Female pelvic floor muscle exercises

This leaflet is for all women, especially those who need to exercise their pelvic floor muscles to improve bladder, bowel or prolapse symptoms.

Why is your pelvic floor muscle important?

Pelvic floor muscles are important for bladder and bowel control and support of the pelvic organs. The pelvic floor muscles act together with the deep abdominal muscles to provide a support for the spine, pelvis and pelvic organs. This supporting action, often known as core stability, is needed all the time to help our bodies move and balance.

Those who are sexually active may find that exercising the pelvic floor muscles improves satisfaction for both partners.

What does the pelvic floor muscle do?

To work properly, the pelvic floor needs to:

• be strong and work at the right time (before a movement)
• work as part of the core (providing postural support/stability)
• be able to relax

Why does the pelvic floor muscle become weak?

The following factors can contribute:

• pregnancy and child birth
• chronic constipation (straining)
• abdominal or pelvic surgery
• hormones
• genetics (connective tissue type)
• heavy or repetitive lifting
• chronic chest conditions (coughing)

Pelvic floor muscles

The pelvic floor muscle is like a hammock made of muscle and connective tissue (ligaments). The muscle is attached from the pubic bone at the front to the coccyx at the back. There are three openings, the urethra (bladder tube) the vaginal opening and the anus (back passage).

Pelvic floor muscle exercises

You can exercise the pelvic floor muscles in any position but sitting is a good position to start in. Sit upright on a firm chair with your weight evenly on the sitting bones in your bottom cheeks.

It is important to work all parts of the pelvic floor muscles and to do this you need to practise both short and long contractions as described below.

Try to imagine that you need to stop yourself from passing wind and you are stopping the flow of urine mid-stream. You should feel a slight lift and tightening inside the vagina. Try not to tighten the bottom muscles or hold your breath.

Short contractions

Try the action above, pulling the muscles up strongly and then letting go completely. Repeat until the muscle tires. Aim to get to 10 contractions.

Long contractions

Try the action above and hold whilst still breathing for as long as you can, which may only be a few seconds to begin with. Build this up gradually to a maximum of 10 seconds. You should be able to control the letting go of these muscles. Repeat until the muscles tire.

How many repetitions?

To make a difference to your symptoms you need to do them frequently throughout the day, equally spaced out. If you find it difficult to remember to do your pelvic floor muscle exercises, try to find some prompts, for example after you have emptied your bladder; when the kettle is boiling; cleaning your teeth, whilst in the car, or mobile phone prompts (NHS ‘squeezy’ app).

A physiotherapist can assess your pelvic floor muscles, then give you more specific advice and complete the section below.

Practise your exercises ……. times a day

Practise when …… standing ……. sitting …… lying ……. other

Try and perform ……. short contractions

After a rest:

Hold the muscles tight for ……. seconds Relax for …... seconds

Repeat each squeeze ……. times

It is helpful to contract the muscles before you do anything that can put the muscles under pressure, such as lifting, coughing and sneezing.

Remember relaxing the muscle is as important as tightening so ensure you fully relax the muscles after exercising.

Frequently asked questions about pelvic floor muscle exercises

Will I need to continue the exercises for ever?

It is recommended that you do pelvic floor muscle exercises for life. Like any muscle it gets weaker if not used.

Will the exercises get easier to do?

Yes. Any new skill needs practice at first. As the muscle gets stronger and the nerve pathways improve you will find it easier to feel the contraction.

Can I do too many exercises?

Yes. The muscles fatigue quickly. It’s better to do them little and often. Remember to spread them out throughout the day. Rest in between each squeeze and make sure you relax after each exercise.

How long does it take to strengthen the muscle?

It may take up to three months of regular exercise before you notice an improvement.

I have back problems – will I be able to do the exercises?

Yes, core stability exercises including pelvic floor exercises are the treatment of choice for many back problems.

Resources

Pelvic floor muscle exercises video Pelvic health and obstetric physiotherapy (opens in a new tab)

For further physiotherapy advice

For further advice, you can leave a message for the pelvic health physiotherapists on 01223 217422.