There’s a reason why so many women struggle with pelvic floor issues at some point in their lives: from the pressures that come with pregnancy and childbirth to the challenges presented by ageing and hormonal changes such as menopause, the pelvic floor muscles go through a lot.

And despite all this, very few of us train or take care of our pelvic floor muscles in the same way we do our glutes, biceps or abs – even though studies have shown that pelvic floor dysfunction can have an impact on both our physical and mental health. After all, our pelvic floor muscles not only help with sex and bodily functions such as bowel movements, but they also support the pelvic organs – the bladder, bowel and uterus.  

The good news is that things are changing as we become more aware of how important these muscles are. So, to help you start taking more care of your pelvic floor, we asked Helen O’Leary, physiotherapist at Complete Pilates, to share six simple things we can all do on a regular basis to improve our pelvic floor health.  

“Constipation is the enemy of a healthy pelvic floor. Straining to empty your bowels places a lot of downward pressure on the pelvic floor muscles,” O’Leary says. “This is thought to contribute to the weakness of the pelvic floor and can contribute to conditions such as pelvic organ prolapse.”

The key to avoiding constipation is taking care of your gut, and that starts with your diet and nutrition. While factors including genetics, hormones and the composition of your gut microbiome can impact how prone to constipation you are, simple things – like drinking plenty of water and increasing your intake of soluble fibre – can help.

Key sources of soluble fibre include apples, oats, bananas, avocados, citrus fruits and carrots – so upping your fruit and veg intake is a great place to start. 

While constipation is the primary cause of straining on the toilet, it’s not the only reason why it happens, O’Leary explains. In fact, it could be your positioning.

“The position we adopt when sitting on the toilet is not the optimal position for emptying the bowels,” she explains. “Placing your feet up on a stool changes the angle of your back passage and makes it a smoother passage for your poo to exit.”

Again, this helps to avoid any unnecessary downward pressure on the pelvic floor muscles, which in turn can stop them from becoming weakened. 

“Often when we talk about pelvic health, the focus is on strengthening the pelvic floor,” O’Leary says. “However, it has become apparent in recent years that it is also important to be able to relax the pelvic floor; a pelvic floor that is overactive and can’t relax can lead to pelvic pain and pain during sexual intercourse.”

An easy way to ensure you’re able to relax your pelvic floor is to stretch it out through exercises like the happy baby stretch, O’Leary adds.

“In the happy baby position, we stretch the pelvic floor, which helps it to relax,” she says. “It also provides good sensory feedback for us [meaning you’re able to feel and engage with your pelvic floor stretching]. In this position, use deep breathing to further relax. As you exhale, try to let go of any tension in the pelvic floor.” 

Making pelvic floor exercises part of your training routine can make a huge difference in both the short and long term. You don’t even need to head to the gym to get started – many pelvic floor exercises can be done while you’re sitting at your desk.

The key, O’Leary says, is making sure you’re doing them properly. “Pelvic floor exercises are often recommended for pelvic floor problems, such as urinary incontinence,” she says. “However, it isn’t always easy to know if you are doing them right. If you imagine the pelvic floor like a hammock, you want to imagine drawing the hammock up and into you and holding. This is a better cue than ‘squeezing’, which can lead people more towards clenching their buttocks or bearing down.” 

Your pelvic floor exercise routine should include both long and short holds, as this helps to improve both the power and endurance fibres inside your muscles, O’Leary adds. “Start by holding for 10 seconds (make sure you watch the clock instead of counting) and repeating 10 times,” she says. “If you feel you can’t make it all the way to the end of 10, this is a sign you need to work on your endurance. You may need to start with a shorter duration – say three to five seconds – then build up.

She continues: “Next, practice doing 10 short holds (one per second). Make sure you fully relax in between each hold.” 

While your pelvic floor muscles have a lot of work to do, they’re not completely isolated – and using the muscles in and around your pelvic area can help them.

“Strengthening the inner thigh muscles can help with pelvic floor activation as the two are linked by fibrous connective tissue, and when the inner thighs contract, the pelvic floor also contracts,” O’Leary explains. “A good way to do this is to lie on your back on the floor with your legs bent and feet flat on the floor. Place two cushions or a pillow folded in half between the knees. Gently squeeze the pillow with about 30% effort and hold for up to 10 seconds. Repeat 10 times.”

The key, O’Leary adds, is to make sure you keep your buttocks relaxed throughout – the activation should all be in the inner thighs and lower abdominals. 

“While currently the research does not support functional strength training as a substitute for isolated pelvic floor muscle training, there is growing interest in the role other exercises have to play in strengthening the pelvic floor,” O’Leary says. “The benefit of using such exercises is that they may be easier for some to execute than the pelvic floor exercises.”

Squatting, O’Leary says, is a great way to strengthen the glutes, hamstrings, quads and inner thighs, and may also trigger reflex action (an automatic response) in the pelvic floor muscles.  

Images: Getty