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.

Why are the pelvic floor muscles so important, and why should all women do regular exercises to maximise their fitness?

1. Pelvic floor fitness is the best way of beating stress incontinence.
One in three women who have ever had a baby experience stress incontinence at some point in their lives, when ordinary activities such as laughing, sneezing or jumping cause them to lose small amounts of urine. Sometimes the symptoms appear immediately after delivery, but for many women, years pass before they notice they have a problem.

Fortunately, it isn’t necessary to wear pads for ever. Over two-thirds of women who try pelvic floor exercises – and do them properly – are cured of their stress incontinence, without the need for drugs or surgery.

2. Pelvic floor fitness improves sexual response.
Pelvic muscles are directly responsible for the amount of sensation a woman feels during intercourse, and for the amount of grip felt by her partner.

Exercise improves muscle tone which means that the muscle is tighter, so is stretched more during intercourse. Strong, firm muscles have more nerve endings, and more nerve endings mean more sensations.

Rhythmic contractions of the these muscles contribute to arousal the ability to achieve orgasm. Many women report they are able to reach orgasm more easily, and that their orgasms are more powerful, after a pelvic exercise program.

3. Pelvic floor fitness contributes to an easier labour and better recovery after childbirth.
Over half of pregnant woman experience stress incontinence, with symptoms commonly persisting for a year after the birth. Even twelve months later, one woman in five still has symptoms that will worsen over the years.

Pelvic strengthening exercises, either before or during early pregnancy, can significantly reduce the risk of stress incontinence later. Research shows that the strength of these muscles at twenty weeks of pregnancy is an excellent indicator of the likelihood of stress incontinence later.

And the best news of all for pregnant women is that an exercise program during pregnancy has been shown to have a positive effect on labour.

4. Pelvic floor fitness is an excellent defence against urge incontinence, common amongst women in their later years.
Urge incontinence is the most common form of incontinence in women over 70, leading to major unwanted changes in lifestyle for many women, and even to nursing home admission.

Urge incontinence is a complex problem, with many contributing factors, but a strong muscles increase the chances of successful treatment if it does occur. So commitment to a program of effective pelvic floor exercises in earlier decades can be a woman’s best defence against incontinence in old age.

5. Pelvic floor fitness is a vital factor in total fitness.
The pelvic floor muscles are hidden from view and can be a significant weakness in an otherwise healthy toned body. Many women who pride themselves on high levels of aerobic fitness are shocked to find that this important area of their bodies can let them down in their middle years. Ironically female athletes need to pay particular attention to these muscles as their sporting activities place even more stress on the pelvic floor than day-to-day activities. Yet many fitness trainers neglect this area altogether.

Fortunately women can take control of this area of their body for themselves. Pelvic floor fitness needs personal commitment, and access to quality information. But, given these factors, most women can achieve it through a program of exercise, supported when necessary by the use of well-chosen exercise and strengthening products.