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Pelvic floor muscles are layers of muscles and connective tissues that support the pelvic organs (bladder, bowel, and uterus in women). They give you the ability to control the release of urine, faeces, and flatus, and support sexual function in both men and women. Pelvic floor muscles can weaken over time due to injury, aging, pregnancy, childbirth, prostate cancer treatment, obesity, and constipation, leading to conditions like incontinence or pelvic organ prolapse. Pelvic floor exercises, also known as Kegels, are commonly used to strengthen these muscles and improve muscle tone.
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What You'll Learn
Pelvic floor muscles support the bladder, bowel and uterus
The pelvic floor muscles are a group of muscles that support the bladder, bowel, and uterus in the pelvis. They are made up of layers of muscle and other tissue, stretching from the pubic bone at the front to the tailbone (coccyx) at the back, and from one sitting bone (ischial tuberosity) to the other. The pelvic floor muscles are usually firm and thick, and they help to stabilise the core while assisting with essential bodily functions, such as urination, defecation, and sexual intercourse.
In women, the pelvic floor muscles support the bladder, bowel, and uterus (womb), with the urethra, anus, and vagina all passing through these muscles. These muscles normally wrap tightly around these passages to keep them closed. When contracted, the pelvic floor muscles lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor muscles allows for the passage of urine and faeces. Pelvic floor muscles are also important for sexual function in both men and women. In men, they are important for erectile function and ejaculation.
Weakened pelvic floor muscles can lead to problems with bladder and bowel control, as well as sexual dysfunction. Pregnancy, childbirth, prostate cancer treatment, obesity, and chronic constipation are common causes of pelvic floor weakness. Weak pelvic floor muscles can also lead to conditions such as incontinence and pelvic organ prolapse. Pelvic floor exercises, such as Kegels, are often recommended to strengthen the pelvic floor muscles and improve muscle tone and brain connectivity.
On the other hand, pelvic floor muscles that are too tight, a condition known as hypertonic pelvic floor, can cause difficulties with bladder and bowel emptying. This can lead to constipation, pelvic pain, painful intercourse, and urinary issues. Treatment options for hypertonic pelvic floor include physical therapy, relaxation techniques, injections, medications, and cognitive behavioural therapy.
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Pelvic floor dysfunction and incontinence
Pelvic floor dysfunction is a condition that affects both men and women, although it is more prevalent in women. The pelvic floor muscles support the bladder, bowel, and uterus (womb) in women. These muscles are located between the tailbone (coccyx) and the pubic bone within the pelvis. They are responsible for controlling the release of urine, faeces, and flatus (wind). When contracted, these muscles lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor muscles allows for the passage of urine and faeces.
Pelvic floor dysfunction can lead to incontinence, which is the loss of control over urination and defecation. Incontinence is a common symptom of pelvic floor dysfunction, with leaking urine when coughing, sneezing, laughing, or running being a specific example. In addition to incontinence, pelvic floor dysfunction can also cause pelvic organ prolapse, which occurs when the pelvic organs, such as the bladder and uterus, slide down into the vagina or anus. This can result in a distinct bulge and deep vaginal aching.
Weak pelvic floor muscles can be a contributing factor to pelvic floor dysfunction and incontinence. Pregnancy, childbirth, prostate cancer treatment, obesity, and chronic constipation are common causes of weakened pelvic floor muscles. Additionally, reduced oestrogen levels and the normal ageing process can also lead to muscle weakness over time. Pelvic floor exercises, also known as Kegels, are often recommended to strengthen the pelvic floor muscles and improve muscle tone. These exercises involve routinely squeezing and relaxing the pelvic muscles to build control. Biofeedback may be used during Kegel exercises to help individuals identify and contract the correct muscles.
In some cases, pelvic floor muscles may be overly tight or hypertonic, leading to constipation, difficulty moving the bowels, pelvic pain, and painful intercourse. This condition is less commonly discussed and understood. Treatment options for hypertonic pelvic floor muscles include physical therapy, relaxation techniques, injections, medications, and cognitive behavioural therapy.
The financial burden of pelvic floor dysfunction is significant, impacting both patients and healthcare systems. The costs associated with incontinence pads, diagnostics, and treatments can be substantial for individuals, while the healthcare system bears the costs of surgical repairs, which are often necessary for prolapse corrections.
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Pelvic floor exercises to strengthen muscles
Pelvic floor muscles support the bladder, bowel, and uterus. They also assist with essential bodily functions like urination, defecation, and sexual intercourse. Weak pelvic floor muscles can lead to conditions like incontinence, pelvic organ prolapse, and sexual dysfunction. Pelvic floor exercises, also known as Kegels, are an effective way to strengthen these muscles and improve overall pelvic health.
To perform Kegel exercises, start by identifying your pelvic floor muscles. You can do this by inserting a finger into your vagina and squeezing the muscles around it. Alternatively, try to stop the flow of urine midstream—the muscles you use to do this are your pelvic floor muscles. Once you've identified these muscles, practice squeezing and releasing them to strengthen and train them.
