Pelvic Floor 101: What It Is and Why It Matters

Leaking a little when you cough or sneeze. Needing to rush to the toilet. A heavy, dragging feeling low in the pelvis. These are common problems, especially after childbirth and around menopause, and they're often linked to the pelvic floor.

What the pelvic floor is

The pelvic floor is a group of muscles that stretch like a hammock from your pubic bone at the front to your tailbone at the back. They:

• Support the bladder, bowel and, in women, the womb
• Control the openings of the bladder and bowel, helping you hold on and let go
• Stabilise the spine and pelvis together with your deep core muscles
• Contribute to sexual function

Men have a pelvic floor too, and it can be affected after prostate surgery.

What weakens it

• Pregnancy and childbirth
• Menopause and hormonal changes
• Chronic constipation and straining
• Long-term heavy lifting
• A chronic cough
• Being overweight
• Ageing

Signs of pelvic floor problems

• Leaking urine when coughing, sneezing, laughing, jumping or lifting
• Sudden urges to pass urine, or going very frequently
• Difficulty controlling wind or bowels
• A feeling of heaviness or a bulge in the vagina (possible prolapse)
• Pain during sex or in the pelvic area

How to find your pelvic floor

Sitting or lying comfortably, imagine you are trying to stop yourself passing wind and stop the flow of urine at the same time. You should feel a squeeze and lift inside. Your buttocks, thighs and stomach should stay relaxed, and you should keep breathing.

Don't practise by stopping your urine flow regularly while on the toilet, as this can interfere with normal bladder emptying.

Basic pelvic floor exercises

1. Slow squeezes: squeeze and lift, hold for up to 10 seconds, then fully relax for 10 seconds. Repeat up to 10 times.
2. Fast squeezes: squeeze and lift quickly, then let go straight away. Repeat up to 10 times.

Do these three times a day. It usually takes several weeks to a few months of regular practice to notice improvement.

Not everyone needs to squeeze more

Some people have pelvic floor muscles that are too tight, which can cause pain, difficulty emptying the bladder or painful sex. For them, relaxation is more important than strengthening. That's why an individual assessment matters.

Get help, not embarrassed

These problems are common, but they're not something you have to put up with. Pelvic health physiotherapy is a recommended first treatment for many bladder and pelvic floor problems. Our consultations are private and handled with sensitivity.