Learn how to strengthen the pelvic floor Learn how to strengthen the pelvic floor

Taking care of this set of muscles and ligaments is key to avoiding urinary incontinence, among other matters.

Advisors: Jaime Ruiz Collazos, gynecologist
Esteban Gómez Correa, urologist

The pelvic floor is the set of muscles, ligaments and tissues located at the bottom of the pelvis. Its function is to support the organs located in this area: the bladder, the urethra, and the rectum. In women, it also supports the uterus and vagina, and in men, the prostate.

Its structure helps these organs to maintain their place and function properly to facilitate delivery and good deposition and output of fluids. However, these tasks cannot always be accomplished, as the ligaments stretch, weaken and stop holding the uterus, which slides into the vagina causing genital prolapse. Gynecologist Jaime Ruiz Collazos explains that this happens for several reasons: pregnancy (due to the weight of the uterus), vaginal delivery, constipation, obesity, chronic cough, and excessive physical exertion (because it increases abdominal pressure towards the pelvis). Other factors include the deterioration of support tissues caused by age (after age 60 or 70), loss of collagen (loss of pelvic floor tension), surgeries such as hysterectomy (removal of the uterus), hereditary factors, and resisting or forcing the urge to go to the bathroom.

Pelvic floor problems and their symptoms also affect women’s quality of life on a personal, family, social and sexual level. These cause vaginal dryness, involuntary output of urine or fecal matter, pelvic pain, constipation, vaginal relaxation syndrome, and pain or lack of pleasure during sex.

Esteban Gómez Correa, urologist, emphasizes these problems may vary depending on the severity of pelvic floor disorders. For example, there are women who present these problems, but do not recognize them because they have lost their sensitivity. In these cases, muscles can be strengthened through treatments, such as Kegel exercises, physiotherapy, the use of intravaginal weights, known as Ben Wa balls or Chinese balls, and biofeedback, which consists of the placement of special electrodes within the vagina or around the perineum, which transmit low-intensity modulated electrical signals, to stimulate, contract and strengthen the pelvic floor muscles.

Gómez Correa highlights the importance of consulting for routine checkups and early detections. Ruiz Collazos adds that, if the condition is advanced, there are treatments such as surgery, or the placement of a mesh when the prolapse of pelvic organs is severe. As a form of prevention, specialists recommend a good diet, no smoking, adequate fluid and fiber intake, not holding or forcing the urge to go to the bathroom, guided exercise and avoid physical exertion. He clarifies that during pregnancy and postpartum women should work on strengthening their pelvic floor. 

 

Kegel Exercises

American gynecologist Arnold Kegel created a series of exercises in the 1940s to correct his patients’ urinary incontinence after childbirth. Later, these became a way to strengthen the pelvic floor for both men and women.

  1. They consist of contracting your pelvic floor muscles and hold to the maximum with proper breathing: inhale and exhale for a minute or two, rest for a minute and repeat. Do it three times a day.
  2. Tighten your muscles for ten seconds and release. Do 20 repetitions, three or four series, three times a day. After each repetition relax for a minute.

It is important to perform them in a comfortable position (sitting or lying down). It is not recommended to do these exercises during urination.

Related: The bladder can also suffer from overactivity