Your pelvic floor is not a single muscle, but a collection of muscles, ligaments, and connective tissue that forms a hammock-like structure at the base of the pelvis. It supports the bladder, uterus, and intestines, working daily to allow you to move, laugh, and live without conscious awareness. When changes occur in these structures (due to pregnancy, childbirth, surgeries, traumas, etc.), various discomforts may arise, such as urinary, gas, and fecal leakage, feelings of pressure and heaviness, or painful intercourse. These are indications that your body requires attention.
Studies indicate that over one-third of women experience some form of pelvic floor disorder during their lifetime (Fedorchenko and Usen, 2025). Nevertheless, many of these conditions can be improved or even prevented through increased awareness and targeted exercises.
Pregnancy
During pregnancy, the pelvic floor works harder than ever before. It supports not only your organs but also the increasing weight of the growing baby. Hormonal changes make tissues more elastic, preparing the body for childbirth, but simultaneously, the first pelvic floor issues may emerge (such as urinary leakage when sneezing or coughing, or difficulty with urinary continence).
Pregnancy is an ideal time to learn to consciously contract and relax the pelvic floor muscles. This practice can reduce discomfort during pregnancy, prepare the pelvic floor for childbirth, and promote postpartum recovery. If a woman has regularly performed pelvic floor exercises during pregnancy, she will find it easier to reconnect with these muscles after childbirth. Muscle memory aids in better muscular recovery.
Childbirth
Childbirth presents a significant challenge to a woman’s body, and vaginal delivery imposes considerable strain and trauma on the pelvic floor muscles. During labor, tissues must stretch by over 300%, which can result in tears and muscle damage. In some instances, vaginal delivery may temporarily diminish nerve sensitivity and muscle function in the pelvic region, though most women recover within a few months (Mahoney et al., 2022).
Studies have demonstrated that pregnancy and childbirth are significant risk factors for pelvic floor dysfunction. Vaginal delivery, particularly instrumentally assisted delivery, is associated with a higher risk of pelvic organ prolapse and urinary incontinence later in life (Kearney et al., 2025).
Therefore, it is crucial that all women who have given birth understand the importance of pelvic floor muscle exercises for their health. These are among the first exercises that should be initiated soon after childbirth, and it is recommended to perform them regularly for at least three months. If you experience difficulties with voluntarily contracting your pelvic floor muscles, it is important to consult a pelvic floor physiotherapist.
(Peri)menopause
During perimenopause, hormonal changes – primarily a decrease in estrogen levels – can lead to measurable structural and functional alterations in the pelvic floor muscles. These changes may impact bladder control, sexual function, and pelvic organ support, making pelvic floor health particularly crucial during this life stage. If a woman has not previously trained her pelvic floor muscles (e.g., after childbirth), various discomforts may begin to manifest during perimenopause.
These symptoms should certainly not be overlooked. In addition to pelvic floor muscle training, quality of life can be improved by vaginal estrogen therapy, nutritional counseling, regular exercise, and, if necessary, oral contraceptives, hormonal IUDs, iron supplements, or antidepressants. To determine the most suitable combination of solutions, it is advisable to consult a gynecologist.
You are not alone. And your body – at all stages of its life – is worthy of care, comfort, and confidence. The pelvic floor can be trained at any age.
