Illustration a vagina, where the ovaries are muscles lifting weights

HOW TO: DO PELVIC FLOOR EXERCISES
(BECAUSE THEY’RE REALLY IMPORTANT)

Think of the pelvic floor as a hammock of muscles that support the bladder, bowel, urethra, vagina and uterus. If strong, these muscles can help to stop urinary incontinence, prevent pelvic prolapse and improve sexual sensation. But if weak, there’s a chance the body could lose control of the areas the pelvic floor is meant to be supporting. Symptoms of a weak pelvic floor include: urinary or faecal incontinence; vaginal prolapse; an urgent and more frequent need to pee; and pain during penetration.

PPelvic floor issues are particularly common post-pregnancy. Symptoms are likely to show themselves in the form of urinary incontinence or a heavy feeling between the vagina and anus (the perineum). ‘In the first year following a vaginal delivery, up to 66% of women have a degree of leakage,’ says pelvic floor surgeon Dr Mayoni Gooneratne.

In 2019, the National Institute for Health and Care Excellence (NICE) published new guidelines that encourage people to strengthen their pelvic floor muscles when signs of incontinence or prolapse present themselves – and there’s evidence these simple squeezes really work. The NHS found that by practising pelvic floor exercises ‘before and during a cough or any increase in abdominal pressure, urine loss can be reduced by 73% within one week’. So, what’s the best way to get started?

What exactly are pelvic floor exercises?

Squeeze your back passage as if you are trying to stop yourself from breaking wind (it should feel like you are drawing yourself inwards). At the same time, squeeze your vaginal muscles like you’re cutting off a pee mid-flow – these muscles should mirror the movement of your anus and retract upwards. The clenching/lifting sensation of the front and back pelvic areas at the same time is exactly what forms this strengthening exercise. Some women chose to use Pelvic Floor Trainers to help with this.

Woman relaxing with legs crossed practising kegel exercises

How many should you do?

Now you know how the exercise works and feels, start a set. The first squeeze should be short and sweet, so make sure you relax your muscles after a second or two. Then, after a little rest, repeat the squeezing process. This time round, hold the clench for up to 10 seconds before you release. It’s important not to tense any of the body's other muscles (buttocks, legs or tummy), or squeeze for longer than 10 seconds, as you don’t want to tire the pelvic floor muscles. Also, don’t forget to keep your breathing steady. Once you’ve got the movement down, aim to reach around 10 repeats of each exercise, four to six times a day.

What’s the best position?

You can learn to improve your strength, stamina and quick response by doing your exercises regularly, but make sure you’re in the right position. The NHS advises you lie, sit, stand or kneel on all fours to perform the tightening movement. As you re-educate your muscles and the area becomes stronger, you can start performing pelvic floor exercises when you really need them. Rely on your squeezing techniques as you cough, sneeze, laugh, lift, or run.

How do you know you’re doing it right?

Not quite sure whether you’re doing your pelvic floor exercises correctly? Get into a comfortable position on a bed or in a warm bath and gently insert your index and middle fingers inside the vagina. Perform the squeeze and check if you can feel your muscles closing around your fingers. Alternatively, you might find it easier to use pelvic floor trainers in different weights, which are inserted into the vagina.

Using a Pelvic Floor Trainer

Pelvic Floor Trainers are small weights that are designed to fit comfortably inside your vagina. By holding them inside the vagina using the correct muscles and technique, you can gradually strengthen your pelvic floor by progressing from smaller to slightly heavier weights.

Should you see your doctor?

It’s always a good idea to visit a medical professional if you think your pelvic floor muscles are on the weak side. Book an initial assessment with a doctor and have a vaginal and rectal examination to determine which area needs the most help, then gradually increase its strength by performing your GP’s suggested exercise plan as instructed.