Your pelvic floor is a group of muscles underneath your pelvis, between the tops of your legs. These muscles surround your clitoris, your urethra, your vagina, and your anus. These muscles are very important to help to support your pelvic organs and control your bladder and bowel movements. If the muscles of your pelvic floor become weak or uncoordinated, you may find that you leak urine or poo, have pain when going to the toilet or during sex, or feel a dragging or heaviness in the lower tummy or pelvic area.

Your pelvic floor muscle can strengthen and get more coordinated with training. Done correctly, regular pelvic floor exercises can be preventative for pelvic floor problems, as well as reducing leakage and improving bowel, bladder and sexual function, and enhancing your quality of life.  They are easy to do anywhere without needing to lie down. You can start exercising your pelvic floor at any stage of life.

Pelvic floor muscles – POGP

Pelvic floor muscle training explained by the Pelvic Health Physio Team NHS Bristol

Some people find using an app very helpful to take control of their pelvic health, the Squeezy App has been recommended by physiotherapists in Dorset.

Pelvic Floor exercises are good practice for everyone, however if you are experiencing problems with your pelvic health it’s always best to speak to your doctor.

Pelvic floor muscle exercises and advice for the LGBTQ+ community from POGP:

Good pelvic health is essential for physical, mental, social, and sexual wellbeing. There are steps you can take to help reduce your risk of problems with pelvic health:

If you are experiencing symptoms of bladder incontinence, drinking 1.5-2 litres (6-8 cups), spread throughout the day can help. Do not be tempted to reduce your fluid intake, as doing daily pelvic floor exercises is better than drinking less fluid.

Try to avoid:

150 minutes (30 minutes, five times a week) of moderate physical activity can help improve bowel, bladder and pelvic floor health.

If you are experiencing incontinence or prolapse symptoms worsened by running, jumping or high impact activities, it’s recommended you reduce or avoid them until your symptoms improve.

Moderate physical activity, like walking, housework or gardening, which raises your heart rate or leaves you out of breath, can help maintain fitness and be part of your daily routine.

For further information on how to live well, visit Live Well Dorset:

Anyone can experience pelvic floor issues at any stage of life, but particularly after pregnancy, giving birth, during, or after the menopause.

If you have any new unexplained symptoms or changes in your bowel or bladder, new pain, unexpected vaginal bleeding or bleeding from your back passage, it always best to talk to your doctor. Tracking your pain/bowel habits/leakages will help you to tell your doctor about your experience.

If you feel like you haven’t been listened to or your problems haven’t been solved by speaking to a healthcare professional, the Wellbeing of Women website has advice on the steps you can take.

Incontinence is the loss of control of bladder and/or bowels that results in leakage of urine and/or poo. The amount of leakage can vary between individuals or at different times.

Some long-term medical conditions that cause you cough a lot, like asthma, can affect your pelvic floor. Your doctor can refer you to the right support services.

If you have new, unexplained symptoms or changes in your bowel or bladder habits, speak to a doctor about what has changed. You can start pelvic floor exercises at any time as these can often help. But it is important that your doctor makes a proper diagnosis and establishes the underlying cause of these changes. If you are not seeing an improvement after three months of regular pelvic floor exercises, then your doctor may refer you to a specialist, like a Physiotherapist or a hospital Consultant.

Many people experience constipation at some point. For most it is temporary and not serious, but for some it can be chronic and cause ongoing issues. Understanding its causes, prevention and treatment can help to manage and control your symptoms.

Our local pelvic health physio team recommend this video to their patients:

Natural Constipation Relief in 3 Easy Steps

Talk to your doctor if you:

A prolapse in the pelvis or pelvic floor area can feel like heaviness or dragging in the lower stomach, vagina, bowel or anus. It is usually because one of your organs has slipped down from its usual position and is pressing on your vagina, bowels or anus. Pelvic organ prolapse is common, affecting one in ten women over the age of 50. Its symptoms should not be ignored or endured.

Symptoms can usually be improved with pelvic floor exercises and lifestyle changes, but sometimes medical treatment is needed. Treatment choices for prolapse include physiotherapy, support pessaries or surgery.

Vaginal mesh is a surgical mesh that is implanted through the vagina and was used to treat pelvic organ prolapse and urinary stress incontinence. Vaginal mesh is no longer routinely used on the NHS due to concerns regarding complications.

If you had vaginal mesh surgery as an NHS patient in England, and experience any of the following symptoms, talk to your doctor:

A vaginal pessary is a device made of plastic or silicone inserted into the vagina to support a prolapsed uterus, vaginal wall, your bowel or bladder. It can be used as an alternative to surgery. You will be able to continue with your everyday activities including exercising, working and caring for your family.

There are different types of pessaries, and your doctor or healthcare professional will help determine the best type and size for you, which sometimes takes more than one visit. Once correctly fitted it can help to reduce your symptoms and improve comfort. A specialist doctor (gynaecologist) or nurse will usually fit the pessary.

Self-management of pessaries for pelvic organ prolapse can be a safe and cost-effective alternative to regular clinic visits.

Some women only have intermittent symptoms, such as during exercise or when out and about, and so wish to insert and remove the pessary regularly. Many choose to remove it for sexual intercourse. Others simply want to have the ability to remove it when they choose, even if they keep it in most of the time.

Pelvic pain can range from a sharp, stabbing pain that comes on suddenly, to a dull, heavy ache.  There are also lots of causes including constipation, urinary tract infections (UTIs) or sexually transmitted infections (STIs). On rare occasions, it could be something more serious. Talk to your doctor if you are experiencing pelvic pain.

Pain or a change in the sensation in your vagina and/or leaking during sexual intimacy can have many underlying causes. Some are biological, some are psychological, and others are social.

Sexual challenges, such as an inability to orgasm, can be unrelated to pain.

Some of the conditions which lead to pain with sexual intercourse can lead to pain in other activities, such as experiencing pain or difficulty inserting a tampon.

These symptoms should not be endured, for information regarding sexual health, visit Sexual Health Dorset.

For further information on sexual health:

Medications and recreational drugs such as ketamine can affect your bladder and bowels, causing leaks or problems passing urine. If you notice any changes since taking a new medication, talk to a pharmacist or your doctor.

Urinary incontinence and feeling of heaviness is not unusual during pregnancy and after childbirth but should not be ignored. Pelvic floor exercises and physiotherapy can help. The Maternity Matters Dorset website has information on what you can do to help and when and where to seek help.

For further information on pregnancy:

Changes in your hormones during and after menopause can weaken the muscles in your pelvic area. This can increase the risk of urinary incontinence, pelvic organ prolapse or changes in your bladder. Regular pelvic floor muscle exercises can improve these symptoms.

For further information on the menopause:

If you have any new unexplained symptoms or changes in your bowel or bladder, new pain, unexpected vaginal bleeding or bleeding from your back passage, it always best to talk to your gp. Tracking your pain/bowel habits/leakages will help you to tell your doctor about your experience.

Most women see improvement with self help over a 3-5 month period. Please speak to your GP about referral to an NHS pelvic health physiotherapy team if you have tried self help and things are not improving for you.

Dorset’s Bladder & Bowel Continence Service runs clinics for adults and children across Dorset.

The Maternity Matters Dorset website has information on how to self-refer to a physiotherapist during pregnancy and after giving birth.

It may feel embarrassing to talk about bladder and bowel problems, and you may feel anxious, isolated or lonely. Joining a support group can help you manage those feelings and connect with people going through similar experiences.