The P Word


Before pregnancy and childbirth your pelvic floor is almost mythical, something that all your older female relatives and friends talk about losing but that never really means much to you.

That is at least until you have an 8lb tiny human resting on it like some sort fetal hammock in paradise and you start to realise you totally took for granted all the times you laughed without peeing yourself (or worse). Amongst your mums friends it seems totally normal and completely acceptable to leak whenever you chase your toddler around soft play and Susan from Zumba says she pees with every samba.

Well I have news for you mama IT IS NOT NORMAL and furthermore you do not have to accept any sort of leakage (from either end) and you CAN fix it. So here’s what you need to know about your pelvic floor, the do’s and the dont's to help you really appreciate your pelvic floor and restore it to its former glory days.

First things first, what is your pelvic floor?

Essentially your pelvic floor is a muscle that stops your organs falling out of your vagina!.

The pelvic floor muscle is made up of three layers and is very much like a muscular trampoline joined at one end to your spine and the other end is connected to your pubic bone. Above the pelvic floor are your bladder, bowel and uterus which is supported and held in place by your pelvic floor. As well as keeping your pelvic organs in place your pelvic floor is responsible for helping us release urine and faeces and plays a huge part in sexual function and pleasure too (oh so now you’re paying attention)

What can happen if the pelvic floor is weakened?

If your pelvic floor becomes weakened you may experience some signs of dysfunction such as:

  • Urgency to go to the toilet

  • Leakage of urine

  • Anal leakage (faecal and wind)

  • Pain either vaginal or in the abdomen

  • Lack of sensation or pain during sex

These are all signs that your pelvic floor is weakened and you should see your doctor or midwife if you are experiencing any of these symptoms. Unfortunately there are times when the pelvic floor becomes so weak that one or more of your pelvic organs may fall out of place, this is called a prolapse. There are four types of prolapse

  • Front wall vaginal prolapse (previously called a cystocele)

  • Back vaginal wall prolapse (previously called a rectocele)

  • Uterine prolapse

  • Vaginal vault prolapse

If you have a pelvic organ prolapse you may feel a heaviness or bulging in your vagina and in some cases you may even be able to see the bulge by placing a mirror between your legs. There may also be other symptoms such as inability to urinate/move your bowels. If you think you may have suffered a prolapse then you should see either your GP or a specialist women’s physiotherapist.

What can cause pelvic floor dysfunction?

There are a lot of things that can cause pelvic floor dysfunction or a pelvic floor prolapse, the most common cause in women is pregnancy and childbirth. Around 35% of new mums will experience some sort of pelvic floor dysfunction, most commonly urinary incontinence. Many believe that pelvic floor dysfunction does not effect mothers who have had cesarean sections however as the pelvic floor is still under immense pressure during pregnancy this is simply not true and there is no evidence to suggest that a C-Section reduces the risk of pelvic organ prolapse or dysfunction. Other factors that can lead to pelvic floor dysfunction are;

  • Obesity and being overweight, the more weight your body carries, the more pressure there is through the pelvis and onto the pelvic organs.

  • Heavy Lifting, the increase in abdominal pressure may make a prolapse more likely

  • Family history, this is thought to be due to an inherited weaker collagen type.

  • Age

  • Menopausal changes

  • Constipation

  • Chronic cough

  • Previous pelvic surgery

So what the chuff (excuse the pun) can you do if you are experiencing pelvic floor dysfunction?

The most important thing to remember is that prevention is better than cure when it comes to pelvic floor health so even if you don’t have any of the symptoms mentioned above you should still show your pelvic floor a little TLC to ensure it stays that way.

As with any muscle the key to a strong pelvic floor is to exercise it, in the same way you would squat to improve your leg strength you need to do pelvic floor exercises or ‘kegels’ to strengthen your pelvic floor.

To correctly activate your pelvic floor imagine you are trying to stop yourself from urinating, the sensation should be that of both a lifting and squeezing. Your abdomen, buttocks and shoulders should not move. Once you have activated your pelvic floor gently release as if you were going to pee and you have performed your first kegal. It is important to try and visualise exactly how the muscles lift and tighten to ensure you are focusing on the correct muscles. A great way to do this is by visualising sucking up a golf ball with your vagina – gross but totally effective.


So now you’ve mastered the technique you need to put in some practice. First try lifting and releasing ten times, taking your time and remembering to gently release your pelvic floor after each lift. Once you have done that try activating the muscles and holding for ten seconds. This is much harder and of course you probably won’t be able to do it the first try but you will get better the more you do. You should do this routine three times a day EVERY DAY!

Kegels shouldn’t hurt so if you experience any pain or bleeding after doing kegels you should see you doctor or midwife immediately and cease doing your kegels until you have.

Is there anything you should avoid if you are experiencing pelvic floor dysfunction?

There a definitely somethings you should avoid if you are experiencing any symptoms that suggest your pelvic floor is weakened.

  • High impact sports such as horse riding or aerobics

  • Deep squats

  • Sit ups, planks, crunches (or any core exercises that encourages you to bare down on your pelvic floor)

  • Standing for long periods of time

  • Heavy Lifting

  • Running

It doesn't mean that you won't be able to do those things ever again but it is best to give your pelvic floor time to heal before resuming them. Even if you did them before and during pregnancy it doesn't mean your pelvic floor is strong enough to do them now.

The good news is that with a little bit of love and a lot of kegels your pelvic floor can go back to its previous strength relatively quickly.There is a fantastic app called Squeezy that helps you to remember to do your pelvic floor exercises and gives you more information about help if you feel like you need it. You can download the app here.

#pelvicfloor #prolapse #femalehealth #pregnancy #postnatal #exercise #dysfunction #kegels

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