The benefits of pelvic floor exercises are well-documented, and are recommended to help prevent problems such as stress urinary incontinence and a prolapsed uterus. Despite this, a recent survey conducted by Health & Aesthetics revealed that a third of women who have had or are expecting a baby admitted to never practising the exercises.
The pelvic floor muscles stretch from the tailbone to the pubic bone within the pelvis. They are important as they help control the bladder, bowel and uterus. They also affect the vaginal muscles, which may result in less satisfying sex and reduced sensitivity.
Causes and symptoms
Problems occur when the pelvic floor muscles weaken, which many women experience after certain life stages such as menopause but some women have weak pelvic floors from an early age. Other causes include:
- constant coughing
- constipation (which is common in pregnancy)
- ageing, due to hormonal changes
Yet pregnancy is still the main cause of pelvic floor problems. The muscles stretch and weaken during childbirth and sometimes from as early as 12 weeks into the pregnancy.
A damaged pelvic floor may cause the following problems:
- Stress urinary incontinence
- Difficulty in emptying the bowels or bladder
- Painful sex
- Pain in the pelvic area
- Dislodged tampons
- A feeling of heaviness in the vagina
Stress urinary incontinence is one of the most common and embarrassing side effects of weakened pelvic muscles. This is when increased pressure to the abdomen causes involuntary urination, whether it’s through physical activity or simply sneezing, laughing or coughing. Those who suffer with the condition might begin to struggle with social interactions and lose confidence and self-esteem as a result. Doing pelvic floor exercises will help the patient prevent any accidents from happening by strengthening their muscles.
How to carry out pelvic floor exercises
The patient can find their pelvic floor muscles and learn how to control them when they go to the toilet by trying to stop the flow of urination. However, this should only be done once as it isn’t good for their bladder and doing this repeatedly can cause a urinary tract infection (UTI). However, once they know how to locate the muscles, the exercises can be done anytime and anywhere.
To strengthen pelvic floor muscles, it’s recommended to do the exercises every day during pregnancy. They can be carried out straight after childbirth–if the patient is comfortable to do so—it’s perfectly safe and will make a dramatic difference to how quickly the muscles recover. However, if the patient isn’t happy to continue doing them immediately, it’s never too late to start. The pelvic floor naturally weakens with age, so regular movements can help keep them as strong as possible. A study carried out in 2010 found that the exercises improve symptoms of stress urinary incontinence by up to 70%.
Depending on what is more comfortable, the exercises can be carried out lying down, sitting or standing. While breathing as normal, the patient should squeeze the muscles slowly and pretend they are trying to stop the flow of urination midstream (without actually urinating) and hold for between five and 10 seconds. However, they might not be able to grasp the squeeze for very long when first doing the movements, so they may wish to hold for less time to begin with and then build up to a longer time. It is important that they have some of the squeeze left to release slowly at the end of the exercise. This should also be done without tightening their legs, stomach or buttock muscles.
For the muscles to regain their full strength, the exercises will need to be done between eight and 12 times a day for at least three months.
Time constraints and a lack of support
Having children is a life-changing event, so it’s unsurprising that many new and expectant mothers say they aren’t doing pelvic floor exercises because they can’t find the time.
In its survey, Health & Aesthetics found that 29.2% of women surveyed had never done pelvic floor exercises throughout their pregnancy and afterwards. It’s very likely this was due to time constraints, as pelvic floor exercises are a daily commitment. After all, 22.6% of women also said they only did the exercises if they had time or remembered.
It’s easy to forget to do pelvic floor exercises every day, especially for busy new mothers. It’s useful to fit them into a daily schedule and for patients to complete a set while doing something else, such as eating a meal, talking on the phone or cleaning their teeth. If they are still likely to forget, it might also be helpful to place notes around their home as a reminder.
Another reason women may not be doing the exercises as often as recommended is because they don’t think they work (as 6.1% of women in the survey claimed). Perhaps this is because they aren’t achieving the accurate technique that is needed for the exercises to be effective. But with midwives and health visitors as overstretched as they are, many women might not be getting the support they need, during or after pregnancy, to achieve these goals.
Results according to age
Looking at the survey results by age, we see that 18 to 24-year-olds were the main age group not to do pelvic floor exercises (32.6%). Many women at this age fall pregnant with their first child and yet aren’t aware of how pregnancy affects their pelvic floor and how important it is to do the exercises. Interestingly, this age group was the least willing (6.5%) to try an alternative that was proven to work. This may be because they are unlikely to have suffered with weak pelvic floors for a long time and don’t think an alternative is necessary.
Women aged between 35 and 44 were the most likely (22%) to do pelvic floor exercises if they remembered or had time. This age might be when some women begin to have children or decide to have more. As a result, many of them might already be suffering with weak pelvic floors and know how the movements can help. However, if they are working full-time and are more career-driven, it’s possible they don’t have the time to do their pelvic floor exercises as often as required.
Similarly, women aged 25 to 34 were the most probable (7.9%) to try an alternative if it saved time. Again, this may be because they are too busy to do the recommended number of pelvic floor exercises but do suffer with this issue and want to change it.
Women aged between 45 and 54 were the most willing (13.1%) to try an alternative if they knew it would work. On average, women reach menopause between 45 and 55 and a weakened pelvic floor is a common symptom. Many women of this age might have already dealt with this issue earlier in life after having children but now find it worsening due to menopause. At this point, they may be looking for a way to finally resolve this problem.
Interestingly, one in five of the women surveyed said they would consider trying an alternative if it saved time (7.6%) and worked (13.4%). Fortunately, there are other options available that demand less time, while offering certain relief from the misery and embarrassment of stress urinary incontinence. If the symptoms are too severe for pelvic floor exercises to improve the problem, an alternative treatment might be necessary.
Femilift is a painless, innovative, non-surgical procedure which encourages collagen growth in the vaginal tissues. Collagen improves vaginal tone, strengthening the tissue that supports the bladder and helping to ease pelvic floor symptoms such as stress incontinence.
This procedure takes less than 30 minutes, so is perfect for new mums who don’t have the time to do all of their daily pelvic floor exercises. To see longer-lasting results—usually around 18 months to two years—it’s recommended to have three treatments every four to six weeks.
As well as helping with stress incontinence, Femilift can also relieve vaginal dryness and soreness and heighten sensation, making sex less painful and more enjoyable. Because it involves no surgery, there isn’t any recovery time and they also won’t suffer any side effects. However, it’s advised to wait at least three months from giving birth before having the treatment, so that any scars from tears or episiotomy have had the opportunity to heal.
To further prevent the pelvic floor muscles from weakening with age, patients could also:
- squeeze and hold the muscles before sneezing, coughing or lifting
- avoid lifting heavy objects when possible
- fully empty their bladder when going to the toilet
- refrain from going to the toilet when their bladder doesn’t feel completely full because urinating when not needed teaches the bladder to want to empty itself more frequently (however, keep in mind that during pregnancy it is normal to go to the toilet more)
- drink plenty of fluids and introduce more vegetables, fruit and fibre into their diet to avoid constipation