Pelvic floor health: what it is, exercises and when to get help
Quick answer
The pelvic floor is a group of muscles that supports the bladder, bowel and, in women, the womb. Everyone has one. Pregnancy, childbirth, ageing, prostate surgery and long-term straining can weaken it, leading to leakage or prolapse symptoms. Regular pelvic floor exercises help many people, and a GP or pelvic health physiotherapist can assess problems that do not improve.
Key points
- The pelvic floor muscles support the pelvic organs and help control the bladder and bowel.
- Pelvic floor problems affect people of all genders, not just those who have given birth.
- Pelvic floor exercises involve repeatedly squeezing and relaxing these muscles; results usually take a few months of regular practice.
- Leaking urine is common but not something you have to put up with: it is often treatable.
- A pelvic health physiotherapist can check you are doing exercises correctly and tailor a plan.
What is the pelvic floor?
The pelvic floor is a layer of muscles and connective tissue stretching from the pubic bone at the front to the tailbone at the back, rather like a supportive sling. It holds the bladder and bowel in place, and the womb in people who have one. These muscles help you control when you pass urine, stools and wind, and they also play a role in sexual function.
Like other muscles, the pelvic floor can become weak, or sometimes too tight. Both can cause symptoms, which is why a professional assessment is helpful if you have ongoing problems.
Who can have pelvic floor problems?
Anyone can. Pregnancy and vaginal birth are common causes in women, and menopause can weaken pelvic tissues further. In men, pelvic floor weakness is common after prostate surgery and can cause leakage or dribbling after passing urine.
Other factors that strain the pelvic floor in people of any gender include long-term constipation, a persistent cough, being overweight, regular heavy lifting and getting older.
How do pelvic floor exercises work?
Pelvic floor exercises strengthen the muscles by repeatedly tightening and lifting them, holding briefly, then fully relaxing. A typical routine combines longer holds with quick squeezes and is done several times a day. Relaxing fully between squeezes matters as much as the squeeze itself.
Many people find it hard to find the right muscles at first. Avoid holding your breath or tightening your stomach, thighs or buttocks instead. Do not practise by regularly stopping the flow of urine, as this can interfere with normal bladder emptying. It usually takes around three months of regular practice to notice a clear improvement, and continuing afterwards helps maintain it.
How can you look after your pelvic floor after childbirth?
Some leakage in the weeks after birth is common. Gentle pelvic floor exercises can usually be started soon after delivery, as long as they are comfortable, and your midwife, health visitor or doctor can advise you, especially after a caesarean section or a significant tear.
If you still have leakage, heaviness or pain at your postnatal check or several months after birth, mention it. These symptoms are treatable, and you can ask to be referred to a pelvic health physiotherapist.
When should you see a physiotherapist or GP?
See a GP if pelvic floor symptoms are affecting your daily life or are not improving after a few months of exercises. In some areas you can refer yourself to a pelvic health physiotherapist. Signs that are worth getting checked include:
- Leaking urine when you cough, sneeze, laugh or exercise, or a sudden urgent need to pass urine.
- Difficulty controlling wind or stools.
- A feeling of heaviness, dragging or something coming down in the vagina, or a bulge you can see or feel, which can be signs of prolapse.
- Pain in the pelvis or during sex, which can sometimes be caused by overly tight pelvic floor muscles.
When to see a doctor
- Get urgent medical help if you suddenly cannot pass urine, or lose bladder or bowel control together with back pain or numbness around the buttocks or genitals.
- See a GP if you have a bulge or a feeling of something coming down in the vagina.
- Book an appointment if you have leakage of urine, wind or stools that affects your daily life.
- Ask for a referral if pelvic pain or pain during sex continues.
Frequently asked questions
Do men need to do pelvic floor exercises?
They can benefit. Men have pelvic floor muscles too, and strengthening them can help with leakage after prostate surgery, dribbling after passing urine and some bowel control problems. A doctor or physiotherapist can show you how to find the right muscles and how often to practise. Anyone with new urinary symptoms should also see a GP.
How long do pelvic floor exercises take to work?
Most people need to practise regularly for around three months before they notice a clear difference. Results depend on doing the exercises correctly and consistently. If you see no improvement after this time, or are unsure whether you are using the right muscles, a pelvic health physiotherapist can assess you and adjust your programme.
Is leaking urine after having a baby normal?
It is common, particularly in the first weeks after birth, but it is not something you have to accept long term. Pelvic floor exercises help many people. If leakage continues for more than a few months, or affects your confidence or activities, talk to your GP, midwife or health visitor about a referral.