Why Your Pelvic Floor Deserves Your Attention

You may not even know what your pelvic floor is or does. Find out more about why maintaining these muscles is crucial as you grow older.

This won’t be the first place you’ve read that muscle mass dwindles as we age. But it may be news to you that the pelvic floor, a group of muscles and ligaments that support the bladder, uterus, and large intestines, also benefits from strength training.

“There are 28 different muscles in your pelvis,” says Aleece Fosnight, PA-C, a board-certified physician assistant in North Carolina who specializes in reproductive health and urologic care. She is the medical advisor at Aeroflow Urology. “Similar to the way muscles you can see — such as your calves or biceps — atrophy if you don’t use them, pelvic floor muscles can weaken as well.”

When that happens, it can cause problems with your bladder, your bowels, your stability, and your sex life. Understanding this part of your body better can help you maintain its function. This expert advice will get you up to speed.

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What does the pelvic floor do?

The pelvic floor muscles hold the organs in your pelvis in place. The ability to tense and relax those muscles helps remove waste from your body. Squeezing the muscles narrows the urethra and anus, so you can hold things in. Relaxing these muscles allows you to pee or poop.

Healthy pelvic floor muscles can be controlled deliberately, just like flexing a bicep. These muscles also help with blood flow and vaginal contractions during sexual activity. They also support vaginal delivery during childbirth.

“The pelvic floor contributes to keeping you balanced, stable, and mobile,” says Fosnight. “It can really affect your quality of life in profound ways, so it’s worth taking the time to support that part of your body, whether you’re noticing issues with your pelvic floor or not.”

Are there other reasons besides muscle loss that can weaken the pelvic floor?

Beyond the muscle loss that occurs naturally with age, which is known as sarcopenia, there are many other reasons why the pelvic floor muscles lose strength:

• Injury
• Surgery
• Childbirth
• Chronic coughing
• Repeated heavy lifting
• Hormone changes during menopause
• Chronic constipation
• Obesity
• Genetics

How can I tell if my pelvic floor is weak?

If you’re noticing any of these symptoms below, there is a good chance that those muscles could use a workout.

• Feeling of heaviness in the front, lower part of the pelvis
• Difficulty starting to urinate, or feeling like the bladder doesn’t empty completely
• Urine leaks when exercising, coughing, or laughing
• Urgent or frequent need to urinate
• Pain while urinating
• Leaking stool or difficulty controlling gas
• Frequent constipation
• Difficulty making it to the bathroom on time
• Reduced sexual arousal
• Infrequent orgasms

Which exercises can strengthen the pelvic floor?

The tricky part of focusing on the pelvic floor muscles is that there are no tiny dumbbells you can “lift” with your pelvis. But strengthening the area around the pelvic floor, like your lower abdomen, lower back, and hips, can make the core muscles work together more effectively, according to Fosnight.

Even if you’re not experiencing any symptoms of pelvic floor dysfunction, doing exercises like these — and staying active overall — can help you preserve the muscle strength you already have.

Kegels: This move involves squeezing and lifting the pelvic floor muscles, much like what you do when you need to urinate but aren’t near a bathroom. They can be done while sitting or standing. Breathe normally and hold the squeeze for 10 seconds, then relax the muscles completely. Try doing five repetitions in a row and work your way up to 12.

Bridges: This classic yoga pose is usually done to build gluteal muscles, but it strengthens the pelvic floor too. Lie on the floor with your knees bent, feet on the ground. Keep your arms straight at your sides with palms facing down. Pushing through your heels, raise your hips off the ground and gently squeeze your glutes. Pause for a few seconds and lower back down. Try doing 10 of those. (Here are three bridge pose progressions to try.)

Bird Dogs: This pose engages numerous muscles used for stability. Start on your hands and knees, with wrists under shoulders and knees under hips. Brace your core muscles as you straighten your left leg and right arm, keeping your back straight. Hold for a few seconds, then switch sides. Try doing 10 on each side. (Here are standing bird dog progressions to try.)

Are there medical treatments for pelvic floor problems?

Yes. If your symptoms interfere with daily function, you need to be checked by your health care provider, says Fosnight. The same thing is true if there’s pain or your symptoms are getting worse. You need to rule out any potential underlying conditions that could be a concern.

One relatively new treatment that is gaining popularity is pelvic floor therapy. This is a type of physical therapy that focuses on stabilizing the pelvis and spine. These sessions can include exercises that target the pelvic area, as well as electrical stimulation and biofeedback therapy. Like other types of physical therapy, you’re usually given exercises you can do at home too.

If therapy isn’t proving effective, your doctor may suggest medications instead. Local vaginal estrogen is one treatment method, as are certain drugs that are used to treat incontinence. Pelvic floor surgery may also be an option for severe or complex cases, especially if you’ve tried other treatments and your condition doesn’t improve.

What if my pelvic floor feels tight?

This is a less common condition than weak muscles, but it does happen. Tension tends to happen more often in men, with weakness more common in women, Fosnight adds.

Although some of the symptoms may overlap with those that come from weak muscles — constipation, urinary incontinence, and straining to urinate — tense muscles in this area can also contribute to constipation and lower back pain.

See our sources:
Pelvic floor muscles: Cleveland Clinic
Causes of pelvic floor disorders: National Institutes of Health
Pelvic floor exercises: UTHealth Houston
Pelvic floor therapies: Mayo Clinic
Medications for pelvic floor disorders: University of Chicago

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