we have in the pelvic floor and abdominal wall. Supplementing with collagen seems like a good option for some who are wishing to support their bones, skins, muscles, ligaments, tendons, blood vessels, and pelvic floor. Supplementing with bioactive collagen peptides and other known beneficial therapies, namely exercise, must be considered.
Combining resistance training with collagen peptides can help with bones, muscles, and even strength as found in one study. The objective of the study was to assess the influence of post -exercise protein supplementation with collagen peptides versus placebo on muscle mass and muscle function following resistance training in elderly subjects with sarcopenia. So sarcopenia is the age -related muscle loss.
53 subjects, all male, underwent a 12 -week guided resistance training program, three sessions per week, and were supplemented with either collagen peptides or silica as a placebo. Following the training program, all the subjects showed significantly higher levels for fat -free mass, bone mass, isokinetic quad strength, and sensory motor control with significantly lower levels for fat mass. The effect was significantly more pronounced in subjects receiving collagen peptides.
We can again speculate that there may be a benefit to oral supplementation of a specific bioactive collagen peptide and perhaps see even further benefit if it is combined with the whole body and pelvic floor muscle specific exercise. A similar study looked at 77 premenopausal women and found that resistance training in combination with supplementation of specific collagen peptides induced a significantly higher increase in fat -free mass and hand grip strength.
than resistance training and placebo supplementation. In addition, there was significantly higher loss in fat mass and a more pronounced increase in leg strength in the treatment group compared to the control group. There was a systematic review that showed that collagen peptide supplementation is most beneficial in improving joint functionality and reducing joint pain.
Kim (16:16.91)
We also know from another study that intake of specific collagen peptides increased bone mineral density in postmenopausal women with a primary age -related reduction of bone mineral density. In addition, specific collagen peptide supplementation was associated with a favorable shift in bone markers, indicating increased bone formation and reduced bone degradation. Knowing this information and also that as we age, we lose muscle mass, as I mentioned earlier, and that the menopause transition
increases our risk of osteoporosis and joint pain and weight gain and incontinence, perhaps supplementing with collagen would be worth considering as a possible way to slow down or minimize the increased risks that we face around midlife. I know that I am not waiting for research about collagen. Mind you, there is a decent amount of it. I mean, specific to the pelvic floor. I am supplementing now. So what else can help with collagen production?
There was an interesting article that evaluated the effect of vitamin D in preventing pelvic organ prolapse by aggregating elastin and collagen expression. They looked at cell cultures from the uterus sacral ligament from female patients undergoing hysterectomy. They divided the cells into various groups that would be exposed to different levels of vitamin D and one group that was not exposed to vitamin D at all.
They found that vitamin D exposure had a significantly positive effect on increasing extracellular matrix expression with the most effective dose of vitamin D for collagen expression being 800 millimoles. I have to get that back to you. 800 millimoles, I think it is. I can't read that. I'm sorry. I don't remember what that marker is, but I'm going to post it in the notes below. It's also interesting to note that there is a correlation of low vitamin D with pelvic floor disorders.
One study looked at post -menopausal women in particular, and while the study looked at a broader age range and found that mean vitamin D levels were significantly lower for women reporting at least one pelvic floor disorder, and for those with urinary incontinence, irrespective of age. The researchers observed significantly decreased risks of one or more pelvic floor disorders with increasing vitamin D levels in all women age 20 or older, and in the subset of women 50 years of age and older. Additionally,
Kim (18:34.702)
the likelihood of urinary incontinence was significantly reduced in women 50 and older with vitamin D levels at 30 nanograms per milliliter or higher. I've taken these from the study. So again, I'm not the best at reading those measurements, but they'll be listed down below. My apologies on that. Which collagen supplement is best? Well, I have tried a few. I've tried several.
And in the article that I will post below, I will link to a couple that I do like. There are many, and there are many different brands. There are many different types. We've talked about varicell being a type of collagen peptide that has been researched. So you can find ones that have varicell in them.
I've tried Totally Derma Collagen. I've tried the one from New Skin. I've tried the one from Sparkle Wellness. I've tried the one from Organica. I've tried a lot and I would say I probably noticed the biggest difference from the New Skin, the Totally Derma and the Sparkle.
There's also a new, I'm learning about it's been around for a long time, but it's a new to me, product called fulvic humic acid. Fulvic and humic acid are mineral rich compounds that contain vital nutrients and vitamins and trace minerals that are in fruits and vegetables. But because our soils are becoming so depleted due to mass farming practices, we end up being depleted too.
Fulvic and humic minerals contain a complex of ionic minerals found within the deep organic soil layers of four distinct climate regions in North America. The trace minerals, electrolytes, and amino acids work synergistically together to help relieve the body of toxins, heavy metals, and pesticides. Supporting the immune system, the gastrointestinal, and the digestive systems, the formula may reduce excess acidity, improve microbial balance, and assist in the production of digestive enzymes.
Kim (20:44.59)
Fulvicumic acid helps draw out toxins that hinder your body's ability to absorb nutrients. When you absorb trace minerals and nutrients, your skin and your hair will benefit. Fulvicumic acid also increases your body's own collagen synthesis and they are an antioxidant so they fight free radicals that can damage the skin, the hair and nails. So I am currently testing fulvicumic acid and not taking the collagen to see if I notice a difference so you can stay tuned on.
So there you have my report on collagen and the pelvic floor and diastasis recti. The book, The Collagen Cure, I was trying to see if I have it. I don't have it on my shelf close to me, but that's a book that I read that has loads and loads of evidence. I highly, highly recommend that read, The Collagen Cure. And as I said in the notes, I will share a link to the article where I have
all the proper measurements or dosing numbers, as well as the article with the references. So you can have a read for yourself. And I will keep an eye open for any new research as it pertains to pelvic floor and collagen. And we'll continue to update the article as I find that. So let me know in the comments, do you supplement with collagen? What's your favorite brand? What are the biggest differences that you've noticed?
For me, it was skin hair, nails. I didn't notice a difference with my pelvic floor. I don't necessarily have any symptoms that I'm trying to manage. I didn't notice any drastic changes to my pelvic floor, but I definitely noticed, especially my nails. That's the biggest place that I noticed when I do take collagen consistently. I have very strong, very fast growing nails. My hair grows very quickly. It didn't for me change the texture of my hair.
My hair is quite dry, didn't change that. I did notice hydration levels in my skin improved with collagen. So those are the observations that I have noticed, but I'm not just taking it because I want better skin, hair and nails. I am taking it knowing that I am losing muscle mass, knowing that I am losing bone density as I age. I'm doing everything that I can to fight that. Resistance training, supplementing with collagen, eating a good diet.
Kim (23:06.35)
getting good sleep, all of what we know we should be doing, I'm trying to do. So hopefully you found that helpful and let me know in the comments below if you yourself take collagen. And one more ask, if you find the content that I share here on the podcast helpful, I would love for you to provide a review, ideally a five -star review. I've got only five stars so far, which is great.
I'd love to increase that number. I'd love to increase the reach and make sure that people are getting the pelvic health education that they deserve and that they need so they know that they are not alone. All right. Thanks again. We'll see you in the next episode.
