What’s the Deal with Pelvic Floor Muscles – Should I Train Them?
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Article published:
Sep 2, 2025
Overview
The female pelvis and pelvic floor play key roles in supporting the body, enabling childbirth, and maintaining control over urination, bowel movements and sexual function.
Pelvic floor muscle training is important not only when problems have already occurred but also as prevention—especially during pregnancy and after childbirth. Regular training helps reduce pelvic organ prolapse, urinary incontinence, and other discomforts, and improves quality of life at any age.
Pelvic Structure and Pelvic Floor
The pelvis in women is a bowl-shaped area at the bottom of the torso, right below the abdomen. It has three main jobs: it supports the spine, connects the upper body to the legs, and holds organs involved in reproduction, urination, and digestion. In females, the pelvis is specially designed to allow for childbirth and houses the uterus and ovaries.
The bony pelvis is made up of several interconnected bones: two hip bones (each consisting of the ilium, ischium, and pubis), the sacrum, and the coccyx (tailbone). These bones form a strong protective ring to which many muscles and ligaments attach.
Inside this ring is the pelvic cavity, where vital organs are located—the bladder, rectum, uterus, fallopian tubes, and ovaries.
At the bottom of the pelvis are the pelvic floor muscles. These form a supportive "net" (like a hammock) that holds up the bladder, uterus, and rectum. The main muscles, such as the levator ani and coccygeus, keep organs in the correct position, help control urination and bowel movements, and support the body during childbirth.
The female pelvis differs from the male pelvis with its wider and more circular shape to allow for childbirth. The birth canal is also larger, and the pelvic floor muscles are stronger and more elastic to support female-specific organs—the uterus, ovaries, and fallopian tubes.
Why Do Pelvic Floor Muscles Weaken?
Pelvic floor muscle weakening is usually the result of several factors combined. The most important risk factor is childbirth—especially vaginal or assisted delivery (such as with forceps or vacuum), which can stretch or damage muscles and connective tissue. Carrying a baby with a high birth weight increases the risk even more.
Over the years, the pelvic floor is also affected by aging and menopause, when hormonal changes reduce tissue elasticity and recovery ability.
Additional stress comes from lifestyle factors such as being overweight, chronic constipation, frequent coughing, heavy physical work, and smoking—all of which increase repeated pressure on the pelvic floor.
Some women also have a genetic predisposition, as connective tissue structure may be naturally weaker and therefore more susceptible to changes. Less commonly, previous gynecological surgeries or pelvic area injuries may be the cause.
Research shows that it's precisely the combination of these factors—childbirth, age, lifestyle, and connective tissue properties—that largely determines who develops pelvic floor problems and when.
How to Prevent Problems and Strengthen Muscles
Pelvic floor muscle training is one of the simplest and most effective ways to prevent and treat these problems. It is currently considered the best non-surgical first-line treatment for both urinary incontinence and pelvic organ prolapse.
The training is based on conscious muscle contraction and relaxation—like trying to briefly stop the flow of urine. The contraction is held for a few seconds, then the muscles are relaxed. Exercises are done regularly, several times a day. Consistent training can bring results within a few weeks, improving muscle strength and control.
However, if you already have symptoms like urine leaks, prolapse, or pelvic pain, it's important to consult a physiotherapist or healthcare provider before starting exercises. Doing pelvic floor exercises incorrectly—or doing them when they're not appropriate for your situation—can sometimes make problems worse. A specialist can assess your specific condition and teach you the proper technique.
During pregnancy and after childbirth, it's also recommended to work with a physiotherapist to ensure you're doing the exercises correctly and avoiding excessive strain.
In addition to exercises, pelvic floor health is supported by maintaining a healthy weight, avoiding constipation, quitting smoking, and balancing physical activity.
When to See a Specialist
If you experience urine leaks, a feeling of heaviness in the lower abdomen, or a sensation that "something is dropping down," it's worth seeing a general practitioner or a gynecologist. If needed, you'll be referred to a physiotherapist who specializes in pelvic floor rehabilitation. The physiotherapist will help assess the condition of the muscles and create a personalized training plan.
