Pelvic health
Pregnancy strains the pelvic floor muscles. Strengthening them through regular exercises helps prevent issues like leakage, supports recovery post-birth, and promotes long-term health, especially through menopause.
Pelvic floor muscles
Your pelvic floor muscles sit in a hammock underneath your pelvic organs - bladder, womb and the lower part of your bowels. Healthy pelvic floor muscles are important for bladder function, bowel function and sexual function.
Pregnancy and childbirth can put a strain on the pelvic floor muscles. By the end of pregnancy, your pelvic floor is supporting roughly twice the weight of your baby. Your baby is being carried along with your (now bigger) womb, the fluid around your baby, and your placenta.
Pelvic floor exercise
Pelvic floor exercise is recommended during pregnancy and after the birth to help avoid problems during this time.
It is also important to get into good habits exercising these muscles, as any problems or weakness will typically get much worse as we get older. Menopause brings changes which can make pelvic floor problems worse.
The good news is that by choosing to work out your pelvic floor you can build up strength, avoid problems and stay healthy and active into later life. With a strong pelvic floor you can:
- get active playing with your children without worrying about leaks
- laugh at those funny parenting moments without worrying about leaks
- have more sensation during sexual activity.
Pelvic floor muscle exercises should be practised three to six times every day for life, after childbirth. Squeeze your anus, just like you are trying to stop wind from escaping, for about 10 seconds while breathing normally. Repeat 10 times.
Symptoms of pelvic floor weakness
Up to one third of women will experience some problems with their pelvic floor muscles at some point. Symptoms of pelvic floor weakness include:
- Leaking of urine, particularly when coughing, sneezing, laughing or exercising
- A sudden need to go to the toilet, or going very often
- Leaking of stool (poo) or wind
- Difficulty getting clean after a bowel movement
- Feeling of something 'coming down' in the vagina
- Lack of sensation during sexual activity.
How to do a pelvic floor squeeze
The muscles you need to squeeze to exercise your pelvic floor are the same ones you would use to hold in a wee, if you were in a queue for a toilet, and to hold in wind. When you try to exercise these muscles for the first time, you may find it easiest to lie on your back with your knees bent. With a stronger pelvic floor, you can exercise them in a sitting, or even a standing position too.
With clean hands, you can feel inside your vagina with a thumb or finger to check whether you can feel a squeeze. The pelvic floor contraction should feel different from when you tense up your buttocks or your stomach muscles.
If you are not confident that you are able to do pelvic floor squeezes, talk to your midwife.
Where to get help with problems?
Do not suffer in silence. Pelvic floor problems are very common and can be improved with the right support. Maternity services are working to make sure it is easier for you to see a specialist women's health physiotherapist, when needed. A women's health physiotherapist can support you to exercise your pelvic floor effectively, and also identify when further treatment or surgery may be needed. Speak to your midwife or GP.
How to build up your pelvic floor strength
As with any muscle, to build strength you will need to repeat the exercise until the muscle gets tired, and then do this regularly to build up how much you can do over a number of weeks and months. For pelvic floor strength, exercise three times a day is recommended. It takes around five minutes each time. Ideally, you would be able to do 10 squeezes, holding each for the count of 10 and relaxing your pelvic floor completely in between. You would then do 10 quick squeeze and release patterns.
Effective pelvic floor strengthening is a commitment, but well worth it. It needs to be built into a routine, and this is difficult when looking after a baby and perhaps other children. You may wish to set yourself reminders. You might consider downloading the NHS Squeezy app to provide reminders and an exercise guide. However, it is worth it to avoid problems and enjoy the advantages of a strong pelvic floor.
Pelvic girdle pain
Have you recently given birth and feel pain around your pelvis or lower back? You may have pelvic girdle pain. PGP is treatable with hands-on manual therapy and exercises. See your GP for an NHS physiotherapy referral.
Pelvic health videos
What is your pelvic floor?
What to expect at a pelvic health appointment
Pelvic Girdle Pain (PGP)