What You Don’t Know About Your Pelvic Floor Muscles, But Should

Andrew Siegel, M.D. 6/18/16

* Please note that although this entry is written for women, it is equally applicable to men.

In dogs, the pelvic floor muscles (PFM) play an important role with respect to tail position and movement. They are responsible for tail wagging in circumstances when dogs are happy and for the tail being held down between the legs when dogs are frightened or anxious. Weak PFM are virtually unheard of in the canine population, suggesting that with constant tail movement, the PFM are exercised sufficiently to maintain tone and vitality.


foot in water bowl

Photo above is Charley, my English Springer Spaniel.  Note her happy, erect tail and her curious habit of eating with her foot in her water bowl.

For better or worse, humans do not have tails to wag or place between our legs.  Tails became extinct with the evolutionary process (with the exception of the character played by Jason Alexander in the movie “Shallow Hal”). If we did have tails, our PFM would likely get a great deal more exercise than they typically do.

Sadly, the PFM don’t get the respect that the glitzy, for-show, mirror-appealing, external glamour muscles do. However, the PFM are hidden gems that work diligently behind the scenes–muscles of major function and not so much form-offering numerous powers and benefits, particularly so when intensified by training. Although not muscles of glamour, they are muscles of “amour,” and have a profoundly important role in sexual, urinary, and bowel function as well as in supporting our pelvic organs.

What are the PFM?

The PFM—commonly known as the “Kegel muscles”—are a muscular hammock that form the bottom of the pelvis. They are also referred to as the “saddle” muscles because you sit on them when seated on a bicycle. They are part of the “core” group of muscles.

What are the “core” muscles?

The core muscles are the “barrel” of muscles comprising the torso, consisting of the abdominal muscles in front, the lumbar muscles in back, the diaphragm muscle on top and the PFM on the bottom. The core muscles are responsible for stabilizing the pelvis and holding the spine erect.

1.core muscles

                              Illustration of core muscles by Ashley Halsey from                                            The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health

Where are the PFM?

The deep PFM (pubococcygeus, iliococcygeus, coccygeus) span from the pubic bone in front to the tailbone in the back, and from pelvic sidewall to pelvic sidewall, between the “sit” bones.

2.deep PFM              Illustration of deep PFM muscles by Ashley Halsey

The superficial PFM (ischiocavernosus, bulbocavernosus, transverse perineal, anal sphincter) are situated under the surface of the external genitals and anus.

3. superficial and deep PFM

            Illustration of superficial and deep PFM muscles by Ashley Halsey


What is the function of the PFM?                                                                      

The PFM muscles intertwine with the muscles of the vagina, bladder and rectum,  provide support for the pelvic organs, play a vital role in sexual function and contribute to the control mechanism of the urinary and intestinal tracts.

What is PFM dysfunction?

PFM “dysfunction” is a common condition referring to when the PFM are not functioning properly. PFM dysfunction ranges from “low tone” to “high tone.” Low tone occurs when the PFM lack in strength and endurance and is often associated with stress urinary incontinence (urinary leakage with coughing, sneezing, laughing, exercising and other physical activities), pelvic organ prolapse (when one or more of the pelvic organs fall into the space of the vagina and at times outside the vagina) and altered sexual function (decreased sensation, difficulty accommodating a penis because of looseness, difficulty achieving climax, etc.). High tone occurs when the PFM are too tense and unable to relax, giving rise to a pain syndrome known as pelvic floor tension myalgia (this situation is entirely analogous to the high-strung dog with its tail between its legs).

Trivia: PFM dysfunction often causes symptoms in several domains, e.g., women with urinary control issues often have trouble achieving orgasm, both problems contributed to by weak PFM.

What causes PFM dysfunction?

