Even though these symptoms can be common, 55% of women do not currently do – or have never done – pelvic floor exercises and nearly 23% of women don’t know how to do them. It’s time to turn that around.
Not another menopause symptom
Pelvic floor problems can be aggravated during menopause due to changes in hormones. Common things you might suddenly be experiencing are:
- Urinary leaking with activity, sneezing or coughing
- An overactive bladder or incontinence
- Changes in bowel habits such as incontinence, constipation or straining
- Pelvic pain or painful sex or, in more extreme cases, pelvic organ prolapse.
The pelvic floor muscles lie across the base of your pelvis and keep the pelvic organs – bladder, uterus and bowel – in the correct position. They should be activated and kept strong just like any other muscle in your body.
Can you find yours?
It is important to get the right muscles working in the right way. In a comfortable sitting position, imagine that you are trying to stop yourself from passing wind and urine at the same time, drawing the pelvic floor muscles upwards and forwards from the back passage towards bladder.
You may feel a lifting up and tightening as your muscles contract. Try not to hold your breath – breathe in through your nose letting your muscles fully soften, drawing air to the bottom of your lungs and letting your tummy relax, then breathe out through your mouth and draw forward and up with your pelvic floor on the exhale.
“Build your exercise routine gradually over the weeks and months.”
Improve your pelvic floor muscles
Pelvic floor muscle exercises should include long holds, as well as short, quick, squeezes – ensuring that you let the muscle ‘go’ or ‘relax’ after each squeeze.
Long squeezes
- Tighten your pelvic floor muscles, hold them tight, then release and let them fully relax. Can you hold for 5 seconds? Aim for 10 repetitions.
Short squeezes
- Quickly tighten your pelvic floor muscles, then immediately let them go again. Practice 10 short squeezes at a time.
Things to watch out for
- Can you relax your pelvic floor when you inhale? Being able to both tense and relax the pelvic floor is key to developing tip-top pelvic floor health.
- If you experience pain when exercising the pelvic floor muscles, or if you have abdominal or pelvic pain after doing the exercises, you should seek specialist advice.
If you’re struggling with these, seek help from a specialist pelvic health physiotherapist who will assess your pelvic floor function. You can find a certified one via the Pelvic Obstetric and Gynaecological Physiotherapy website.
Don’t forget to keep it up
Build your exercise routine gradually over the weeks and months. You should notice an improvement in 3-5 months and then keep practising your pelvic floor muscle exercises once a day to maintain the improvement.
Try to make your pelvic floor muscle exercises part of a daily routine, ideally at least three times a day, doing them at the same time as another regular activity (eg brushing your teeth or boiling the kettle).
Here are some tips to help you to remember:
- Put a reminder on your phone.
- Try one of the pelvic floor exerciser apps available like Squeezy.
- Start with ‘little and often,’ especially if you find that you can only hold the squeeze for a short time or only manage to do a few before your muscles tire.
- After emptying your bladder, whilst sitting on the toilet (but don’t practise by stopping your urine flow).
- Take a moment to do them when you go to the gym.
- During a regular journey in the car, bus or train.
It doesn’t start and end with kegels
It’s one thing isolating them during a specific pelvic floor exercise, but let’s face it, that isn’t real life. Practice these to ensure that they’re switching on (and off) when doing every day, functional movement, or if you need to, adapt.
- Practicing the breath connection will help strengthen the mind-muscle relationship, helping the muscles relax and contract fully. Contract on the exhale, relax on the inhale.
- Modify your movement. Decrease weight, reps or switch to something low impact and give yourself time to tune back into your pelvic floor.
- Practice pelvic tilts. Lying on your back, tilt your pelvis away from your belly button when you inhale and tilt it towards you as you exhale. On the exhale, lift your pelvic floor and scoop your belly down towards the floor pressing your lower back down.
- Try glute bridges and pop something between your thighs like a rolled-up blanket or yoga brick. Target your inner leg muscles and glutes to help strengthen.
- Can you draw up your pelvic floor when you rise from squats?
- Child’s pose can help you to relax and gently relax your pelvic muscles and glutes.
