The pelvic floor is a highly integrated structure requiring organs, muscles, and nerves to work together. Pelvic floor function can greatly impact an individual’s quality of life. Yet it’s common for women and men to unnecessarily suffer from pelvic floor disorders because they are too embarrassed to talk with a health-care professional. However, pelvic floor disorders are quite common, do not have to be tolerated, and can be addressed to provide much needed relief.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles that runs across the bottom of the pelvis and holds up various organs, including the bladder, bowel, and uterus. Like any muscle in the body, they usually start out strong, but can weaken or become stretched over time – which can lead to pelvic floor dysfunction.1,2
Approximately one in three women over age 20 report some form of pelvic floor dysfunction.1 Obesity, diabetes, and overactive bladder can lead to pelvic floor problems, along with life events for women, such as pregnancy, vaginal childbirth, menopause, and, for men, surgical removal of the prostate (prostatectomy).3 Regardless of your age or gender, however, pelvic floor disorders are not normal nor are they an inevitable part of aging.

Although it’s not always easy to tell whether your pelvic floor muscles have weakened, there are some common signs: 3,4

  • Urinary incontinence. This occurs when an individual leaks urine or loses bladder control. There are different types of urinary incontinence. Stress incontinence results from added pressure in the abdomen, such as during a sneeze or cough. The muscles and tissue around the urethra don’t close properly, allowing urine to leak out. Another type, urge incontinence, makes a person feel a sudden need to urinate.
  • Fecal incontinence. This type of incontinence leads to an uncontrollable loss of liquid or solid stool. 
  • Pelvic organ prolapse. In women, when the pelvic floor weakens and can’t support the pelvic organs, the bladder, rectum, or uterus can bulge into the vagina or drop, often causing a feeling of fullness in the area. 
  • Other signs. Pelvic floor dysfunction can contribute to pelvic pain and pain during intercourse.

Strengthening the Pelvic Floor with Kegels

Pelvic floor exercises, often referred to as Kegel exercises, are often recommended to help strengthen pelvic floor muscles and relieve existing problems. However, research hasn’t shown that Kegels are effective for preventing new pelvic floor problems from developing. 

These exercises can be done discreetly during daily activities; for example, while brushing teeth, watching TV, or catching up on emails. To perform Kegel exercises correctly, try these tips:3,5,6

  • Find the right muscles. To identify pelvic floor muscles, stop urination midstream or tighten the muscles that prevent gas from escaping. These maneuvers use the pelvic floor muscles. But don't make a habit of using Kegel exercises to start and stop your urine stream because doing Kegel exercises while emptying your bladder can lead to incomplete bladder emptying – which increases the risk of a urinary tract infection.
  • Perfect the technique. Tighten pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. This exercise can be done in any position, although it might be easiest to do it lying down at first. When muscles get stronger, do Kegel exercises while sitting, standing, or walking.
  • Maintain focus. For best results, focus on tightening only the pelvic floor muscles, being careful not to flex the muscles in the abdomen, thighs, or buttocks. Breathe freely during the exercises.
  • Repeat three times a day. Aim for at least three sets of 10 repetitions daily.

Performing Kegel exercises can be tricky, but they get easier with practice. A specialist such as a urogynecologist, urologist, or pelvic floor physical therapist can offer vital feedback to help isolate and strengthen the correct muscles.1,3

Some health-care professionals use biofeedback to help patients effectively perform Kegels. In a biofeedback session, a small probe is inserted into the rectum. A monitor measures and displays the pelvic floor activity as the person relaxes and contracts their pelvic floor muscles. This can determine which muscles to isolate and chart strengthening progress. Electrical stimulation can also be used with biofeedback and helps pelvic floor muscles contract.3 

Although evidence of their effectiveness is limited, weighted vaginal cones can be used by some women to increase pelvic floor strength. The weights are placed in the vagina, and the pelvic floor muscles are used to keep them in place.3

When performed correctly and regularly, results from Kegels – such as less frequent urine leakage – are expected within a few weeks to a few months. Kegel exercises should be a permanent part of a daily routine for continued benefits.5,6

Although generally considered safe, some individuals shouldn’t perform Kegels, including women who have suffered an injury during childbirth and are still healing, as well as those with myofascial pelvic pain syndrome. This condition results from pelvic muscle and tissue problems, which cause painful sex and bladder issues. Kegels can worsen these symptoms.3

Nonsurgical Options Relieve Symptoms

Lifestyle changes can help relieve symptoms of pelvic floor disorders. For example, cutting back on foods and drinks that stimulate the bladder, such as caffeinated beverages, carbonated beverages, citrus fruits and drinks, artificial sweeteners, and alcoholic beverages, might help. Losing weight relieves pressure on pelvic organs. Eating high-fiber foods, such as fruits, vegetables, and beans (legumes) can help prevent constipation and reduce prolapse symptoms.4

Additional methods to tackle pelvic floor disorders include:4

  • Bladder training. Going to the bathroom on a regular schedule might help regain bladder control. This starts by using the bathroom at a specific time and slowly increasing the time between bathroom breaks over a period of months, until breaks are every 2.5 to 3 hours. 
  • Medicine. Some medications can treat bladder control problems or help prevent loose stools or frequent bowel movements. 
  • Prolapse device. A vaginal pessary treats prolapse and can sometimes improve bladder control. A custom-fit pessary is inserted into the vagina to support the pelvic organs. 

If conservative treatments fail, then surgery might be recommended. In some cases, more than one procedure is needed; for example, surgery to correct a prolapsed organ and another procedure to ease urinary incontinence:3,4,7,8

If you suffer symptoms from pelvic floor dysfunction, then take heart, because there are options that can provide relief. A visit with your health-care professional is an important first step to finding solutions. 

A Word from Thorne

Although research is limited on the effect of nutritional supplements on the health of the pelvic floor, supplements that support muscle integrity and function can be considered, including magnesium, collagen, and amino acids.

References

  1. Pelvic floor disorder awareness. Mayo Clinic. https://newsnetwork.mayoclinic.org/discussion/pelvic-floor-disorder-awareness/. [Accessed September 16, 2022]
  2. Strengthening pelvic floor muscles can help prevent bladder leakage. Mayo clinic.   https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/strengthening-pelvic-floor-muscles-can-help-prevent-bladder-leakage. [Accessed September 16, 2022]
  3. Beyond the basics: pelvic floor muscles exercises. https://www.uptodate.com/contents/pelvic-floor-muscle-exercises-beyond-the-basics. [Accessed September 16, 2022]
  4. How are pelvic floor disorders treated? Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/pelvicfloor/conditioninfo#. [Accessed September 16, 2022]
  5. Kegel exercises for men: understand the benefits. https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074. [Accessed September 16, 2022]
  6. Kegel exercises: a how-to guide for women. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283. [Accessed September 16, 2022]
  7. Anterior vaginal prolapse. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cystocele/diagnosis-treatment/drc-20369457. [Accessed September 16, 2022]
  8. Posterior vaginal prolapse. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/rectocele/diagnosis-treatment/drc-20353419. [Accessed September 16, 2022]