Your pelvic floor at every age

Leaking urine when you laugh or feeling heaviness in the vagina are reasons to ask for help. They can be symptoms of bladder-control problems or pelvic organ prolapse. Leaks become more likely with age, but they are not an inevitable part of getting older.

What these muscles do

Your pelvic-floor muscles stretch across the pelvis and support the bladder, bowel and womb. They help control when you pass urine, poo and wind. Pregnancy and childbirth, surgery and ageing can weaken them. Pelvic-floor care matters beyond the weeks after a birth.

Pelvic-floor exercises are also called Kegel exercises or pelvic-floor muscle training. They involve squeezing, holding and releasing these muscles. Relaxing fully is part of the exercise too.

Describe the problem in ordinary words

A leak with a cough or laugh is called stress incontinence; “stress” here refers to pressure on the bladder. A leak with a sudden, strong need to pee is called urgency incontinence. Some people experience both. These descriptions 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 symptoms include a heavy or dragging feeling, a bulge you can see or feel, discomfort during sex, constipation, or a feeling that your bladder has not emptied fully.

You could tell the clinician, “I leak when I lift something,” or “There is a heavy feeling by the end of the day.” Describe the effect on work, exercise or sex if that is what brought you to the appointment. 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 is not a good option in every situation. A doctor, nurse or pelvic-floor therapist can check whether you are using the right muscles and suggest a plan.

To recognise the movement, imagine holding in wind and gently squeeze those muscles. After a hold, release and fully relax. Keep breathing, and avoid pulling your tummy in. Ask for a demonstration if you are unsure what the movement is meant to feel like.

Do not make stopping your urine midstream an exercise routine. Doing exercises while peeing can prevent the bladder emptying fully and increase the risk of infection. More repetitions are not automatically better either: overdoing training can lead to straining when you pee or poo.

When a tailored plan helps

A specialist physiotherapist can support pelvic-floor training for prolapse. If symptoms are bothering you after a birth, the NHS says you can ask a GP or health visitor for help at any time. You do not have to save the conversation for a scheduled postnatal visit.

For prolapse, avoiding constipation can help: the NHS suggests fibre, water and gentle activity such as walking. It also advises avoiding activities that put a lot of strain on the pelvic floor, such as heavy lifting. Discuss 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 vaginal support device called a pessary, or surgery for severe prolapse. Ask what each option could improve and how you will check whether it is helping.

Arrange an assessment

Go to A&E now (UK), an emergency department (US), or your local emergency department elsewhere if you cannot pass urine at all, especially with lower-tummy pain or swelling. Do not 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 ongoing prolapse symptoms when you can still pass urine. An assessment for prolapse can include an examination; you can ask for a chaperone. A bladder diary may also be suggested to record drinks and trips to the toilet.

Bring your main question, even if it is simply, “Can you check whether I am doing these exercises correctly?” Ask who to contact if the plan is not helping and whether a pelvic-floor referral would be useful.