A doctor-led educational guide

Your Pelvic Floor Does More Than You Think

A simple guide to bladder leaks, constipation, and pain with sex - and why it is not always about doing more squeezes.

Your pelvic floor helps support your bladder, bowel, core, and sexual function. But a healthy pelvic floor is not just strong. It also needs to relax, soften, and work at the right time.

Many women are told to "just do Kegels." But if your pelvic floor is tight, tense, or not coordinating well, more squeezing can sometimes make things worse.

What is your pelvic floor?

Your pelvic floor is a group of muscles and connective tissue that sits at the base of your pelvis, like a supportive hammock.

Supports your bladder, bowel and uterus

Controls bladder and bowel movements

Supports sexual function

Works with your breath, core and posture

The key thing to know

Strong enough to support you.
Soft enough to move with you.

Your pelvic floor needs to lift and squeeze. But it also needs to fully let go.

Choose what sounds most like you

Leaky bladder

Leaking when you laugh, sneeze, cough, jump, run or exercise

  • You wear pads "just in case"
  • You cross your legs before sneezing
  • You avoid trampolines, running, skipping or gym classes
  • You feel embarrassed or worried someone will notice

Constipation

Straining, bloating, incomplete emptying or feeling stuck

  • You sit on the toilet for ages
  • You feel like there is more left
  • You strain or hold your breath
  • You have tried fibre, water or supplements without lasting change

Pain with sex

Tightness, burning, guarding, or intimacy that feels painful

  • You tense up before or during sex
  • You have been told to "just relax"
  • You avoid intimacy because you are worried it will hurt
  • You feel confused, embarrassed or dismissed
Leaky bladder

If you leak when you laugh, sneeze or exercise

Leaking is common, but that does not mean you have to accept it forever.

A lot of women think leaking means their pelvic floor is weak. But it can also be a timing, breath and coordination problem.

Your pelvic floor needs to respond at the right moment, especially when pressure increases - like when you cough, sneeze, jump, run or lift.

Simple starting point: the "knack" technique

Before you cough, sneeze or lift, gently lift your pelvic floor first. Then breathe and move. This helps your body learn timing and support.

Important: If squeezing makes your symptoms worse, or you also have pain, urgency or trouble emptying, you may need to focus on relaxation first.

Want a step-by-step plan for leaks?

View the Stress Incontinence Program
Constipation

If you struggle to empty your bowels

Constipation is not only about how often you go.

You may be constipated even if you open your bowels every day, if it takes a lot of effort, you strain, or you never feel fully empty.

For many women, the missing piece is not more fibre or more pushing. It is learning how to relax the pelvic floor, use breath, and create the right position for your body to empty.

Simple toilet setup

  • Put your feet on a small stool
  • Let your knees sit higher than your hips
  • Lean forward gently
  • Let your tummy soften
  • Keep your jaw and shoulders relaxed
  • Breathe out gently instead of holding your breath
  • Do not sit and strain for long periods

Your bowel does not usually need more force.

It needs more space, breath, and relaxation.

Want help with constipation and incomplete emptying?

View the Constipation Program
Pain with sex

If sex feels painful

Pain with sex is not something you should just push through.

Sometimes the pelvic floor becomes tight, guarded, or overactive. This can happen after pain, birth, stress, fear, menopause changes, or years of bracing without realising it.

If your pelvic floor is already tense, more squeezing is usually not the first step.

The first step is often learning how to down-train

  • Slow breathing
  • Pelvic floor relaxation
  • Gentle stretches
  • Releasing tension in the jaw, tummy, hips and glutes
  • Helping your body feel safe again

You are not broken. Your body may simply be protecting you, and it can learn a new pattern.

Want a gentle step-by-step program for painful sex?

View the Eliminate Pain With Sex Program
The missing piece

How to relax your pelvic floor

Down-training teaches your pelvic floor how to soften and let go.

Try this

  1. Lie on your back with your knees bent, or sit supported.
  2. Place one hand on your belly and one hand on your chest.
  3. Breathe in slowly through your nose.
  4. Let your belly gently expand.
  5. Imagine your pelvic floor softening, widening or dropping.
  6. As you breathe out, stay relaxed. Do not squeeze.

Supportive stretches

Child's pose
Happy baby
Supported deep squat
Seated forward fold

Hold each stretch for 30-60 seconds while breathing slowly.

When strengthening may be useful

Pelvic floor strengthening can help with bladder leaks, core support, and confidence with movement. But it works best when you can also fully relax between each squeeze.

Simple starting point

  • Sit, stand or lie comfortably
  • Imagine gently stopping wind and lifting the muscles up and in
  • Hold for 3-5 seconds
  • Release slowly and fully
  • Rest before repeating

Important

  • Do not grip your glutes, thighs or tummy.
  • Do not hold your breath.
  • The release matters as much as the squeeze.

When should you see a pelvic floor physiotherapist?

Please get individual support if you:

  • Have ongoing pelvic pain
  • Have pain with sex
  • Feel heaviness or bulging
  • Have trouble starting your urine stream
  • Cannot empty your bladder or bowel properly
  • Have symptoms that are getting worse
  • Are unsure whether you should strengthen or relax first

Disclaimer: This guide is general education only. It does not replace medical advice, diagnosis or individual treatment. If you are unsure, please speak with your GP or a pelvic floor physiotherapist.

Choose the support that fits you best

Doctor-led online programs by Dr Diana Moghaddas.

Leaky Bladder / Stress Incontinence

Stop leaking when you laugh, sneeze or exercise

A doctor-led online program to help you retrain your pelvic floor with release, breath, timing and whole-body movement.

View the Stress Incontinence Program

Pain With Sex

Eliminate pain with sex

A gentle, step-by-step program to help you understand pelvic floor tension, reduce guarding, and rebuild confidence with intimacy.

View the Pain With Sex Program

Constipation

Empty your bowels with less strain

A practical program for women struggling with constipation, incomplete emptying, straining or prolapse-related bowel symptoms.

View the Constipation Program

Common questions

Sometimes, but not always. If your pelvic floor is tight or overactive, you may need to learn how to relax first. Leaks can be about timing and coordination, not just strength.

It can contribute. When you open your bowels, your pelvic floor needs to soften and move out of the way. If it stays tense, emptying can feel difficult or incomplete.

Pain with sex is common, but it is not something you should just push through. A tight or guarded pelvic floor can be part of the picture, and pelvic floor physiotherapy can often help.

No. This page is general education only. It does not replace individual advice from a health professional.