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I’ve never had a problem with my pelvic floor, thanks. Why should I start thinking about it now? – October 2023

A common belief we see from a lot of women is that they don’t need to know about performing their pelvic floor exercises because they have never had a problem before- don’t fix it if it’s not broken, right? WRONG!

The pelvic floor is a group of muscles that a lot of people haven’t thought much about, the muscles have always done what they need to do and we might not even be aware of what they are doing, until they aren’t doing it anymore…

We know that the pelvic floor does a great job of helping to keep the bladder and bowel openings closed and also allowing the bladder and bowel to empty by relaxing when we want it to.

We also know that over time, if not exercised like any other muscle in the body, the pelvic floor can become weaker.

Factors that can influence the strength of the pelvic floor include;

Pregnancy. The change in hormones and the weight of a baby on the muscles supporting the uterus and other pelvic organs can result in a weaker pelvic floor than pre pregnancy. This might reveal itself by leaking urine when you cough or sneeze, or leaking wind accidently, or feeling you can’t hold on to any urine once the urge to go is there and having to rush to the toilet to avoid an accident.  This is not normal.

Gaining weight –an increase in body weight can increase the pressure on the pelvic floor muscles so they can’t support the organs as effectively. Again, symptoms such as leaking urine, wind or even faeces (poo) will tell you if your pelvic floor isn’t keeping up with the increase of weight within the body.

High impact exercise- while the pelvic floor may cope well with day to day activities, high impact activities and jumping exercises may increase the pressure on the pelvic floor muscles meaning they can’t support the bladder and pelvic organs as well. Know anyone who can’t bounce on the trampoline anymore in case they have an accident? This is why!

Smoking- a regular cough such as “smokers cough” causes pressure on the pelvic floor every time you cough meaning the pelvic floor may not be strong enough to cope with the sudden increase in pressure of the quick movement.

Perimenopause and menopause- during this time in a female’s life, oestrogen hormones reduce. Oestrogen plays an important role in our urinary and reproductive systems, the drop in oestrogen during perimenopause and menopause causes changes in the lining of the bladder and urinary tract (the tube which carries urine out of the body) as well as changes in the muscles and ligaments. This can result in the pelvic floor becoming weaker and the bowel is more susceptible to dysfunction. This can cause problems such as- urinary incontinence, not being able to hold it once the urge is there, or feeling the need to frequently pass urine as well as constipation. Pelvic organ prolapse is also a common complaint from menopausal women who may complain of a feeling of heaviness or dragging in the vagina or feeling like something is coming out of the vagina and as if there is an egg or a ball there.

If you are experiencing any symptoms of heaviness, dragging or as if something is slipping out of your vagina, please see your GP as you may need to be assessed by a pelvic health professional.

So what should you do if you have started to experience any of these symptoms? Firstly, don’t worry! Although not normal, these problems are very common and can be easily resolved with some commitment and effort to perform pelvic floor exercises every day.

In order to see a positive change in pelvic floor strength we need to perform our pelvic floor exercises 3 times a day and it can take between a few weeks to a few months to see a change difference depending on how strong or weak the muscles are to begin with.

Please go to you are not sure how to perform your pelvic floor exercises and if you don’t see an improvement or are struggling to do the exercises, please let your midwife or GP know so that you can be referred to a pelvic health specialist.

Written by – Amanda Argyle, Specialist Pelvic Health Midwife. 16.10.23