Pelvic floor exercises for women Whakangungu pae papatoiake mā ngā wāhine

Your pelvic floor muscles are a group of muscles that:

• stretch from your tailbone at the back, to your pubic bone at the front, and from side to side
• can move up and down, a bit like a trampoline.
• have holes in them to allow your urethra (the tube you wee through), anus (where your poo comes out) and vagina to pass through.

Together with other muscles, your pelvic floor muscles support and stabilise your pelvis and spine. They also help with bladder and bowel control and prevent leakage of wee (urine), farts and poo.

Female pelvic floor muscles 3D animation — YouTubeexternal link

Female pelvic floor muscles and pelvic organs 

When your pelvic floor muscles get weak or are damaged, they do not work as well. Weak muscles may be caused by:

• excessive straining when pooing due to constipation
• repeated heavy lifting putting pressure on the muscles
• persistent coughing
• the muscles getting weaker with age
• being an unhealthy weight, which puts more pressure on the muscles
• pregnancy and childbirth
• hormonal changes due to pregnancy, your menstrual cycle or menopause.

Your healthcare provider may recommend that you do exercises to strengthen your pelvic floor muscles. Or you may want to do them to avoid problems in the future.

Exercising your pelvic floor can help to:

• improve or maintain your bladder and bowel control
• support your pelvic organs, helping to prevent or relieve the symptoms of a prolapse (when your pelvic organs sag down into your vagina)
• make sex more pleasurable
• improve your recovery after childbirth
• improve the stability of your core (torso).

Pelvic organ prolapse

The first step is to identify your muscles.

• Sit or lie down on a comfortable surface like your bed.
• Relax your thighs, buttocks and tummy muscles.
• Breathe normally, do not hold your breath or change your breathing pattern
• Lift and squeeze your pelvic floor and hold the contraction for 5 seconds.

To make sure you target the right muscles you can imagine:

• trying to hold a fart in by squeezing your back passage closed
• stopping yourself from weeing (urinating)
• squeezing around a tampon and trying to suck it up into your vagina.

Everyone's brain works differently, so it is a good idea to try different methods to see what works for you.

If you are not sure if you are doing it right, try to stop your flow when weeing, then restart it. Only do this once to identify and test the correct muscles to use. Do not exercise your pelvic floor muscles this way as it can cause issues with your pelvic health.

You can also test your pelvic floor muscles by placing 1 or 2 clean fingers into your vagina and squeezing your muscles around them. The muscles should be squeezing around your fingers and lifting your fingers into your vagina.

If you cannot feel any definite squeeze and lift action in your pelvic floor muscles, it is important that you see your healthcare provider. They may refer you to a continence advisor or a pelvic floor physiotherapist.

Continence advisers — Continence NZexternal link

Pelvic floor physiotherapists — Physiotherapy NZexternal link

Do the following exercises 2 to 3 times per day. You can do them lying, sitting or standing.

1. Tighten your pelvic floor muscles as firmly as you can and hold for 5 to 10 seconds.
2. Rest for 10 seconds.
3. Repeat the first 2 steps 5 times.
4. Do 5 short, fast, strong contractions (pulling up quickly and immediately letting go).

When doing the exercises do not:

• hold your breath
• push or bear down
• tighten your buttocks or thighs too much.

As your pelvic floor gets stronger, you can increase the:

• length of time you hold your muscles tight
• number of times you repeat the exercise
• number of sets you do.

You can also try changing position and doing the exercises when doing other activities.

Your goal is to be able to tighten your pelvic floor muscles strongly before you cough, sneeze or lift something heavy.

If you have been assessed by a pelvic floor physiotherapist, they will give you a specific pelvic floor exercise programme to follow.

Pregnancy and childbirth can weaken or damage your pelvic floor muscles. 

It is a good idea to start doing pelvic floor exercises before pregnancy and to continue while you are pregnant and after you give birth to your pēpi. This helps with bladder and bowel control and prevents leakage of wee (urine), farts and poo.

Talk to your midwife or doctor about pelvic floor muscle exercises after childbirth.

Exercising after childbirth

After the birth of your pēpi, it is very important to give your pelvic floor muscles time to recover. You should not return to high-impact sport too soon after your baby is born. You can find information about safely returning to sports after childbirth on the Continence Health Australia website.

Returning to sport or exercise after birth — Continence Health Australiaexternal link