The truth about pelvic floor exercises

Photo: SHUTTERSTOCK
Photo: SHUTTERSTOCK Photo: Shutterstock

Over a third of Australian women suffer from urinary incontinence, and it's estimated at least half of women who've had more than one child have some degree of genital prolapse.

Pelvic floor disorders affect many women, and health professionals often recommend exercising the pelvic floor muscles in order to keep them strong to reduce symptoms and prevent disorder.

We asked five experts if all women should be exercising these muscles regularly.

Jane Chalmers - Physiotherapist

Yes, but perhaps not in the way they're currently doing them. While pelvic floor strengthening exercises (Kegels) are important to avoid stress incontinence and to enhance sexual pleasure, it's equally important to learn to relax the pelvic floor muscles. Increased tone of the pelvic floor muscles has been associated with various types of pelvic pain and painful sex.

There are plenty of helpful resources available that take women through a guided relaxation or gentle stretching of the pelvic floor muscles. Find a comfortable and well-supported place to sit or lie down, completely relaxing the body, especially the abdominal muscles.

Perform a very gentle pelvic floor contraction for three seconds, then relax and lengthen the pelvic floor muscles for ten seconds. Concentrate on this sensation of relaxation and lengthening. Avoid holding your breath or using your abdominals to push down. Allow the pelvic floor to naturally lengthen.

Hannah Dahlen - Midwife

Women should do pelvic floor exercises as this can help reduce and prevent urinary incontinence and faecal incontinence and may also have an impact on sexual health. There is also some evidence if you start pelvic floor exercises before you have had a baby there are some labour and birth benefits, such as a reduction in the really long pushing stage of labour. But we need more research to confirm this.

It's really important these exercises are done correctly as you can put more stress on the pelvic floor and this is not a good thing. Pelvic floor muscle exercises are not always easy to do and around 50 per cent of women are not doing them correctly. Consulting a physiotherapist is a good way to get into healthy exercise patterns. For instructions on pelvic floor exercises visit here.

Victoria Salmon - Physiotherapist

All women benefit from healthy pelvic floor muscles throughout their life. The pelvic floor helps keep the bladder, womb and bowel in the right place, and healthy muscles stop leaking of urine, wind or faeces, improve sexual function, and help with childbirth.

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Many women have weak pelvic floor muscles leading to problems with leakage or prolapse, which negatively affects their well-being. Problems can start young (such as giggle incontinence in girls), and can affect all women whether they have had children or not.

Good news – research shows doing enough pelvic floor muscle exercises, and doing them correctly, helps prevent and treat these problems and keeps the pelvic floor healthy for life! Ask a health professional for a referral to an expert physiotherapist or nurse if you aren't sure what to do, find the exercises painful, or feel something coming down inside when you exercise – make sure you're exercising correctly for life.

Helena Frawley - Women's health

Ideally, all women should do pelvic floor muscle exercises for good pelvic health. Pelvic floor disorders are common in women, and pelvic floor muscle exercises help two of the most common of these disorders (urinary incontinence and pelvic organ prolapse), with evidence emerging the exercises can help other kinds of pelvic floor problems.

While not all women may need to do pelvic floor exercises if they don't experience pelvic floor problems, the benefits for those who do outweigh any negatives of doing the exercises. In fact, there are few negatives!

If done correctly, the exercises are not uncomfortable, there are no side-effects, there is no cost if women self-manage their exercises, and the worst outcome may be no change to pelvic floor problems if they are present. In this case, women should seek help from a health professional, like a pelvic floor physiotherapist, to teach them how to do the exercises effectively, as the exercises can be difficult for some women to do correctly.

Being an 'internal' muscle, it can be challenging to know if you are doing them correctly. However, most women learn very quickly, and have a good chance of helping their pelvic floor problems.

Anna Rosamilia - Urogynaecologist

The short answer is yes, particularly for child bearing women. A physiotherapy-led weekly exercise class with daily home exercises decreases urinary incontinence in late pregnancy and up to six months after birth. A more intensive program is recommended for postpartum women who have had a forceps delivery or vaginal delivery of a large baby (4kg or more).

There is preliminary evidence pelvic floor muscle training may help prevent urinary incontinence in older women but this needs further study. Supervised pelvic floor muscle training should be offered as a first-line conservative treatment for women of all ages with urinary incontinence. Pelvic floor muscle training can also help some symptoms associated with vaginal prolapse.

This article originally appeared on The Conversation

The Conversation