Pelvic Floor Basics for Every Woman

The pelvic floor is a large hammock of muscles stretching from side to side across the floor of the pelvis. It is attached to your pubic bone in front, and to the tail end of your spine behind. The openings from your bladder, your bowels and your womb all pass through these muscles.

What does the pelvic floor do?
. It supports your pelvic organs and the contents of your abdomen, especially when you are standing or exerting yourself.
. It supports your bladder to help it stay closed. It actively squeezes when you cough or sneeze to help avoid leaking.
. It is used to control wind and when "holding on" with your bowels.
. It helps to increase sexual awareness both for yourself and your partner during sexual intercourse.

What weakens the pelvic floor muscles?
Pelvic floor muscles weaken for similar reasons to other muscles in our bodies: natural ageing and inactivity. But these particular muscles are also often weakened through hormonal changes in women's bodies, and through pregnancy and childbirth. Factors such as being overweight, ongoing constipation and a chronic cough can put extra pressure on them and pelvic surgery can also have damaging effects.

Why are pelvic floor exercises (also known as Kegel exercises) important?
A poorly toned, weak pelvic floor will not do its job properly. Women with weak pelvic muscles often experience incontinence and reduced sexual response. But research has shown that these muscles respond to regular exercise. With regular exercise, it is possible for most women to reduce or completely overcome the symptoms of a weak pelvic floor, no matter what their age.

A regular exercise regime, introduced early in life, will also prevent many of the problems associated with weak pelvic floor muscles emerging later. It is never too early or too late to begin to exercise these important muscles.

A woman whose muscles are already badly weakened may need the advice of a health professional before embarking on an exercise program. But many women with milder symptoms prefer to try a simple exercise regime for themselves initially. Easy-to-use and affordable exercise aids can provide feedback on correct exercuse technique and provide ongoing support.

How to do pelvic floor exercises (kegel exercises)
Exercise 1
Tighten the muscles around your back passage, vagina and front passage and lift up inside as if trying to stop passing wind and urine at the same time. It is very easy to bring other, irrelevant muscles into play, so try to isolate your pelvic floor muscles as much as possible by

. not pulling in your tummy,
. not squeezing your legs together,
. not tightening your buttocks and
. not holding your breath.

The effort should be coming from the pelvic floor muscles themselves.

For how many seconds can you hold the muscles tight? Try holding it as long and as hard as you can. Build up to a maximum of 10 seconds. Rest for 4 seconds and then repeat the contraction as many times as you can up to a maximum of 10 contractions.

Try to do these exercises in a slow and controlled way with a rest of 4 seconds between each muscle contraction. Practise your maximum number of held contractions (up to 10) about six times each day.

Exercise 2
The ability to work these muscles quickly helps them react to sudden stresses from coughing, laughing or exercise. Practise some quick contractions, drawing in the pelvic floor and holding for just one second before releasing the muscles. Do these steadily, aiming for a strong muscle tightening with each contraction up to a maximum of 10 times.

Try to do one set of slow contractions (exercise 1) followed by one set of quick contractions (exercise 2) six times each day.

If you do these exercises regularly, you will see optimum results within 3 to 6 months, but you should continue them for life to keep your pelvic floor muscles as fit as possible.

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