Pelvic floor exercises or Kegal exercises are performed to help women with bladder control and mild prolapse symptoms. The pelvic floor muscles extend from behind the pubic bone as a shelf across the base of the pelvis and connect to the sacral bone. This acts as a platform for all of the pelvic organs to be supported in the upright position. There is an opening towards the front of this platform called the genital hiatus which allows the urethra, the lower part of the vagina and the rectum to pass through. These pelvic floor muscles are usually very strong. They can be severely affected by child birth, the menopause and congenital connective tissue problems. As this genital hiatus widens, we see an increase in the level of stress incontinence and prolapse as these structures drop through the opening and are no longer fully supported. Damage to these muscles can also be made worse by chronic constipation, a chronic cough and obesity. The pelvic floor muscles also play a role during intercourse and are often referred to the “squeeze muscles”.

What Symptoms Are Caused by Poor Pelvic Floor Muscles?

  1. Stress incontinence or incontinence with exertion, sporting activities, coughing and sneezing.
  2. Urge incontinence associated with a sudden desire or urge to pass urine.
  3. Stress and urge incontinence together, or mixed incontinence.
  4. Pelvic floor prolapse.
  5. Poor sensation during intercourse or a feeling of looseness.

How Do I Perform Pelvic Floor Exercises?

In many cases a physiotherapist who is specifically trained in women’s health and pelvic floor exercises in particular can be a good starting point. Most patients however, will begin their pelvic floor exercises on their own. The pelvic floor exercises can be contracted by reproducing the sensation caused when someone asks you to stop your flow of urine or stop yourself passing gas from the bowel. This should create a sensation of pulling up and tightening around the vagina and anus.

Patients are advised to pull up on their pelvic floor muscles and keep then contracted for a maximum of 10 seconds. This is followed by a relaxation phase for the same time. This tighten, hold and release should be repeated around 10 times in a session. These sessions should be repeated 3 to 6 times a day. This will build up longer term endurance. In the long term, these contractions should be repeated at least 3 times a day for up to 6 months. You should see results in 2-6 weeks. Remember it is important not to give up particularly if you can see an improvement in your symptoms.