In a way, your pelvic floor is the unsung hero of the body, holding it all in place. Belly laughs, enjoyable sex, going to the bathroom with ease—yep, that’s all your pelvic floor at work. And yet, we don’t really talk about it, especially when we have problems down there.
Discussions around the pelvic floor are often coloured by embarrassment; however, issues with this area of the body are a lot more common than we may think: approximately one in three women globally will experience a pelvic floor condition in her lifetime, and millions of Canadians live with symptoms of dysfunction, including incontinence, pelvic pain, or prolapse.
The good news is that while related disorders are highly prevalent, the pelvic floor is a muscle group like any other, and with the right care and support, you can continue to have a healthy and well-functioning pelvic floor throughout your life.
A muscle group most of us don’t think about
Its name is slightly misleading, because the pelvic floor is more like a bowl of muscles and connective tissue that works to stabilize your centre and assist with key bodily functions, such as pooping, peeing, and having sex. Shaped like a hammock strung from the base of your pelvic bones, it holds vital organs in place, including your bladder, bowel, and reproductive organs.
Michelle Soh, MScPT and owner of Inner Circle Physio, notes that there is a general lack of awareness around this muscle group and finds it essential to educate her clients about pelvic anatomy. “We can exercise our biceps; we can exercise our hamstrings and quads,” Soh says, “but nobody ever thinks about the pelvic floor.”
During an assessment, Soh evaluates the core system as a whole: the diaphragm, deep back muscles, abdominal muscles, and, of course, pelvic floor muscles. That’s because the pelvic floor muscles work alongside all the rest to absorb pressure and protect your inner organs and spine.
The thing is, because the brilliant body has made it so these muscles work automatically, you may never even think about them until things start to malfunction.
Pelvic floor dysfunction: what is it?
Pelvic floor dysfunction (PFD) can be broadly categorized into whether the pelvic floor is overactive (too tight); underactive (too weak); or poorly coordinated, when the muscles don’t function as they should, and it can be difficult to contract or relax them.
The function of the pelvic floor depends on unique interrelationships between muscles, nerves, connective tissue, and bones. Disorders happen when any of these relationships are disrupted.
Although often associated with women, PFD can affect anyone and may develop for a variety of reasons, including after pregnancy or childbirth, with aging or menopause, from repeated strain on the pelvic floor (such as heavy lifting, obesity, or persistent coughing), after surgery, due to nerve damage or injuries, or even stemming from psychosomatic causes such as stress or trauma.
Signs and symptoms of PFD
- urinary leakage, especially during coughing, sneezing, laughing, or exercising
- frequent or urgent need to urinate
- difficulty starting urination or a weak/interrupted urine stream
- feeling that the bladder or bowels do not fully empty
- constipation or difficulty passing stool
- straining during bowel movements
- loss of bowel control or difficulty controlling gas
- pelvic pressure, heaviness, or a bulging sensation in the vagina or rectum
- chronic pelvic pain
- pain during sex or discomfort with tampon insertion
- pain in the lower abdomen, hips, or tailbone
- needing to shift position or press on the pelvis to urinate or have a bowel movement
- reduced sensation or discomfort during sexual activity
When to seek help
If something doesn’t feel right, don’t ignore it.
Soh emphasizes that “everybody knows their body the best,” but that any new, persistent, or worsening change in bladder, bowel, or pelvic-area comfort is a reason to seek an expert opinion. She adds that “if you are pregnant and you’re experiencing increasing urinary incontinence, or you’re getting a little bit older and this has never happened before,” then it may also be time to seek support from a pelvic floor physiotherapist.
Everyday strategies to support pelvic floor health
There is good news in this whole story: because the pelvic floor is a muscle group, it can be taken care of similarly to any other part of the body.
Soh stresses a whole-body approach to pelvic floor health, sharing that “it often boils down to taking care of yourself. Take care of it all. Take those breaks, drink that water, take this time to do the things that make you happy.”
In terms of exercise, make sure to take a personalized approach to your movement routine. Kegels (which involve squeezing the muscles used to stop the flow of urine, holding for up to10 seconds, and relaxing for a similar amount of time) can work for underactive pelvic floors, but overactive ones require different methods, including relaxation techniques and stress management. The pelvic floor requires both strength and flexibility to function well.
The goal, according to Soh, is to work toward functional integration, meaning you are able to use the pelvic floor while walking, moving, lifting, or doing daily tasks. This ensures quality of life as you continue to age and change.
How to locate your pelvic floor muscles
- Imagine stopping the flow of urine; the muscles you tighten are those of your pelvic floor.
- Think about trying to prevent passing gas. By activating the area around the anus, you also use the pelvic floor.
- If you have a vaginal opening, insert a finger and try to squeeze it.
In each scenario, you should feel a lifting and tightening sensation inside the pelvis indicating that the correct muscle group is activating.
Some other ways to show your pelvic floor love
- Fibre: Adequate intake helps bowel motility and reduces constipation.
- Hydration: Sufficient water intake keeps muscles flexible and relaxed, prevents straining and constipation, and maintains tissue elasticity.
- Core exercises: Physical training strengthens the pelvic floor and supports the entire region.
- Regular movement: Staying active helps keep the zone toned and functional for everyday activities.
- Breathwork: Diaphragmatic breathing, or deep breathing, helps relax the area.
- Relaxation techniques: For overactive pelvic floors, try yoga, meditation, or warm baths.
- Not holding it in: Holding in pee or poop increases pressure on the pelvic floor and can lead to issues.
- Not pushing it out: Pushing too hard can strain the muscles and lead to dysfunction down the line.
Taming the taboo
Learning more about our pelvic floor can help make the area feel a lot less mysterious and break some of the stigma around it. When we start normalizing conversations about this part of our body and are more open to discussing the warning signs that something isn’t quite right, we help ensure that healthy living reflects all muscle groups, seen and unseen.
Supports for a healthy pelvic floor
- Magnesium helps your muscles contract and relax properly, which contributes to healthy pelvic floor function and coordination.
- Collagen has a positive effect on pelvic floor connective tissue and helps regulate instability in the region.
- Psyllium husk and other fibrous compounds support healthy bowel movements and reduce straining and constipation (which can weaken the pelvic floor over time).
- Synbiotics have been shown to effectively reduce constipation, therefore supporting bowel and pelvic floor functioning.
- Antioxidants such as vitamins C and E can reduce inflammation and pelvic pain.
- Vitamin D helps absorb calcium, which the pelvic muscles need to function effectively; deficiency has been linked to pelvic floor disorders and bladder issues.
- Creatine and Leucine have been shown to improve muscle strength and function in the pelvic floor.
- Iron is important for oxygen delivery and muscle function.
This article was originally published in the July 2026 issue of alive magazine.
