What is the pelvic floor? The pelvic floor is a group of muscles and ligaments in the lower pelvic cavity that has important roles in health and well-being: It provides support , protects from external injuries, and maintains the pelvic organs , that is, the bladder and rectum and, in women, also the uterus, in the correct position; Along with other structures, it takes part in the mechanisms that control urine, gases and feces output ; In exertion, or when coughing or sneezing, the contraction of the pelvic floor muscles helps prevent involuntary loss of urine ; It also plays an important role in sexual intercourse . What is pelvic floor weakening? For the pelvic floor muscles to perform their functions correctly, they must maintain their integrity and functional capabilities. However, the weakening of the pelvic floor is frequent. In addition to the normal aging process, other common circumstances contribute to the weakening of pelvic floor muscles, especially in women, for example: Weight overload during pregnancy; Vaginal births, especially if there is any muscle damage; Hormonal changes associated with menopause; Abdominal distension caused by repeated exertion, for example when there is constipation or chronic coughing; The non-usual use of these muscles. Problems associated with pelvic floor weakening The weakening of the pelvic floor can be the cause or aggravate problems such as : Stress urinary incontinence , that is, involuntary loss of urine when exerting, during physical exercise (for example, when running or jumping), when blowing or when coughing or sneezing; Urge urinary incontinence , that is, involuntary loss of urine when there is an urgent need to urinate; Mixed urinary incontinence (stress and urgency); Anal incontinence , for gas and feces; Pelvic organ prolapse or genital prolapse, ie descent of pelvic organs – bladder, rectum and uterus – from their normal position. In more severe forms, this descent can go beyond the entrance of the vagina and cause discomfort, requiring manual reduction or surgical correction. Loss of sexual desire or satisfaction due to a feeling of vaginal fullness or swelling. Exercises to strengthen the pelvic floor Exercising pelvic floor muscles regularly, and not just after having children or through menopause, strengthens and tones the muscles and helps prevent problems . This is particularly important in women. However, properly adapted, they are also beneficial in men. In many circumstances, pelvic floor rehabilitation is also advised following births or pelvic surgeries and initiated with physiotherapy. In these cases, it may involve other types of intervention, in addition to teaching and exercising, such as biofeedback or electrical stimulation. The technique of pelvic floor strengthening exercises , or Kegel exercises , must be learned correctly, otherwise the exercises will not have the desired effects. The exercises are sequences of contracting, holding and relaxing the pelvic muscles, without using the abdominal, buttocks or thigh muscles, with a simultaneous ascent and approximation of the vagina and anus; It can be difficult to understand at first which muscles are working in the exercises, but it is very important that these are done correctly; In case of doubt, talk to your physiatrist, gynecologist or urologist , who will be able to assess your needs and advise on learning the exercises; Physical therapists are professionals qualified to teach these exercises and to periodically assess whether they continue to be performed correctly. Once learned, the exercises should become part of daily life activities . They are easily done autonomously. There is no need to reserve a specific time of day for this purpose, as they are not noticeable by others and can be done in any position – sitting, standing, or lying down. In most cases and as a preventive measure, it is sufficient to do 3 sets of 8-12 sequences, 3 times a day, 2 days a week . There are also some activities that should be adopted to help preventing problems, for example contracting your pelvic floor muscles before coughing, sneezing, jumping, or carrying weights. Exercise regularly your pelvic floor and your muscles will progressively be able to contract harder and longer, and respond with a quick contraction when you cough, laugh, exercise, carry weights or have a urinary urge to control . When exercises cannot compensate the complaints of urinary incontinence on exertion, minimally invasive surgical techniques are currently available with efficiency rates above 90%. In symptomatic genital prolapses, surgical treatment also has high success rates . Author : Bruno Graça Sources Brubaker B. Pelvic floor exercises. www.uptodate.com International Urogynecologial Association. Pelvic Floor Exercices. www.iuga.org Conheça a equipa de urologia da rede Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
