Aging is inevitable, and with aging comes major changes to our body. But losing control of your
bladder, having difficulty getting on and off the floor, or experiencing pelvic pain does not have to
be “just part of the aging process.”
There are many things you can do to support your pelvic floor and maintain confidence, comfort,
and function of your body for years to come.
What is the Pelvic Floor?
The pelvic floor is a group of muscles, ligaments, and connective tissues that sit like a hammock
at the bottom of your pelvis and attach from your pubic bone to your tailbone. These muscles
play an important role in supporting the bladder, uterus, and rectum, maintaining
urinary and bowel continence, contributing to sexual function, and providing stability to the
pelvis and spine for posture.
The pelvic floor doesn’t work alone. It’s part of a larger system often referred to as the core
canister, which includes 1) the diaphragm, your primary breathing muscle, 2) the abdominal
muscles, 3) the muscles along your spine, and of course 4) the pelvic floor
These muscles work together to manage pressure within the abdomen during everyday
activities like lifting, walking, coughing, exercising, and even breathing.
Your Breath Matters More Than You Think
One of the simplest ways to support your pelvic floor is by improving how you breathe. During
an inhale, your diaphragm gently lowers, allowing your rib cage to expand. At the same time,
your pelvic floor naturally lengthens and relaxes. During an exhale, your diaphragm rises, your
abdominal muscles gently engage, and your pelvic floor naturally recoils and contributes to
stability.
Rather than constantly “holding” your pelvic floor or squeezing your core throughout the day,
healthy movement comes from allowing these muscles to move naturally with your breath.
Notice how your breath is while you are doing things like getting out of a chair, lifting your
groceries into your trunk, vacuuming your house, or even rolling over in bed. Understanding
how breath plays a role not just with exercise, but with every day movements that puts load on
to your body, will significantly help maintain the integrity of your pelvic floor
Strength Matters, But Not Just Pelvic Floor Strength
Many people immediately think of Kegel exercises when discussing pelvic floor health. While
Kegels may be appropriate for some, they are not the answer for everyone.Your pelvic floor
functions best when the entire body works together, especially the muscles involved in the core
canister!
The American College of Sports Medicine recommends that adults over age 65 perform
muscle-strengthening activities at least twice per week, in addition to regular aerobic exercise,
balance training, and flexibility exercises. Maintaining strength throughout the body, including
the hips, legs, core, and back, helps support posture, mobility, and overall pelvic health as we
age.
When larger muscle groups are doing their job effectively, the pelvic floor is less likely to
compensate or become overworked during everyday tasks.
Healthy Bladder Habits Make a Difference
Many bladder habits develop over years without us realizing it. One common example is
urinating “just in case.”
While it may seem harmless, consistently emptying your bladder before it is truly full can train
your bladder to send signals of urgency at smaller volumes. Over time, this may contribute to
increased urinary frequency and urgency, making it feel like you constantly need to find the
nearest bathroom.
Allowing your bladder to fill and empty at appropriate intervals also helps support the normal
coordination between your bladder, brain, and pelvic floor muscles, which can reduce
unnecessary pelvic floor tension and promote healthy bladder function. Try to listen to your
body’s normal bladder signals and avoid unnecessary trips to the bathroom unless there is a
practical reason, such as before a long car ride or flight.
Adequate hydration is also equally important. Drinking too little water can lead to more
concentrated urine, which may irritate the bladder. Keeping the bladder healthy helps promote
normal coordination between the bladder and pelvic floor muscles during filling and emptying.
Don’t Ignore Constipation
Your bowel habits are just as important as your bladder habits.Frequent straining during bowel
movements places repeated downward pressure on the pelvic floor and surrounding connective
tissues. Over time, excessive straining may contribute to pelvic floor muscle dysfunction and
increase stress on the tissues supporting the pelvic organs.
To support healthy bowel function, you want to stay well hydrated, eat adequate fiber (if
medically appropriate), exercise regularly, respond to the urge to have a bowel movement rather
than delaying it, and consider using a small footstool to place your knees above your hips during
bowel movements, which can help promote easier stool passage
If constipation is persistent, discuss it with your healthcare provider.
Hormonal Changes During Perimenopause and Menopause
As estrogen levels decline during perimenopause and menopause, changes naturally occur
throughout the pelvic tissues. Estrogen helps maintain healthy vaginal tissue, elasticity, blood
flow, lubrication, and tissue integrity around the urethra and bladder
As estrogen decreases, some women experience vaginal dryness, discomfort during
intercourse, urinary urgency, increased urinary tract infections, and irritation around the vulva
and urethra. These changes are common—but they are not something you simply have to “live
with.”
Talk with your healthcare provider about your symptoms. For some women, topical vaginal
estrogen may be an appropriate treatment option. Because it works locally within the tissues,
topical estrogen can improve vaginal tissue health and lubrication. Your healthcare provider can
help determine whether it is appropriate based on your individual medical history.
Keep Moving
Movement truly is medicine.Regular physical activity helps maintain muscle strength, bone
health, balance, posture, flexibility and cardiovascular health. It also helps your pelvic floor
continue functioning as part of your entire movement system.
Whether you enjoy walking, yoga, resistance training, swimming, cycling, or gardening, staying
active supports both your overall health and your pelvic floor.
When Should You See a Pelvic Floor Physical Therapist?
You don’t have to wait until symptoms become severe.
Pelvic floor physical therapy can help if you experience urinary leakage, urinary urgency or
frequency,constipation, pelvic pain, pain with intercourse, feelings of pelvic heaviness or
pressure, difficulty returning to exercise, and questions about aging, menopause, or pelvic floor
health
A pelvic floor physical therapist can evaluate how your breathing, posture, strength, mobility,
and movement patterns all work together to help you move more efficiently and confidently.
Healthy aging isn’t about preventing every change that comes with time. It’s about giving your
body the tools it needs to adapt well.
Maintaining strength, practicing healthy bladder and bowel habits, staying active, understanding
the effects of hormonal changes, and seeking help when needed can all play an important role
in supporting pelvic floor health throughout every stage of life.
The goal is staying connected to your body and giving it the support it deserves as it changes
over time.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.