The PFM can become weakened, flabby and poorly functional with pregnancy, labor, childbirth, menopause, weight gain, a sedentary lifestyle, poor posture, sports injuries, pelvic trauma, chronic straining, pelvic surgery, diabetes, tobacco use, steroid use, and disuse atrophy (not exercising the PFM). Sexual inactivity can lead to their loss of tone, texture and function. With aging there is a decline in the bulk and contractility of the PFM, often resulting in PFM dysfunction.

Why are the PFM so vital to your health?

The PFM are perhaps the most versatile yet under-appreciated muscle group in your body. They provide vaginal tone, support to the pelvic organs, a healthy sexual response–enhancing arousal and orgasm–and urinary and bowel sphincter control. They play a key role in your ability to carry and deliver a baby as well as contributing to the mobility and stability of your torso.

A simplified way of thinking of the female pelvic organs–bladder, uterus and bowel–is as “storage containers” for urine, fetuses, and stool, respectively. Each organ is connected to the outside world by tubular structures, the urethra, vagina and anal canal, respectively, through which flow the contents of the organs. The PFM play a strong role in compressing the tubes for storage and relaxing them for emptying.

What Is the muscle function of the PFM?

Whereas most skeletal muscles function as movers (joint movement and locomotion), the PFM are unique in that they function as stabilizers—helping to keep the pelvic organs in proper position—and compressors—helping to tighten the vagina, urethra and rectum—important to urinary and bowel control as well as to sexual function. During sex the PFM activate, causing a surge of genital blood flow that helps lubrication and clitoral engorgement; at the time of orgasm, the PFM contract rhythmically.

Why bother exercising your PFM?                                                        

The PFM are out of sight and out of mind; however, they have vital functions, so are muscles that you should be exercising. PFM training is based upon solid exercise science and can help maintain PFM integrity and optimal function into old age. The PFM are capable of making adaptive changes when targeted exercise is applied to them. Pelvic training involves gaining facility with both the contracting and the relaxing phases of PFM function. Their structure and function can be enhanced, resulting in broader, thicker and firmer PFM with a stronger resting tone and the ability to generate a powerful contraction at will. PFM training can be effective in stabilizing, relieving, improving and even preventing issues with pelvic support, sexual function, and urinary and bowel control. In addition to the muscle-training benefit of PFM training, it also supports tissue healing by stimulating the flow of oxygenated, nutritionally-rich blood to the vagina and other pelvic organs.

Because of pregnancy, labor and delivery, the PFM get stretched more than any other muscle group in the body. Through pelvic training, the PFM have the capacity of rebounding from this obstetrical “trauma,” recovering tone and function. Prenatal pelvic training can help fortify the PFM in preparation for pregnancy, labor and delivery.

Bottom Line: The PFM may literally be at the bottom of the barrel of our core muscles, but in terms of their important functions, they are figuratively furthermost from the “bottom of the barrel.” Without functioning PFM, your organs would dangle out of your pelvis, you would be wearing adult diapers and your sexual function would be non-existent. It behooves you to keep these vital muscles in tip-top shape. 

Please check out the following 3 minute video entitled “Why Kegel?”:


Wishing you the best of health,

2014-04-23 20:16:29


A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health– and MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health available on Amazon Kindle, Apple iBooks, B&N Nook and Kobo; paperback edition available at TheKegelFix.com

Author page on Amazon: 


Apple iBook:


The Kegel Fix trailer: 


Co-creator of Private Gym and PelvicRx: comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training programs. Built upon the foundational work of Dr. Kegel, these programs empower men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

Pelvic Rx can be obtained at http://www.UrologyHealthStore.com, an online store home to quality urology products for men and women. Use promo code “UROLOGY10” at checkout for 10% discount. 

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One Response to “What You Don’t Know About Your Pelvic Floor Muscles, But Should”

  1. “Vanishing Penis” Syndrome: What, Why and How to Manage It | Our Greatest Wealth Is Health Says:

    […] lifestyle: wholesome nutrition, weight management, exercise including pelvic floor muscle training, tobacco cessation, moderate alcohol intake, stress […]

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