Pelvic Floor Exercises for Women

Your GP or healthcare professional has advised you that you would benefit from doing pelvic floor exercises.

This leaflet tells you about your pelvic floor and explains how to do exercises to help strengthen it.

What is the pelvic floor muscle?

The pelvic floor is a made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your tailbone (see diagram below). It provides the floor to your pelvis. These muscles help to hold your bladder, bowel and the uterus (womb) in position. 

They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

The pelvic floor muscle controls the openings to the organs which pass through it:

• The urethra (the tube you pass your urine through).

• The anus (the back passage, through which you open your bowels).

Sometimes your pelvic floor can weaken. If this happens you may have some symptoms which include:

• An aching or dragging feeling in your vagina.

• A feeling of something coming down inside your vagina, which may be due to a prolapse (this is where one or more organs in your pelvis such as your womb or vagina drop down from their normal position).

• Stress urinary incontinence. This is where you leak urine when you cough, laugh or sneeze.

• A need to go to the toilet more often (referred to as frequency) during the day and night.

• Urge urinary incontinence. This is where you have an urgent need to go to the toilet but do not make it in time.

• An inability to control the passage of wind from your back passage.

Why should I do pelvic floor exercises?

All women need to do pelvic floor exercises throughout their lives. Pelvic floor muscles may become weak for several reasons, including:

• After childbirth.
• Through lack of exercises.
• As a result of the menopause.
• Following pelvic surgery, such as a hysterectomy (removal of your womb) or bladder repair.
• By straining to open your bowels.
• By being overweight.
• Having a chronic cough.

Pelvic floor exercises can help strengthen your muscles so that they can give your organs support again. This will improve your bladder and bowel control and should help to reduce or stop any leakage.

There are 2 ways of doing these exercises. You will need to do both.

Slow exercises

You should:

• Sit comfortably with your knees slightly apart.

• Imagine you are trying to stop yourself passing wind from your bowel by squeezing and lifting the muscles around your anus (back passage). You should be able to feel the muscle move and the skin around your anus tightening and being pulled up. Make sure you do not clench your buttock muscles while you do this.

• Next, imagine you are sitting on the toilet trying to stop passing urine, almost like you are “zipping up” inside. You should be using the same muscles you used before.

• Join both of these exercises together to strengthen your pelvic floor. This is called pulling up your pelvic floor. Hold for a count of 5 seconds, then relax for 5 seconds. Try not to hold your breath and breathe normally.

• Then slowly relax and let go.

• You should repeat this slow exercise 8 times.

You may not be able to hold for 5 seconds at first but try your best and keep practising.

After resting for 2 minutes, you should start your fast exercises.

Fast exercises

You should:

• Quickly tighten and pull up your pelvic floor muscles as before then let them relax straight away.

• Repeat 8 times or until your muscles feel tired.

Do these exercises at least 3 times every day.

Once you feel confident in doing the exercises, try doing them in other positions, such as standing and squatting. Remember to tighten your pelvic floor muscle during and after any activity that makes you leak (for example, rising from a chair or coughing) so that tightening becomes an automatic reaction.

While performing the exercises, it is important not to:

• Squeeze your buttocks together.

• Bring your knees together.

• Pull your tummy in.

• Hold your breath.

• Lift your shoulders, eyebrows or toes upwards.

If you do any of the things mentioned above, you will not contract (tighten) your muscles correctly.

Do not expect instant results. It may take several weeks of regular exercises to regain the strength in your pelvic floor muscles.

How can I check I am doing the exercises properly?

You can feel your pelvic floor contracting by putting 1 or 2 fingers into your vagina whilst having a bath or shower. Tighten your pelvic floor so that the muscles squeeze your finger hard.

You should check this using a mirror, by holding a mirror so you can see the area between your legs. Squeeze the muscles – the skin between the anus and the vagina should move inwards and away from the mirror.

Every 2 weeks you should test the strength of your pelvic floor by stopping the flow of urine mid-stream. This will feel similar to the exercises above and uses the same muscles.

You may not be able to completely stop the flow of urine to begin with, but you may notice you are able to slow the flow down.

You should continue to do these exercises every day for the rest of your life. It is important you continue to enjoy life and not allow your bladder to control your life.

It is easy to forget your pelvic floor exercises. You could use coloured stickers or reminder notes, set an alarm or electronic calendar on your mobile or do your exercises at meal times.

These are just a few suggestions, you may think of something more suitable to suit your own personal circumstances.

It is important you continue to enjoy life and not allow your bladder to control your life.

Contact numbers

If you need further advice or have any questions or worries, you should talk to your nurse or continence nurse.

North Tees and Hartlepool NHS Foundation Trust

Specialist Pelvic Health Team

Telephone: 01429 522500

Monday to Friday, 08:30 a.m. to 04:30 p.m.

Further information is available from:

Bladder & Bowel Community

Forward House
17 High Street
Henley-in-Arden
B95 5AA
Email: [email protected]
Home Delivery Service: 0800 031 5406

Bladder & Bowel UK

Burrows House
10 Priestley Road
Wardley Industrial Estate
Worsley
M28 2LY
General enquiries Telephone: 0161 607 8219
Website: www.bbuk.org.uk/
Or Email: [email protected]

RADAR KEYS (for disabled toilet access)

11 Church Street
Exmouth
EX8 1PE
General enquiries Telephone: 01395 222588
Website: www.radarkeys.org
Email: [email protected]

Information used in the development of this leaflet

• Abrams, Khoury S, Wein A.  The 1st International consultation on incontinence, co-sponsored by the WHO, Monaco; Health publication 1999.

• Department of Health (2000) Good Practice in Continence Services. webarchive.nationalarchives.gov.uk/+/www.dh…/DH_4005851

• National Institute for Health and care Excellence (NICE) 2019 Urinary Incontinence and Pelvic Organ Prolapse in Women; management. www.nice.org.uk/guidance/ng123

Comments, concerns, compliments or complaints

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Leaflet feedback

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