In addition to Kegels, there are other exercises that can help strengthen the pelvic floor. Pelvic tilts, for example, help strengthen the lower back and abdominal muscles, contributing to pelvic floor stability. To perform pelvic tilts, lie on your back with your knees bent and feet flat on the floor. Tighten your abdominal muscles and press your lower back into the floor, holding for a few seconds before releasing. Repeat this movement 10-15 times, gradually increasing the number of repetitions as your muscles strengthen.
The bird-dog exercise is another great option for activating multiple muscle groups, including the pelvic floor. Start on your hands and knees with your wrists under your shoulders and your knees under your hips. Keep your back straight and engage your core muscles while retracting your shoulder blades down toward your hips. Simultaneously extend and raise your left leg and right arm, maintaining a neutral body position. Hold this pose for a few seconds before switching sides. Aim to incorporate these exercises into your fitness routine 2-3 times a week for optimal results.
For those with hypertonic pelvic floor muscles, or muscles that are too tight, specific exercises can help promote relaxation and lengthening. The Happy Baby Pose is a great option for stretching and releasing the pelvic floor. To do this pose, lie on your back with your knees bent and bring them toward your belly at a 90-degree angle, with the soles of your feet facing up. Open your knees wider than your torso and bring your feet up toward your armpits, flexing your heels and pushing your feet away from your body. Remember to always consult with a healthcare professional before starting any new exercise regimen, especially if you have pre-existing health conditions.
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Pelvic floor muscles and sexual function
Pelvic floor muscles are crucial for sexual function in both men and women. These muscles support the bladder, bowel, and uterus (womb in women). They help prevent incontinence and maintain bladder and bowel control. Pelvic floor muscles also play a role in sexual sensation and pleasure. When contracted, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. This contraction-relaxation combination allows for enjoyable sex.
In women, pelvic floor muscles support the bladder, bowel, uterus, and vagina. Weakened pelvic floor muscles in women can lead to reduced vaginal sensation and painful sex. Pregnancy, childbirth, and obesity are common causes of pelvic floor weakness, which can result in issues with sexual function. Pelvic floor exercises, also known as Kegels, are recommended to strengthen the muscles and improve sexual function.
In men, pelvic floor muscles are important for erectile function, ejaculation, and bladder and bowel control. Weakened pelvic floor muscles in men can lead to stress incontinence, where urine leaks during activities like coughing or sneezing. Pelvic floor exercises can help men improve their symptoms and enhance sexual function.
It is important to maintain strong pelvic floor muscles to support sexual function. Weak or overactive pelvic floor muscles can cause pain during sex and affect the ability to control urine and faeces. Pelvic floor exercises can help improve muscle tone and brain connectivity, preventing the need for corrective surgery. Physiotherapists specialising in pelvic health can assist individuals in strengthening their pelvic floor muscles and improving their sexual function.
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Weak pelvic floor muscles and pregnancy
The pelvic floor is a group of muscles, ligaments, and sheet-like tissues that support the bladder, uterus, and bowel. They form a "sling" or "hammock" that stretches from the pubic bone at the front of the body to the tailbone at the back. Pelvic floor muscles help to stabilize the core and assist with essential bodily functions like urination, defecation, and sexual function.
Pregnancy and childbirth are common causes of pelvic floor muscle weakness. During pregnancy, the pelvic floor has the extra job of supporting the growing baby. The weight of the baby can cause the pelvic floor muscles to stretch and weaken over time. This can lead to a loss of bladder control, especially during the second and third trimesters. Weak pelvic floor muscles may also make it harder to control the release of urine, feces, and flatus (wind).
Women who have had multiple births, assisted births (with forceps or ventouse), third and fourth-degree perineal tearing, or large babies (over 4kg) are at greater risk of pelvic floor muscle damage. Vaginal births, particularly those involving the use of forceps, are more likely to cause damage to the pelvic floor. Pregnancy itself, especially the first pregnancy, can also cause pelvic floor weakness, and a Caesarean section may not necessarily protect against it.
Weak pelvic floor muscles can lead to various problems, including urinary or fecal incontinence, constipation, pelvic pain, back or leg pain, painful intercourse, and sexual dysfunction. Pelvic floor dysfunction can cause a loss of bladder control, anal incontinence, and reduced vaginal sensation. In some cases, the internal organs supported by the pelvic floor, such as the bladder and uterus, can slide down into the vagina, a condition called prolapse.
Pelvic floor exercises, also known as Kegels, can help strengthen the pelvic floor muscles and improve muscle tone. These exercises involve routinely squeezing and relaxing the pelvic muscles to build control. They can be started within 24 hours after birth and can improve circulation in the area, aiding faster healing. Women are encouraged to exercise their pelvic floor muscles daily throughout their lives to prevent weakness and improve strength.
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Frequently asked questions
PF muscles are your pelvic floor muscles. They are layers of muscles and connective tissues that support the pelvic organs (bladder, bowel, and uterus in women).
PF muscles give you the ability to control the release of urine, faeces, and flatus. They also support the internal organs of the pelvis.
You can feel your PF muscles by squeezing the vaginal opening, urethra, and anus. In each case, you should feel muscles inside your pelvis pull inward and upward.
Pelvic floor exercises, or Kegels, are commonly used to strengthen PF muscles. These exercises involve routinely squeezing and relaxing your PF muscles to build control.
