Your pelvic floor at every age

Leaking pee when you laugh, or a heavy feeling in the vagina, are reasons to ask for help. They can be signs of bladder control problems or pelvic organ prolapse. Leaks get more likely with age, but they aren’t something you just have to accept as you get older.

What these muscles do

Your pelvic floor muscles stretch across the bottom of your pelvis. They support the bladder, bowel and womb, and help control when you let out pee, poo and wind. Pregnancy and giving birth, surgery and getting older can weaken them. Looking after your pelvic floor matters long after the weeks following a birth.

Pelvic floor exercises are also called Kegel exercises or pelvic floor muscle training. They mean squeezing, holding and letting go of these muscles. Relaxing them fully is part of the exercise too.

Describe the problem in ordinary words

Leaking when you cough or laugh is called stress incontinence. Here, “stress” means pressure on the bladder. Leaking with a sudden, strong need to pee is called urgency incontinence. Some people have both. These names can help you explain what happens without deciding the cause yourself.

Prolapse is when pelvic organs, such as the bladder, bowel or womb, bulge into the vagina. Possible signs include a heavy or dragging feeling, a bulge you can see or feel, discomfort during sex, constipation, or a feeling that your bladder hasn’t fully emptied.

You could tell the clinician, “I leak when I lift something,” or “I get a heavy feeling by the end of the day.” If the effect on work, exercise or sex is what brought you in, say so. Your own words are enough to start the conversation.

Learn the squeeze and the release

Ask a healthcare professional whether pelvic floor training is right for you. It isn’t a good option in every situation. A doctor, nurse or pelvic floor therapist can check whether you’re using the right muscles and suggest a plan.

To find the movement, imagine you’re holding in wind, and gently squeeze those muscles. After a hold, let go and relax fully. Keep breathing, and try not to pull your tummy in. Ask someone to show you if you’re not sure what it should feel like.

Don’t make stopping your pee midstream part of your routine. Doing the exercises while you pee can stop your bladder emptying fully and raise the risk of infection. Doing more isn’t always better either. Overdoing it can make you strain when you pee or poo.

When a personal plan helps

A specialist physiotherapist can help with pelvic floor training for prolapse. If symptoms bother you after a birth, the NHS says you can ask a GP or health visitor for help at any time. You don’t have to wait for a planned postnatal visit.

For prolapse, avoiding constipation can help. The NHS suggests fibre, water and gentle activity such as walking. It also advises avoiding things that put a lot of strain on the pelvic floor, such as heavy lifting. Talk about how to adapt the activities that matter to you.

Exercises are one possible part of care. Depending on the problem, options can include bladder training, a support device that goes in the vagina (a pessary), or surgery for severe prolapse. Ask what each option could improve and how you’ll check whether it’s helping.

Arrange an assessment

Go to A&E now (UK), an emergency department (US), or your local emergency department elsewhere if you can’t pee at all, especially with pain or swelling low in your tummy. Don’t wait for a routine appointment or try more exercises.

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, for leaks or signs of prolapse that won’t go away, if you can still pee. A check for prolapse can include an examination, and you can ask for a chaperone (someone else in the room). You may also be asked to keep a bladder diary of your drinks and trips to the toilet.

Bring your main question, even if it’s just, “Can you check whether I’m doing these exercises right?” Ask who to contact if the plan isn’t helping, and whether a referral for your pelvic floor would be useful.