Pelvic floor dysfunction affects half of women – and there's an unexpected cause
The female pelvic floor is a remarkable yet often overlooked structure: a complex 'hammock' of muscles and ligaments that stretches from the front of the pelvis to the tailbone.
These muscles support the bladder, bowel and uterus, wrap around the openings of the urethra, vagina and anus and work in sync with your diaphragm, abdominal and back muscles to maintain posture, continence and core stability. It's not an exaggeration to say your pelvic floor is the foundation of your body's core.
Throughout a woman's life, various events can challenge the pelvic floor. Pregnancy, for example, increases the weight of the uterus, placing added pressure on these muscles. The growing baby can cause the abdominal muscles to stretch and separate, naturally increasing the load on the pelvic floor. Childbirth, particularly vaginal delivery, may result in perineal trauma, directly injuring pelvic floor tissues.
However, contrary to popular belief, pelvic floor problems aren't only caused by pregnancy and childbirth. In fact, research shows that intense physical activity, even in women who have never been pregnant or given birth, can contribute to dysfunction.
Exercise is essential for overall health and is often recommended to ease symptoms of menopause and menstruation. But one side effect that's not talked about enough is the effect that repeated strain, such as heavy lifting or high impact movement, can have on the pelvic floor. The increased intra-abdominal pressure during these activities can gradually weaken the pelvic floor muscles, especially if they're not trained to cope.
Pelvic floor dysfunction often results when these muscles aren't strong enough to match the workload demanded of them, whether from daily life, exercise, or other core muscles. And it's a growing issue, affecting more women than ever before.
Common symptoms include leaking urine or faeces when coughing, sneezing or exercising, a dragging or heavy sensation in the lower abdomen or vaginal area, painful sex, changes in bowel habits, visible bulging in the vaginal area (a sign of prolapse). The emotional toll can also be significant, leading to embarrassment, anxiety, low confidence and a reluctance to stay active – all of which affect quality of life.
Prevention
The good news? Help is available and, better yet, pelvic floor dysfunction is often preventable.
If you're experiencing symptoms, speak to your GP. You may be referred to a women's health physiotherapist, available through both the NHS and private services. But whether you're managing symptoms or hoping to avoid them in the first place, there are practical steps you can take:
Stay active and maintain a healthy weight
Drink enough water to encourage healthy bladder function
Go to the toilet only when your body signals the need; avoid going 'just in case'
Prevent constipation through a high-fibre diet and good bowel habits
Don't hold your breath when lifting or exercising
Most importantly, build strength with regular pelvic floor exercises.
Here's how to do a basic pelvic floor contraction:
Imagine you're trying to stop yourself passing wind – squeeze and lift the muscles around your back passage.
Then, imagine stopping the flow of urine mid-stream – engage those muscles too.
Now, lift both sets of muscles upwards inside your body, as if pulling them into the vagina.
Hold the contraction for a few seconds, then fully relax. Repeat.
If you're just starting, it may be easier to practise while sitting. With time and consistency, you'll be able to hold contractions for longer and incorporate them into your daily routine, like brushing your teeth or waiting for the kettle to boil.
Like any muscle, the pelvic floor gets stronger with training, making it more resilient to strain from childbirth, ageing, or strenuous activity. Research shows that a well-conditioned pelvic floor recovers faster from injury.
So be proud of your pelvic floor. Support it, strengthen it – and don't forget to do those squeezes.
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