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MumsnetGuestPosts (MNHQ) Fri 14-Jun-19 09:49:36

Guest post: “Pelvic floor issues are still frequently ignored”

Jane Simpson, Continence Nurse and author of The Pelvic Floor Bible, explains what steps you can take to strengthen your pelvic floor muscles.

Jane Simpson

Continence Nurse at The London Clinic

Posted on: Fri 14-Jun-19 09:49:36

(36 comments )

Lead photo

“I want to normalise discussions around this part of our body and make pelvic floor exercises part of our everyday routine.”

Why aren’t strong and well-functioning pelvic floor muscles really important to us all? Why is leaking when we sneeze OK, or standing on the doorstep, desperately trying to get the key in the door, and racing to the toilet before disaster strikes something that we put up with?

I’ve been a continence nurse for the last 25 years, currently working at The London Clinic on Harley Street. I’ve seen over 35,000 patients in that time and was recently described by the Times as ‘the Dr Dolittle of Vaginas’. I was inspired to write my new book, The Pelvic Floor Bible, when I heard the report from the recent Royal College of Midwives stating that a third of existing and expectant mothers don’t do pelvic floor exercises, despite their reported benefits. This statistic shocks me and has inspired me to start a pelvic floor revolution. We need to look after our pelvic floors in the same way we treat and exercise the rest of our body. Our pelvic floor is so important and when working well it helps keep us continent, is good for our sex lives, prevents prolapse and even enables us to poo better.

There is no reason that anyone has to put up with weak pelvic floor muscles. Yet we do. I wonder if it’s because it’s neatly tucked away, or it’s one of those things we say we’ll get round to, but never do. I imagine there’s a lot of pelvic floor leaflets in a box somewhere in your house that you took home from the maternity ward, gathering dust. I also think that while it is a very common condition, with over 200 million people affected by it worldwide, it’s still hugely under-reported and remains a taboo. While we’ve almost become comfortable discussing periods and tampons, pelvic floor issues are still frequently ignored, despite affecting one in three women in the UK. This absolutely has to change. I want to normalise discussions around this part of our body and make pelvic floor exercises part of our everyday routine.

While we've almost become comfortable discussing periods and tampons, pelvic floor issues are still frequently ignored, despite affecting one in three women in the UK.


I hope the next bit inspires you to make a plan. Pelvic floor exercises, when done correctly, take up just a few moments of your day. Regardless of whether you’ve suffered any problems thus far, it’s important to get into the habit and make it work for your lifestyle. That way, you are much more likely to do it. It’s all about making it doable for you.

Here are my quick tips for great pelvic floor muscles:
The two most important things of all are, are you using the right muscles and are you doing the exercises regularly.

Sit on the arm of a chair, or any hard surface with your feet flat on the floor. Lean slightly forward with your vulval area in contact with the hard surface. With your hands on your thighs try to lift the area around your vagina and anus away from whatever it is you are sitting on.

Draw up all the muscles at the same time, squeeze, lift and hold for a count of five if you can, then try to build up to holding for ten seconds over time. Then, let go gently and count to five, repeat five times. Try to do the exercises at least twice a day; while cleaning your teeth is good time so that way you will never forget..

Once a day, you should try to also do ten short, sharp contractions. Done in a rhythmic pattern of squeeze, let go, squeeze, let go.

If this isn’t going to work for you, please don’t give up. You could try the Squeezy app, vaginal weights, or the Elvie trainer. If you are still not able to, seek help from a women’s health physiotherapist or a continence nurse specialist. Whatever you do, don’t suffer in silence anymore.

The Pelvic Floor Bible by Jane Simpson is published by Penguin Life, priced £9.99

MNHQ UPDATE: Jane Simpson will be returning to this post on 20 June to answer some user questions

By Jane Simpson

Twitter: @PenguinUKBooks

Soola Fri 14-Jun-19 10:30:05

I was so fortunate that my mother told me about pelvic floor exercises when I was a young teenager.

I didn’t know they were called pelvic floor exercises then just that she said when I had a wee to stop start and practice holding it, and this was my first introduction to strengthening my pelvic floor as it were.

As I got older I learnt more and how important it is.

I’m in my fifties and have had two children and have a strong pelvic floor by always doing exercises throughout my life.

I have friends and relatives of a similar age and even younger who have to be careful when them sneeze or cough that they might leak.
Two years ago I did i the ultimate challenge and went on a trampoline and had no fear that I would leak.

Talking about it amongst other women reveals the amount of women who were unaware of the importance of pelvic floor exercises or it was simply never talked about when they were young women.

