Pelvic Floor Issues In Women

Andrew Siegel MD  8/13/16


The pelvic floor muscles (PFM) are integral in maintaining healthy pelvic anatomy and function. When PFM impairments develop, there are typically one or more of five consequences:

  1. Urinary control issues
  2. Bowel control issues
  3. Sexual issues
  4. Pelvic organ prolapse and vaginal laxity
  5. Pelvic pain

25% of women have symptoms due to weak PFM and many more have weak PFM that is not yet symptomatic. Others have symptoms due to PFM that are taut and over-tensioned. More than 10% of women will undergo surgery for pelvic issues—commonly for stress urinary incontinence (urinary leakage with coughing, sneezing, exercise, etc.) and pelvic organ prolapse (sagging of the pelvic organs into vaginal canal and at times outside vagina)—with up to 30% requiring repeat surgical procedures.

The following quotes from patients illustrate the common pelvic issues:

 “Every time I go on the trampoline with my daughter, my bladder leaks. The same thing happens when I jump rope with her.”

–Brittany, age 29

“My vagina is just not the same as it was before I had my kids. It’s loose to the extent that I can’t keep a tampon in.”

–Allyson, age 38

“As soon as I get near my home, I get a tremendous urge to empty my bladder. I have to scramble to find my keys and can’t seem to put the key in the door fast enough. I make a beeline to the bathroom, but often have an accident on the way.”

–Jan, age 57

“Sex is so different now. I don’t get easily aroused the way I did when I was younger. Intercourse doesn’t feel like it used to and I don’t climax as often or as intensively as I did before having my three children. My husband now seems to get ‘lost’ in my vagina. I worry about satisfying him.”

–Leah, age 43

“When I bent over to pick up my granddaughter, I felt a strange sensation between my legs, as if something gave way. I rushed to the bathroom and used a hand mirror and saw a bulge coming out of my vagina. It looked like a pink ball and I felt like all my insides were falling out.”

–Karen, age 66

 “I have been experiencing on and off stabbing pain in my lower abdomen, groin and vagina. It is worse after urinating and moving my bowels. Sex is usually impossible because of how much it hurts.”

–Tara, age 31

These issues come under the broad term pelvic floor dysfunction, common conditions causing symptoms that can range from mildly annoying to debilitating. Pelvic floor dysfunction develops when the PFM are traumatized, injured or neglected. Pelvic floor muscle training (PFMT), a.k.a. “Kegels,” has the capacity for improving all of these situations.

PFM fitness is critical to healthy pelvic function and is an important element of overall health and fitness. PFMT is a safe, natural, non-invasive, first-line self-improvement approach to pelvic floor dysfunction that should be considered before more aggressive, more costly and riskier treatments. We engage in exercise programs for virtually every other muscle group in the body and should not ignore the PFM, which when trained can become toned and robust, capable of supporting and sustaining pelvic anatomy and function to the maximum. Should one fail to benefit from such conservative management, more aggressive options always remain available.

PFMT can be beneficial for the following categories of pelvic floor dysfunction:

  • Weakened pelvic support (descent and sagging of the pelvic organs including the bladder, urethra, uterus, rectum and vagina itself)
  • Vaginal laxity (looseness)
  • Altered sexual and orgasmic function
  • Stress urinary incontinence (urinary leakage with coughing and exertion)
  • Overactive bladder (the sudden urge to urinate with leakage often occurring before being able to get to the bathroom)
  • Pelvic pain due to PFM spasm
  • Bowel urgency and incontinence.

Additionally, PFMT improves core strength, lumbar stability and spinal alignment, aids in preventing back pain and helps prepare one for pregnancy, labor and delivery. PFMT can be advantageous not only for those with any of the previously mentioned problems, but also as a means of helping to prevent them in the first place. Exercising the PFM in your 20s and 30s can help avert problems in your 40s, 50s, 60s and beyond.

Bottom Line: Pelvic floor dysfunction is a common problem that causes annoying symptoms that interfere with one’s quality of life. It is often amenable to improvement or cure with a Kegel pelvic exercise program. There are numerous benefits to increasing the strength, tone, endurance and flexibility of your PFM. Even if you approach public training with one specific functional goal in mind, all domains will benefit, a nice advantage of conditioning such a versatile group of muscles.

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”:

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

Author page on Amazon:

Apple iBook:

Trailer for The Kegel Fix:  

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: or Amazon.  In the works is the female PelvicRx pelvic floor muscle training DVD. 

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

Tags: , , , , , , , , , , , ,

3 Responses to “Pelvic Floor Issues In Women”

  1. Kegels: One Size Does Not Fit All! | Our Greatest Wealth Is Health Says:

    […] Pelvic floor dysfunction is a broad term applied to the scenario when the pelvic muscles and connective tissues are no longer functioning optimally.  This gives rise to pelvic issues including pelvic organ prolapse, urinary and bowel incontinence, sexual dysfunction and pelvic pain syndromes.  A one-size-fits-all Kegel pelvic floor muscle exercise approach has traditionally been used to manage all forms of pelvic floor dysfunctions. For many years, patients who were thought to be able to benefit from Kegels were handed a brochure with instructions to do 10 repetitions of a 10-second Kegel contraction followed by 10 rapid contractions, three times daily. […]

  2. “Preventive” Kegels: A Cutting-Edged Concept | Our Greatest Wealth Is Health Says:

    […] and free from harmful side effects. Although it is always desirable to treat the symptoms of pelvic floor dysfunction, it is another dimension entirely to take a proactive approach by strengthening the pelvic muscles […]

  3. France, England, the USA and Kegels | Our Greatest Wealth Is Health Says:

    […] problems. Pelvic floor training prior to and during pregnancy can help minimize the occurrence of pelvic floor dysfunction and pelvic floor training after childbirth can help hasten the resolution of pelvic floor […]

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: