The pelvic floor has functions that are essential to quality of life because of its positioning. This is why, it is important to understand where it is located and how it works because the number of people suffering from a dysfunction continues to increase.

The pelvic floor is a group of muscles that is made up of three layers that stretch from the pubis in the front and attach around and over the tailbone at the back. These muscles hold the bladder and bowel together and, like all muscles in our body, can break down over time if not trained properly.

Description of the 3 layers:

• Surface layer: these muscles provide tension and engorgement in the clitoris and penis, so they are essential for erectile and orgasmic function;
• Intermediate layer: these muscles perform the function of continence because they surround the openings of the perineum (urethra, vagina, anus) and thus protect the closure and support of these openings so that they are waterproof;
• Deep layer: these muscles are the strongest and largest of the group, combined with the other layers they form a floor that is both strong and flexible where the pelvic organs (urethra, bladder, rectum, colon, small intestine and uterus) come to drop off.

Even if it is not visible, the pelvic floor must be checked at all times.

The pelvic floor as well as the ligaments provide support for the organs. If the pelvic floor has functional impairments, most of the support will rest on the ligaments, which if stretched too long will become loose and will no longer be able to do their job of supporting the pelvic organs (bladder, uterus, rectum) and therefore its action on the sphincters.

This is where the symptoms will start to appear.

Also, it’s important to know that the pelvic floor doesn’t work on its own, it has to coordinate with the other muscles in your body.

There are many factors involved in a sagging pelvic floor, including:

• Lifestyle: holding back for a long time before urinating, wearing tight clothes, a low protein diet, certain medications, sudden weight gain or loss, poor breathing;
• Posture: certain habits obesity, chronic cough (lung disease, smoking), frequent constipation and weight lifting can weaken the pelvic floor;
• Physical exercise: high impact sports activities (jumping, running);
• Age: hormonal changes during menopause and aging can decrease the flexibility of the pelvic floor and cause it to weaken;
• Pregnancy and childbirth: Increasing abdominal weight stretches the pelvic floor and can weaken it. The damage is even more serious if: an episiotomy has been performed, if the baby’s weight is heavy, his head circumference is large, if the mother has gained a lot of weight during the pregnancy, if she has had a multiple pregnancy, if delivery by cesarean section the pelvic floor may also become weak.

A sagging pelvic floor can lead to a whole series of complications and have several consequences:

• Urinary incontinence: accidental leakage of a quantity of urine caused by pressure on the bladder, which can be increased during movement: coughing, sneezing, jumping, dancing or walking;
• Pelvic organ prolapse: descent of the uterus, bladder or rectum. These conditions may require surgery;
• Decreased sexual sensitivity and reduced quality of sexual intercourse;
• Bowel incontinence: pressure variations when they fill, empty, contract;
• Pelvic pain.

Here are some tips for doing pelvic floor strengthening exercises. To find your pelvic floor muscles, contract it as if you were trying to stop your urine in the toilet (it is not recommended to stop the flow of urine when you are in the toilet, as this may have harmful effect on the bladder).

To strengthen pelvic floor muscles with Kegel exercises:

• Sit down, then contract and relax the muscles for 5 seconds then release 5 seconds. It will be possible to maintain this contraction for longer and longer. Be careful not to hold your breath and do not tighten the muscles in your stomach, buttocks or thighs at the same time;
• Lie on your back, head resting on the ground: naturally release your back to the ground, arms at your sides, feet flat on the ground, legs bent, knees up tight against each other, contract your perineum for 10 seconds, then relax for 10 seconds;
• Once you are used to pelvic floor strengthening exercises, you can try holding each contraction for a few more seconds. Each week, add more contractions, while always making sure to rest between sets.