Your pelvic floor is a sling of muscles at the bottom of your pelvis which supports all the organs that sit above it, your bladder, vagina, uterus and rectum.
They don’t work alone but in a team with your abdominal, buttock and hip muscles, ligaments and fascia (which is a gristly web that wraps around all your organs and muscles). If you do a very strong pelvic floor contraction you might find the muscles in your lower belly contract too. This is a good sign because it shows the muscles are strong and able to coordinate.
Here are the sling of pelvic floor muscles with the bladder, vagina and anus passing through them. If the muscles contract, the organs are lifted and their openings tighten, which keeps pee and poo inside. When the pelvic floor relaxes urine and faeces can pass.
The muscles have to be able to both contract and relax. Muscles which “grip” all the time get tired and that can lead to pelvic pain, painful sex and leaking.
The pelvic floor reacts to the forces it is subjected to – if you laugh, cough or sneeze the muscles have to contract quickly to support the neck of your bladder to keep you dry. Here is a picture looking down on the pelvis – you can see that the openings are seated in the muscles, so if the muscles contract they will squeeze the urethra, vagina and anus.
There are lots of pelvic floor muscles, but they all do the same thing – lift your organs up and squeeze your holes shut.
They are also important for sexual function – women’s sensation, arousal, and orgasm partly depend on the pelvic floor muscles.
Like all muscles, the strength and tone of a pelvic floor is affected by age and injury. Childbirth, obesity, repeated impact from exercise, heavy lifting, and hormone changes can all affect their strength and coordination. That is why it is really important women do their pelvic floor exercises every day, sometimes problems only appear with the menopause and as we head towards our prime.
Some of the muscles attach onto ligaments which stretch as we age, and so they can’t support the organs as efficiently as they used to. This is associated with vaginal prolapse and incontinence and can be helped by using a pessary to help support the muscles.
Being able to visualise what the muscles look like and what they do can really help you to do your pelvic floor exercises. Try colouring them in!
References or links:
Rev Urol. 2004; 6(Suppl 5): S2–S10.
Female Pelvic Floor Anatomy: The Pelvic Floor, Supporting Structures, and Pelvic Organs Sender Herschorn, MD, FRCSC