What Causes A Weak Pelvic Floor in Women?


What You Need to Know About Pelvic Floor Health

Pelvic floor issues are a relatively common female problem. Results from a national survey in the United States revealed that one in four women over the age of 20 would have at least one pelvic floor disorder in their lifetime. Though it is often treatable, many ladies suffer in silence from pelvic floor problems. They often worry about sneezing or coughing in public or keep away from social situations altogether for fear of having an accident.

For many women discussing pelvic health issues is embarrassing. As a result, few seek medical information about what causes a weak pelvic floor. Many women think it’s just part of being a woman, something they have to live with. However, consulting a doctor is highly recommended since there are treatments that can restore quality of life, and possibly even help avoid the need for surgery.

worried looking older woman

What Is the Pelvic Floor?

The pelvic floor consists of muscles, ligaments, tendons, connective tissue, and nerves that stretch from the pubic bone at the front to the tailbone located in the back. They help keep the pelvic organs – bladder, vagina, uterus, cervix, urethra, rectum – in the correct position. It also helps to control the elimination of urine, faeces, and wind from the body. The muscles contract to prevent unwanted leakage and relax to allow elimination of the waste. In addition, good pelvic floor muscles play an essential role in female sexual function, like increasing sexual sensation.

Causes of a Weak Pelvic Floor

Pelvic floor muscles can become weak or overstretched, damaged, or torn, just like other muscles in the body. This results in a weakened pelvic structure. So, what causes a weak pelvic floor?

Here are six instances where it can happen:

  1. Pregnancy and childbirth: Women who have had assisted vaginal births (using a ventouse or forceps), experienced severe perineal tears, or delivered large babies are at a greater risk of pelvic muscle damage.mother holding newborn baby

  2. Chronic constipation: Constipation can cause straining during bowel movements. However, if this continues for a prolonged period, it can lead to a weak pelvic floor or pelvic organ prolapse.
  3. Menopause: Decreased levels of estrogen due to menopause can cause the pelvic floor muscles to weaken.

  4. Surgery/radiotherapy: Women who have undergone procedures like a hysterectomy or radiotherapy treatment in the pelvic area are likely to have weak muscles as a result.

  5. Heavy lifting: Using incorrect posture when doing heavy lifting or high-impact exercises while working out can increase abdominal pressure, which may strain and weaken the pelvic floor muscles.

  6. Being overweight/obese: When a woman has a high Body Mass Index (BMI), her pelvic floor has to constantly support a heavier load, leading to high intra-abdominal pressure. Consequently, the pelvic floor ligaments may start to weaken.

Symptoms of Weak Pelvic Floor Muscles

Living with weak pelvic floor muscle symptoms can have a significant impact on everyday life. A study carried out on women with advanced pelvic floor disorders found they were more likely to feel self-conscious and less likely to feel physically attractive. In addition, they tended to avoid people because of how they felt about their appearance and their bodies.

You may need to seek professional medical advice about your pelvic health if you have more than one of the following symptoms:

  • Accidental urine leakage during routine activities like running, sneezing, laughing, coughing, or exercising Sudden urge to use the toilet and not making it in time
  • A constant need to urinate
  • Accidentally breaking wind from the vagina or anus when lifting something or bending over
  • Anal incontinence
  • Distinct heaviness or a bulge at the vaginal opening
  • Pain in the pelvic or abdominal area
  • Decreased vaginal sensation during sexual intercourse

Treatments For A Weak Pelvic Floor


Your doctor will usually start by taking a medical history as well as asking about your symptoms. Honest and thorough answers are essential for questions about urinary tract infections, sexual activity, bladder, or bowel movements.

A physical exam may also be carried out to determine how well you can control your muscles. Tests like an anorectal manometry (to measure how well the anal and rectum sphincters work together) or a uroflowmetry (to check how the bladder is working) may also be carried out. None of these tests are painful.


Depending on the pelvic floor issue and its severity, your healthcare professional will tailor a treatment plan that may combine different approaches. Treatment options include:

Biofeedback: This is a non-invasive way to retrain the pelvic muscles. Electrical sensors are used to monitor the muscles as the patient relaxes and clenches them. After that, the physical therapist gives feedback and works with the patient to improve muscle coordination.

Pelvic floor physical therapy: For those suffering from pelvic pain, pelvic floor physical therapy may prove to be effective. Often used together with biofeedback, it involves accessing the pelvic muscles and then manipulating them to restore their function and strength.

Medication: This may be prescribed to treat specific bladder control issues or prevent frequent bowel movements or loose stool.

Pessary: This is a small silicone or plastic device inserted into the rectum or vagina to support the pelvic organs and prevent prolapse.

Surgery: Your healthcare professional may recommend a surgical procedure if weak pelvic floor muscle symptoms persist after trying less invasive treatment options.

Managing Symptoms

Treating a weak pelvic floor can take weeks or months before there is a substantial improvement. Effectively managing the symptoms helps to improve the quality of life as treatment continues.

Incontinence briefs: These help to manage urinary incontinence. A good pair of incontinence underwear for women should protect your clothes from wetness. At the same time, it should be made from moisture-wicking fabric so that the wearer remains dry and comfortable. Go for washable and reusable incontinence underwear, which is an excellent eco-friendly, money-saving option.

Weight loss: Losing weight can help to reduce pressure on the pelvic floor and help manage bladder control symptoms.

senior woman working out with a personal trainer

High-fiber diet: To prevent constipation and chronic straining when having a bowel movement, include plenty of fiber-rich foods in your diet. This includes vegetables, fruits, legumes like lentils and beans, and whole grains.

Bladder training: This refers to urinating according to a set schedule. The goal is to gradually increase the amount of time between bathroom breaks and train the muscle to stretch more so that the bladder can hold more urine.

Strengthening Your Pelvic Floor Muscles

Just like other muscles in the body, the pelvic floor can be strengthened with regular exercise. Pelvic floor muscle exercises, commonly known as Kegel exercises, involve routinely tensing and relaxing the pelvic floor muscles to strengthen them.

Results will be gradual, not instant. However, if you don’t start seeing some improvement in 2-3 months consider seeking medical advice. Don’t be embarrassed. Just remember, your doctor’s seen it all, you’re not alone, and it’ll be worth the quality-of-life improvement.

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