Why You Need to Rehab Your Poor, Forgotten Pelvic Floor — & How to Do It

Plenty of women deal with problems like leaking pee, pelvic pain and constipation and think it’s all just par for the course of getting older and/or of giving birth. But, often these problems are caused by a weak or overly tight pelvic floor, and luckily there are some things you can do about that. But let’s back up for a minute, in case you don’t know what we’re talking about.

What is the pelvic floor anyway?

You’ve likely heard about the mysterious pelvic floor; it’s an area in your nether regions that can affect everything from orgasms to bladder control. For a lot of women, that’s about all they know.

The pelvic floor is comprised of muscles and tissues that support the bladder, uterus and rectum. Picture a hammock of muscles and tissues that extends around the rectum to around the vagina and just kind of holds everything up when you stand. That’s the pelvic floor. When you go to the bathroom, you are theoretically contracting or relaxing the pelvic floor muscles. A strong pelvic floor can increase pleasurable sexual sensations, which can lead to orgasm. Additionally, maintaining a healthy pelvic floor can reduce vaginal pain during sex.

Why you should exercise your pelvic floor

Being kind to your pelvic floor not only can help you deal with symptoms you may be having, but it can help prevent problems as you age.

When a pelvic floor is weak, people tend to contract their muscles instead of relaxing them, a condition called pelvic floor dysfunction. This can lead to involuntary urination, incomplete bowel movements, constipation, painful urination, pain in lower back and pain during sex.

Leaking pee? You’re not alone

One of the most common symptoms of a weakened pelvic floor is a lack of bladder control; in fact, approximately 25 to 45 percent of women experience urinary incontinence, which is defined as leakage at least one time in the past year. The risk of developing urinary incontinence increases with age; 20 to 30 percent of young women experience the condition, while 30 to 40 percent of middle-aged women and 50 percent of older women experience urinary incontinence.

Unfortunately, many people don’t become aware of their pelvic floor until it starts to weaken. The thing is, a weakened pelvic floor is not just for older women in menopause. It can happen from childbirth, heavy lifting and being overweight.

These women feel so isolated,” says Lauren Streicher, MD. Streicher, who, among other things is an OB/GYN, founder and medical director of Northwestern Medicine Center for Menopause and Northwestern Medicine Center for Sexual Health, and the author of Sex Rx: Hormones, Health and Your Best Sex Ever. “They feel like they’re the only ones with this issue. As a society, we need to talk about it.”

How to get your pelvic floor back on track

So, how exactly do you work on and/or maintain your pelvic floor?

Kegels. If you’ve heard of the pelvic floor, you’ve undoubtedly heard of the kegel. Kegel exercises are an easy way to work on your pelvic floor. To identify the proper muscles, stop urinating midstream; these are the muscles you’ll be focusing on relaxing and contracting.

To do kegels, the Mayo Clinic recommends imaging that you are lifting a marble by tightening your pelvic muscles. Simply squeeze for three seconds, then release for three seconds; just make sure not to flex the muscles in your stomach, thighs or butt. Maintain your focus and repeat this exercise three times per day, aiming for at least three sets of 10 to 15 repetitions.

When done correctly and consistently, kegels can make a difference,” Streicher says. “Sometimes the muscles are too weak to even make a difference, though.”

Pelvic floor physical therapy. Kegels aren’t doing much for you? See a pelvic floor physical therapist. These pros are trained in pelvic floor rehab and can come up with a personalized plan to help you with your own specific case. They also can work with patients on a variety of conditions such as vaginismus or endometriosis. This type of physical therapy typically involves specific exercises to ensure patients can live with as little pain as possible.

Streicher says it may be useful to work with a device such as Attain by InControl, which stimulates muscles to strategically strengthen and calm them for better pelvic floor control. (Disclaimer: Streicher works with the company to promote the device.)

Eat right and exercise. In addition, Streicher recommends eating a balanced diet and exercising regularly, as being overall healthy and strong can help. Plus, obesity can potentially lead to a weaker pelvic floor. The Department of Health and Human Services recommends that adults get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week. Additionally, the Office of Disease Prevention and Health Promotion recommends a balanced diet of vegetables, lean protein and healthy fats.

More than anything, Streicher hopes to change women’s perspectives, letting them know they aren’t necessarily predestined to have bladder control issues. With a little bit of work and commitment, you can potentially work to rebuild your pelvic floor.

“The main thing is to empower the women who have these problems,” she said. “They feel isolated, or they feel like it’s normal. Common is not the same as normal, and you don’t have to accept this.”

Talk to your doctor or a pelvic floor physical therapist if you think you might be having problems with your pelvic floor.

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