The pelvic floor muscles are the muscles beginning at the pubic bone (the lower front and centre part of your pelvis, above your genitals) and ending at the base of the spine. These muscles support the organs of the pelvis, including the uterus, vagina, bladder, urethra, and rectum. They are also used to control or stop the flow of urine.

The pelvic floor muscles can become weakened or damaged due to a variety of causes, including childbirth, hysterectomy, and prostate surgery.

If your pelvic floor muscles are weakened, it can be difficult to hold in urine. You may release urine involuntarily after sneezing, coughing, or activities such as jumping and skipping. Weakened pelvic floor muscles can also result in decreased sensitivity and satisfaction for women during sexual intercourse.

The good news is that there are simple and convenient ways to strengthen the pelvic floor muscles and relieve your symptoms.

Kegel exercises

Kegel exercises were developed as a way to tone up the muscles around the vagina, urethra, and rectum so that you are better able to control your urine. The exercise consists of squeezing the muscles tightly for 1 or 2 seconds and then relaxing for 10 seconds. The goal is to work your way up to squeezing the muscles for a period of 10 seconds with a 10-second relaxation period afterward. This exercise should be repeated 12 to 20 times in a row, 3 to 5 times a day. This exercise can be done while standing, sitting, or lying down.

It can be difficult for people to know if they are working the right muscles. To do the exercise properly, pretend that you are trying to stop your flow of urine mid-stream and trying to stop yourself from passing gas at the same time. You shouldn't be tightening your abdominal, buttock or leg muscles and you shouldn't be holding your breath.

Vaginal cones

Vaginal cones are weighted devices that help women to find and train the right muscles. This type of therapy is called "biofeedback" because once inserted into the vagina, your pelvic floor muscles will contract, as reflex response, to try to keep the cone in place. To use vaginal cones, you begin with the smallest weighted cone and gradually increase to the heaviest cone that you can support for 15 minutes. The cone is usually kept in the vagina for 15 minutes twice daily. Once you are able to support a cone without any effort for 15 minutes, you should increase to the next heavier cone. This process should be repeated daily and the duration of therapy required depends on how weak the pelvic muscles were to begin with.

You can periodically check to see if these exercises are strengthening your pelvic floor muscles. Try stopping your urine flow mid-stream or jumping while your bladder is full to see if you have regained control of your muscles.

Products that are available to Canadians include LadySystem vaginal cones (by Duchesnay Inc.) and Aquaflex, Step Free, and Lady Care Vaginal Weights (by Medgo LLC).

Lisa Tourountzas
With updates by the MediResource Clinical Team