All women of all ages should be aware of hear exercises and encourage them to do them regularly. I’m fortunate I had a mother who knew the importance and instilled it in me but women today need the openness of this subject as when they are young they might not realise that it could affect them when they are older so the younger they start the better.

OhForkItThen Fri 14-Jun-19 10:54:47

What sort of recovery do you realistically see with women who’ve had multiple children? I’ve had two big tears and five births. I’ve come a massive way with pelvic floor strength through care and exercise, I have no fear of wetting myself and can cough 99% of the time. I’ve accepted though that trampolines/ jumping exercise or jogging aren’t for me. I’d love to do them though! Realistic?

LivingOnAPear Fri 14-Jun-19 12:09:33

I’ve found there is very little help available for women after birth. I was given a leaflet about pelvic floor exercises after the birth but when I visited gp at the 6 week check up and a few months later my pelvic floor issues were not taken seriously. If I’d lived a few metres down the road in the next county I could have referred myself directly to a women’s health physio but this needs to be available across the country.

Lb1984 Fri 14-Jun-19 16:12:29

Does it all depend on area and how your birth went?
I had the physio come speak to me before i left hospital about pelvic floor exercises (3rd degree tear) and have already got an appointment for a 6 week check with the physio (they rang me to make it!)
Feeling lucky that my nhs trust understands how important it is to strengthen your pelvic floor and prevent future issues.

misssunshine86 Fri 14-Jun-19 17:13:41

Great post.... 99% of saving your pelvic floor is before you give birth. I would also add that a birthing ball is a great investment for these exercises (and is even if you don't exercise on it!)

I've youtubed a couple of pelvic floor birthing ball exercises (as i never ever remember to do them otherwise) and set aside 10 minutes in front of the TV every night to do them. It's really easy but if anyone is interested:

1) Sat on ball - circles both ways for 2 minutes (clenching in and out)
2) Sat on ball - figure of 8's (clencing in and out) 2 mins
3) Cat cow on ball front to back - 2 mins
4) Wall squat - don't need ball - clench in and out - 2 mins
5) Rotating arm right angle stretches (to stretch out back as my back always hurts now days) - 2 mins
5) childs pose with ball - finish

LivingOnAPear Fri 14-Jun-19 21:30:46

Yes @Lb1984 it totally depends on your area. We didn’t have physios in our hospital and no ability to refer to one apart from going through GPs who often don’t seem to know much or care about postnatal health problems. Friends of mine in different areas had a similar experience to you.

JohnnyMcGrathSaysFuckOff Fri 14-Jun-19 22:41:53

In my area they have cut the 6w postnatal check for mums. It is just for babies now and they do not ask about mood, contraception or check stitches anymore.

As DTs were under NICU outreach team not HVs, I also had no HV input. So basically no support. Thankfully I could pay for a private women's health physio. If not there would have been literally no one at all to talk to post birth.

1forAll74 Sat 15-Jun-19 12:44:54

Oh, all very good advice. I should start up a class in the village hall here,,we already have Zumba,pilates,and yoga and flower arranging,so this would be something new and beneficial,and could be done with some jaunty music.

Welder Sat 15-Jun-19 19:21:12

I've noticed my pelvic floor seems to have weakened since I started running. (Ashamed to say I stopped doing my exercises a few months back, since getting them back to a good place after childbirth). Would Jane advise stopping running, or could I work on my pelvic floor alongside running?

Welder Sat 15-Jun-19 19:21:43

Getting it back, not them...

highlandcoo Sat 15-Jun-19 19:50:58

Is it too late to start pelvic floor exercises many years after having children?

I've recently witnessed my MIL suffering miserably with incontinence after two failed prolapse ops and would love to avoid the same fate.

I'm probably like many women - I know what I should be doing, keep the exercises up for a week or two, get lazy and let them lapse. I do realise it's important though and can make a huge difference to your ability to remain active in later life.

glitterbiscuits Mon 17-Jun-19 21:14:00

Is it true that the advice now is not to start/stop/ start when urinating?

Gingerkittykat Mon 17-Jun-19 21:28:46

I developed problems with bladder control aged 40, not childbirth related. I would lose control of my bladder overnight and need to pee constantly during the day. Male GP gave me tablets, female GP sent me to a pelvic health physio.

