What is the pelvic floor?

The pelvic floor muscles are attached between the bottom of your spine (coccyx)
and the bone between your legs (pubic bone) forming a platform. They support your bladder (where urine is stored), the uterus (womb) and the bowel. These muscles help to control when you pass urine and empty your bowels. The muscles should be strong and firm. If they are weak they will not provide the support and control that they should.

What might have weakened my muscles?

Muscles can be damaged in many ways:

• during pregnancy/childbirth
• changes due to the menopause and age
• a chronic cough
• being constipated and/or constantly straining to empty your bowels
• doing a lot of heavy lifting
• being overweight
• being generally unfit.

What symptoms might I experience?

If your pelvic floor is weak you may leak urine when you cough, laugh, sneeze, exercise or lift.

How can I strengthen my pelvic floor?

By doing pelvic floor exercises. Some people lose control of their bowel and leak some faeces. Pelvic floor exercises may help these people too.

Sit comfortably on a supportive stool or chair with your knees apart and feet flat on the floor. Lean forward and rest your forearms on your thighs.

• Begin by tightening up your back passage, as if trying to stop passing wind

Hold onto this while you:

• Draw up the muscles around the vagina

By doing these two together you should be exercising your pelvic floor.

It is important to do this without:

• Holding your breath
• Pushing down when you are squeezing
• Tightening your tummy or buttocks
• Squeezing your legs together

Slow exercises for endurance

Firstly, do slow exercises (endurance). Tighten your muscles. Hold tight for as many seconds as you can (to a maximum of 10 seconds). Release the contraction and rest for 4 seconds. Repeat this hold for as many times as you can (up to a maximum of 10 times).

Make a note of how long you can hold this, and many times can you repeat the contraction. Repeat this several times a day.

Fast exercises for power

Tighten and relax your muscles quickly. Repeat this for as many times as you can (up to a maximum of 10 times).

Make a note of many times can you repeat the contraction. Repeat this exercise several times a day.

Pelvic floor muscles are like any other muscles. You need to practise exercising them to get to full strength. The muscles may get tired at first but they will get stronger as you practise.

How can I try and reduce leaks of urine whilst building up the strength of the muscles?

You should tighten your pelvic floor muscles before you cough, sneeze or lift. This can help to prevent a leak of urine.

You would expect to have fewer leaks in your underwear after about 3 months, but you may need to exercise for up to 6 months before you see an improvement. As your muscles become stronger and you stop leaking urine, you must still do the exercises 3 times a week for the rest of your life. If you don’t your muscles may become weak again. If exercises don’t help you may need to try other treatments. Your nurse will discuss this with you.

• Have about 8 drinks each day
• Avoid too many caffeinated drinks as these can irritate the bladder
• Don’t go to the toilet too often, only go when your bladder feels full
• Avoid constipation and straining when opening your bowels
• Eat 5 portions of fruit and vegetables each day
• If you smoke, try to stop
• Try and keep to a normal weight
• Don’t lift things that are too heavy for you

Information on bladder and bowel conditions, lifestyle advice, and treatment options is also available via:

• The Bladder and Bowel Foundation website
• Helpline: 0845 345 0165
• General enquiries: 01536 533 255
• NHS Choices website