Most women only hear about the pelvic floor during pregnancy, if at all. Yet it plays a part in bladder control and sexual health at every stage of life, and looking after it is simple once you know what to do.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles that stretches like a hammock from your pubic bone at the front to your tailbone at the back. These muscles hold up the organs in your pelvis, such as the bladder and womb. They also:
Help you hold in urine and wind, then relax to let you go to the toilet
Support your lower back and core when you move
Contribute to sexual sensation and orgasm
What Can Weaken It
Pregnancy and birth are the most common causes of a weaker pelvic floor. Other causes include ongoing constipation and straining, a long-term cough, the drop in oestrogen at menopause, carrying extra body weight and repeated heavy lifting. High-impact sport can also put a lot of load on these muscles.
How to Do Pelvic Floor Exercises
Many women do these exercises incorrectly, often by squeezing their buttocks or holding their breath. In some studies, around half of women could not do them correctly with written or spoken instructions alone. Here is how to get it right:
Sit or lie comfortably and relax your thighs and buttocks
Squeeze and lift the muscles you would use to stop passing wind and urine at the same time, drawing them up and in
Keep breathing normally throughout
For slow squeezes, hold for up to 10 seconds, then relax fully for the same amount of time. Repeat up to 10 times
For quick squeezes, tighten and let go quickly, up to 10 times
Aim for three sessions a day
Avoid practising by stopping your urine flow on the toilet, as this can interfere with normal bladder emptying. It usually takes around three months of regular practice to notice a difference, and a reminder app can help you stay consistent.
When the Pelvic Floor Is Too Tight
Some pelvic floor problems have nothing to do with weakness. Some women have muscles that are tense and struggle to relax, known as an overactive pelvic floor. This can cause pain during sex and difficulty emptying the bladder or bowel. In this case, strengthening exercises can make symptoms worse, and the focus is on learning to relax the muscles.
When to See a Specialist
A pelvic health physiotherapist specialises in these muscles and can check how well yours are working, usually with an internal examination if you are comfortable with it. Supervised pelvic floor training has strong evidence as the first treatment for bladder leaks. In Switzerland, physiotherapy is covered by basic health insurance when a doctor prescribes it. Ask for a referral if you have leaks, a feeling of heaviness in the vagina, pelvic pain or ongoing problems after birth.
A few minutes a day is all it takes to look after these muscles, and the benefits last for decades.