I had honestly never heard of them before, but they were lovely and what could have been a very invasive set of examinations were done really gently and sensitively. After assessing my pelvic floor they gave me exercises which made a big difference. They also taught me bladder training tricks to teach my bladder to hold it longer.

fairybeagle Mon 17-Jun-19 21:56:12

Can you do pelvic floor exercises when you're pregnant?

higherforce Mon 17-Jun-19 22:05:54

Great post. Do vaginal weights actually work? Are some better than others? What if they erm ... fall out?

londonloves Tue 18-Jun-19 19:16:33

I would be really interested to know if pelvic floor exercises actually improve prolapse symptoms or can cure?

moreismore Tue 18-Jun-19 19:21:43

What do you think of hypopressives? Are they better than conventional exercises?

Sara107 Tue 18-Jun-19 21:45:48

What about children? My 9 yo dd has a weak bladder and the paediatrician has mentioned a few times that pelvic floor exercises might help, but she is too young to teach her properly. I’ve read however, that this is a really good approach and has been used successfully for children as young as 4. How would I find someone skilled in treating children?

wisemummy Tue 18-Jun-19 23:13:52

I am having vaginal laser rejuvination next week . Only £1000

PelvicFloorBibleJaneSimpson Thu 20-Jun-19 11:19:22

Hello Everyone,

Thank you for all your questions, I am looking forward to answering them and I hope that they will help and inspire us all to good pelvic floor health.

PelvicFloorBibleJaneSimpson Thu 20-Jun-19 11:34:27

Sara107

What about children? My 9 yo dd has a weak bladder and the paediatrician has mentioned a few times that pelvic floor exercises might help, but she is too young to teach her properly. I’ve read however, that this is a really good approach and has been used successfully for children as young as 4. How would I find someone skilled in treating children?

I am not an expert on children and will not try to be here, but there is a great you tube video nhsh.scot/yourpelvicfloor this is defiantly for children a bit older than 9 it's more aimed at young teenagers but it may help you to teach your nine year old what to do, or it may be helpful in the future. It is a good idea to seek help as pelvic floor exercises may not be the right thing for your child. Try contacting the Association for Continence Advice or the Association of Paediatric Charted Physiotherapists and they will be able to tell you the name of someone local to you that can help you.

PelvicFloorBibleJaneSimpson Thu 20-Jun-19 11:47:27

OhForkItThen

What sort of recovery do you realistically see with women who’ve had multiple children? I’ve had two big tears and five births. I’ve come a massive way with pelvic floor strength through care and exercise, I have no fear of wetting myself and can cough 99% of the time. I’ve accepted though that trampolines/ jumping exercise or jogging aren’t for me. I’d love to do them though! Realistic?

The more children you have the more the pelvic floor will suffer so after five births I think that you are doing really well. Trampolines are the ultimate challenge to the pelvic floor and after five delivers best kept away from. A recent study found a high percentage of young female athletes involved in high impact sports(before giving birth) had stress incontinence in fact in one study the figure was as high as 80% so you are doing super well I don't know how old you are but as we go towards the menopause and your oestrogen levels start to fall the pelvic floor starts to suffer and prolapse may occur, as we will spend 1/3rd of of lives in the menopause we need to care for our pelvic floor so much. If you are desperate to trampoline jog etc you could try wearing a pessary of some kind to give yourself a bit of support. It's a bit like wearing a sports bra. Some people use a tampon(a bit drying for the vagina) or there are a variety of pessaries on the market Good luck and keep up the good work!

DrCristinaYang Thu 20-Jun-19 12:03:15

I'm 19 and having bladder issues which aren't related to childbirth.
I now have to wear inco pads daily and I lean if I cough or sneeze, sometimes even when I walk.
On other occasions I get a sudden urge were I have to pee NOW and I wet myself (not a full bladder but a large enough amount).
I have tried pelvic floors and stopping the stream once I start but it doesn't really work.

PelvicFloorBibleJaneSimpson Thu 20-Jun-19 12:10:20

LivingOnAPear

I’ve found there is very little help available for women after birth. I was given a leaflet about pelvic floor exercises after the birth but when I visited gp at the 6 week check up and a few months later my pelvic floor issues were not taken seriously. If I’d lived a few metres down the road in the next county I could have referred myself directly to a women’s health physio but this needs to be available across the country.

This is why I have written my book The pelvic floor bible. I am so saddened to hear your story and as a result we need to empower ourselves. It's a funny thing the pelvic floor. I think as it's neatly tucked away in our knickers we try not to think about it even when it's giving us grief! We all lead such busy lives jugging too many balls in the air, our health unless it's an emergency goes to the bottom of the to do pile. I am so passionate about the pelvic floor I am busily trying to start a revolution! I really hope that you find the help you need. Or my book can guide you and teach you how to help yourself. I really do wish you the best of luck. Whatever you do don't give up.

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