Starting Out With Pelvic Floor
Pelvic Floor: the few things that matter most, and the mistakes that catch people out early.
The sling of muscle supporting the bladder, bowel and uterus.
Key takeaways
- First-line treatment for stress incontinence: supervised pelvic floor muscle training
- Minimum trial length: at least 3 months
- Most useful single change: Ask for referral to a specialist pelvic health physiotherapist.
- Commonest mistake: Assuming incontinence after childbirth is permanent or normal.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
Incontinence affects a large proportion of women, is strongly associated with childbirth and menopause, and responds well to supervised exercise.
Start here
Begin here, with two things rather than ten.
- Ask for referral to a specialist pelvic health physiotherapist
- Do the exercises daily and give them at least three months
Then add these
Once the first two are automatic, these are worth adding.
- Start during pregnancy rather than after birth
- Treat constipation, which puts sustained strain on the pelvic floor
The numbers, in one place
| Measure | Figure |
|---|---|
| First-line treatment for stress incontinence | supervised pelvic floor muscle training |
| Minimum trial length | at least 3 months |
| Recommended in pregnancy | to reduce postnatal incontinence |
| Referral | to a specialist physiotherapist where symptoms persist |
| Prevalence | common, and substantially under-reported |
Common early mistakes
- Assuming incontinence after childbirth is permanent or normal
- Reducing fluid intake to manage symptoms, which concentrates urine and worsens urgency
- Regular heavy straining on the toilet
Where to go next
- Pelvic Floor: Separating Myth From Guidance
- Answers to the Common Questions on Pelvic Floor
- Pelvic Floor — the reference entry
- The Evidence on Period Pain, Without the Hype
- Heavy Periods: What the Evidence Actually Says
When to speak to a doctor
See a GP for any leakage of urine or stool, a feeling of something coming down in the vagina, or pain during sex. Seek urgent help for sudden inability to pass urine, new incontinence with back pain or numbness around the groin, or leg weakness — these can indicate nerve compression and are an emergency.
Where this comes from
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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