The pelvic floor muscles, often called the body’s “invisible hammock,” silently support our bladder, uterus, rectum, and other pelvic organs, controlling core aspects of urination, defecation, and sexual function. However, factors such as pregnancy, childbirth, aging, obesity, and chronic cough can cause this “hammock” to relax, leading to a series of distressing symptoms: stress urinary incontinence (leakage when coughing or laughing), pelvic organ prolapse, and decreased quality of sexual life.
Many people choose to silently endure these problems. But in fact, pelvic floor muscle relaxation is a preventable and treatable condition. We have compiled this improvement guide, from basic to professional, based on advice from numerous domestic and international experts in pelvic floor rehabilitation.
I. Expert Consensus: Pelvic Floor Health is the Cornerstone of Quality of Life
Professor Wang Jianliu, Director of the Department of Obstetrics and Gynecology at Peking University People’s Hospital, has repeatedly emphasized in public lectures: “Although pelvic floor dysfunction is not life-threatening, it seriously affects patients’ quality of life and mental and physical health, and is known as ‘social cancer.’ Women must overcome their shyness and recognize that this is a common condition with mature treatment options.”
The American College of Obstetricians and Gynecologists also points out in its guidelines that all women should understand their pelvic floor muscles and master the correct Kegel exercises, not only for treatment but also as an important preventative measure.
II. Self-Exercise and Lifestyle Management: The First Line of Defense for Rehabilitation
For those with mild pelvic floor muscle laxity or those wishing to prevent it, self-exercise and lifestyle adjustments are the preferred and most effective methods.
1. Core Exercises: Combining Kegel Exercises with Other Exercises
Kegel exercises are internationally recognized as the most classic method for pelvic floor muscle rehabilitation.
Accurately locating the pelvic floor muscles is key: Dr. Liu Mingmin, Director of Xuzhou Maternal and Child Health Hospital, offers a simple and easy method: “Imagine suddenly stopping the flow of urine while urinating; the muscles that contract at that moment are the pelvic floor muscles. However, be careful not to practice this frequently while urinating, as it may affect normal urination function.”
The key is consistency and proper technique: Dr. Cheng Fang of Huai’an Maternal and Child Health Hospital… A reminder: “Many patients don’t see good results from Kegel exercises on their own because they’re not contracting the muscles correctly, instead using their abdominal or gluteal muscles. The correct way is to contract the pelvic floor muscles, feeling the anus and vagina being lifted upwards, while keeping the abdominal and thigh muscles relaxed. Do 2-3 sets daily, 10-15 contractions per set (hold each contraction for 5-10 seconds before relaxing). It usually takes more than 3 months to see significant improvement.” I find yoga and Pilates very effective for pelvic floor muscle repair. After get off work or during lunch breaks, do some simple exercises. Place a yoga mat vertically against a wall, raise your legs so your upper body and legs form a 90-degree angle, and use your abdominal and gluteal muscles to rhythmically lift your hips off the ground, following your breath. This can appropriately reduce pressure on the pelvic floor muscles. Many similar exercises are available online; you can search for them carefully.
2. Bladder Training
For patients experiencing frequent and urgent urination, Dr. Lü Tingting of Shanghai Gongli Hospital recommends bladder training: “Record the time of each urination and consciously gradually increase the interval between urinations, for example, from once per hour to once every two hours, to help the brain and bladder regain control.”
3. Lifestyle Interventions
Weight Loss: Studies show that for every 5-unit increase in body mass index (BMI), the risk of pelvic floor dysfunction increases by approximately 20%-70%. Weight loss directly reduces the burden on the pelvic floor.
Avoiding Increased Abdominal Pressure: Dr. Jiang Li of Xiangya Third Hospital of Central South University points out: “Long-term constipation, chronic cough, and frequently lifting heavy objects continuously put pressure on the pelvic floor muscles and must be actively managed. Eat more fruits and vegetables to prevent constipation, treat respiratory diseases promptly, and avoid lifting excessively heavy objects.”
III. Professional Non-Surgical Treatment: Precise Rehabilitation Under Scientific Guidance
When self-exercise is ineffective or symptoms have reached a moderate level, professional help should be actively sought. Modern pelvic floor rehabilitation medicine offers a variety of highly effective non-surgical options.
Pelvic floor muscle electrical stimulation and biofeedback therapy: This is one of the most commonly used techniques in pelvic floor rehabilitation centers. Dr. Cheng Fang explains, “Biofeedback is like installing a ‘mirror’ on the pelvic floor muscles. Through instruments, it converts muscle contraction signals into visual images or sounds, helping patients intuitively learn how to contract correctly. Electrical stimulation, on the other hand, uses a weak electrical current to passively stimulate the pelvic floor muscles, awakening dormant muscle fibers and promoting their functional recovery.” This method is particularly suitable for patients who cannot find the sensation of muscle contraction or whose self-exercise is ineffective.
Pelvic Floor Magnetic Stimulation:
Dr. Lü Tingting explains: “This is a non-invasive ‘chair-based rehabilitation.’ The patient sits in a specially designed treatment chair, and a time-varying magnetic field induces a current deep in the pelvic floor, stimulating nerves and muscles. It has good effects on treating stress urinary incontinence, urge urinary incontinence, and pelvic floor pain.”
Local Vaginal Estrogen Therapy:
For postmenopausal women whose estrogen levels have decreased, leading to vaginal and pelvic floor tissue atrophy and reduced elasticity, Director Liu Mingmin suggests: “After evaluation by a doctor, local estrogen ointment can be used to improve blood circulation and elasticity of the pelvic floor tissues, enhancing their support function.”
IV. Surgical Treatment: An Effective Means to Solve Severe Problems
For severe pelvic organ prolapse or stress urinary incontinence unresponsive to non-surgical treatments, surgery is a necessary and highly effective option.
Tension-Free Mid-Urethra Sling: This is the “gold standard” surgical procedure for treating stress urinary incontinence. International experts, including Dr. Emanuel C. Trabuco of the Mayo Clinic in the United States, widely use this technique. It involves a minimally invasive suspension band providing support in the mid-urethra, effectively controlling urine leakage when abdominal pressure increases.
Pelvic floor reconstruction surgery: For severe cases of uterine prolapse, cystocele, etc., mesh-based pelvic floor reconstruction surgery is now commonly used. This minimally invasive procedure repositions the prolapsed organs, restoring them to their normal anatomical position.
Summary and expert recommendations: Improving pelvic floor muscle relaxation is a systematic process requiring a step-by-step approach based on individual circumstances:
Mild/Prevention: Adhere to Kegel exercises + a healthy lifestyle.
Moderate/Ineffective self-exercise: Seek help from a pelvic floor rehabilitation center for professional treatments such as electrical stimulation, biofeedback, and magnetic stimulation.
Severe: Active evaluation and surgical treatment.
Finally, we would like to reiterate the viewpoint of Director Liu Mingmin of Xuzhou Maternal and Child Health Hospital: “The 42 days to six months postpartum period is the ‘golden period’ for pelvic floor rehabilitation, but this does not mean that it is impossible to improve if this period is missed. Intervention at any stage is better than ignoring it.”
Please remember that actively seeking help is the first step towards recovery. By fully communicating with your doctor and choosing the most suitable plan for you, you can absolutely regain pelvic floor health, say goodbye to embarrassing problems, and confidently enjoy a high-quality life.