The Best Pelvic Floor Exercises for Women

pelvic floor exercises
Pelvic floor exercises and incontinence products are important for many midlife women. If you have bladder problems, this physiotherapist’s guide tells you everything you need to know

Why are pelvic floor exercises so important to help female incontinence?

Incontinence is a common issue. Women tell me they can no longer go running because of leakage, or they can’t get through the night without two or three trips to the loo. They might suddenly find themselves bursting to wee. Female incontinence is a big part of midlife. 

I’m always keen to stress to women that this isn’t something they should just put up with. There are things that they can do, and pelvic floor exercises, to help strengthen their pelvic floor. 

How is the pelvic floor affected by menopause? 

The onset of menopause and the loss of oestrogen can cause your pelvic floor muscles – just like the rest of the muscles in your body – to weaken. These muscles support the pelvic organs, which means that if they weaken, the pelvic floor can weaken too.

Reduced pelvic floor muscle function around the time of menopause can also be due to weight gain, which is common during menopause. So pelvic floor exercises are key.

What are the symptoms of female incontinence?

One of the many changes a woman may notice is difficulty controlling her bladder or bowel. The most common symptoms are urinary frequency (constantly needing to go to the toilet) or urgency (needing to get to the toilet in a hurry or not making it there in time).

What are the first signs of female incontinence?

It can often start as a simple reduction in the ability to stop small leaks during explosive exercise, or by increased frequency of urination.

What causes these bladder problems?

This female incontinence is caused by the weakening of the pelvic floor muscular sling that I described earlier. The reduction in oestrogen weakens the smooth muscles and makes the sling more lax. This effect occurs normally in combination with an overall weakening of the gluteal muscles, adductors and abdominal muscles at this time of a woman’s life.

Additional factors include reduced exercise, increased weight and abdominal fat and prolonged sitting, which lengthens the hamstrings.

All of this together leads to an overall drop and weakening in the pelvic sling. This reduces the effectiveness of the pelvic floor. It also reduces the effect of the pelvic sphincter and leads to reduced continence and often sexual function, too.

How common is female incontinence in midlife?

About 25% to 45% of women suffer from urinary incontinence, defined as leakage at least once in the past year. The rates of urinary incontinence increase with age: 20%-30% of young women, 30%-40% of middle-aged women and up to 50% of older women suffer from urinary incontinence.

Is midlife incontinence more likely if you have had children?

Yes, you’re more likely to suffer midlife incontinence if you have had children. Or, if you’ve had traumatic vaginal deliveries or a prolonged end stage of labour. However, just because you haven’t had a vaginal delivery, doesn’t mean you won’t experience pelvic floor weakness and incontinence.

Can midlife incontinence be improved?

Absolutely. You can reduce and stop it with a combined approach of exercise, diet, strength and conditioning around the lumbo- pelvic cortex.

I’ve created a video that describes exactly how to find your pelvic floor, and how to contract the muscles. Most women find it hard to visualise, and it all makes much more sense when they’ve watched me explaining it.

Any other measures?

Increasing your overall cardiovascular fitness and strength around your gluteal region hamstrings, adductors and abdominal region. This can have significantly positive effects on your pelvic floor strength. Changes in overall strength and conditioning take about six to eight weeks.

Can diet and nutrition help?

Improving your diet can make a significant difference to the activity of your bladder. Increasing your fluid intake, decreasing caffeine and stimulants such as alcohol will have an impact on the pelvic floor function.

Reducing the amount of alcohol you consume has a directly positive impact on pelvic floor strength. When you are inebriated,  your smooth muscle responds more slowly to electrical stimulation from the brain to fire and contract, this leads to less effective sphincter control.

What about a pelvic floor trainer?

I recommend a pelvic floor trainer called Pelviva. I work with the company commercially, because I know that the device makes a real difference to my patients.

What is Pelviva and how does it work?

Pelviva treats the cause of bladder leakage by training pelvic floor muscles correctly. It’s a non-surgical answer to treat bladder leakage. It’s made of soft, body responsive foam which is easy to compress and position in the vagina. It adapts to every woman’s individual shape and is comfortable to insert and wear.

Once it’s inserted into the vagina, Pelviva sends pulses directly to the pelvic floor muscles, retraining them in how to contract. It incorporates revolutionary neuromuscular electrical stimulation technology to stimulate pelvic floor muscles to exercise (essentially doing your pelvic floor exercises for you). It mimics what should happen naturally and improves pelvic floor muscle strength and endurance.

What sort of results does it get?

A 12-week clinical study found that 84% of women had improved bladder control and found Pelviva comfortable, easy-to-use and reported no side effects.

Women reported a four-times greater improvement in quality of life versus women who only followed an unsupervised pelvic floor muscle exercise programme.

Is there anything else that you recommend?

Secret Whispers is a product designed to strengthen your pelvic floor safely and gradually by challenging your pelvic floor muscles. It’s like a dumbbell for your pelvic floor. I also work with Secret Whispers commercially, because I believe in the product.

Using these weights teaches you how to do an effective, correct Kegel exercise, as most women find this very difficult to visualise and do correctly. The weights take away the guesswork as the correct pelvic floor muscles have to engage to hold them in.

The weights are discreet and are worn within the accompanying holder like a tampon. Remember, your pelvic floor is a muscle like any other and needs to be exercised every day to keep it strong so that you can avoid leakage and prolapse issues.

The combination of Pelviva, Secret Whispers and a pelvic floor and strength conditioning regime can have a positive effect on creating a strong and functional pelvic floor.

To book your free pelvic floor health check, contact Emma’s clinic on O1442 870686, or email You can find out more about Emma James Physio here, and follow Emma @emmajamesphysio.

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