HealthInfo Waitaha Canterbury

Pelvic floor exercises for women

Whakangungu pae papatoiake mā ngā wāhine

Pelvic floor exercises aim to improve your muscle tone. A health professional may have recommended that you strengthen your pelvic floor muscles (PFMs). Or you might feel that you have or are at risk of pelvic floor problems.

Exercising your PFMs can help to:

• improve or maintain your bladder and bowel control
• support your pelvic organs, helping to prevent or relieve the symptoms of a vaginal prolapse (when your vagina is not supported and sags)
• make sex more pleasurable
• improve your recovery after childbirth.

Find your pelvic floor muscles

The first step is to correctly identify the 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 five seconds. To get the correct contraction, imagine trying to hold a fart in by squeezing your back passage closed, or stopping from weeing (urinating). Or you can imagine you're squeezing around a tampon and trying to suck it up into your vagina. As everyone's brain works differently, it's best to try different methods to see what works for you.

If you aren't sure if you're 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 one to two 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's important that you seek professional advice in private from a continence advisor or pelvic floor physiotherapist. Or you can ask your general practice team for a referral to Nurse Maude.

How to strengthen your PFMs

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

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

Remember:

• do not hold your breath
• do not push or bear down
• do not 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
• increase the number of times you repeat the exercise
• increase the 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 PFMs strongly before you cough, sneeze or lift something heavy.

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

Pregnancy and your pelvic floor

If you're pregnant, you should receive a booklet from your midwife, LMC or maternity ward called Physiotherapist advice after childbirth. This contains a section specifically on PFM exercises after childbirth.

It's very important to give your pelvic floor muscles time to recover and not return to high-impact sport too soon after your baby is born. A leaflet from Pelvic Floor First explains how returning to sports too early can damage your muscles further and sets out a programme for a safe and healthy return to sport.

  HealthInfo recommends the following videos

• Pelvic floor exercises for beginners

  A physical therapist shows you how to do pelvic floor exercises and get started.

  HealthInfo recommends the following pages

• Continence Foundation of Australia – Pelvic floor exercises for women

  Detailed information about pelvic floor exercises and how to do them.

• Continence New Zealand – Pelvic floor training for women

  Information about the pelvic floor and how to train the pelvic floor muscles.

Written by Allied Health – Physiotherapy Services, Christchurch Women's Hospital. Adapted by HealthInfo clinical advisers. Last reviewed April 2023.

Sources

Page reference: 21184

Review key: HIURS-53047