Pelvic Floor & Kegels

What is the pelvic floor?

The pelvic floor includes layers attached to the pelvic bone, which act as a hammock to support pelvic organs including the vagina, uterus, bladder and bowel.


Why does the pelvic floor weaken?

The pelvic floor muscles can weaken with age, weight gain, pelvic surgery, hormonal changes, strenuous physical activity, abnormal or dysfunctional tissue, pregnancy and childbirth. As the pelvic organs are no longer supported, they can shift and push into one another and this condition is called pelvic organ or vaginal prolapse.

There are a number of different types of pelvic prolapse allowing the bladder, rectum, bowel and/or uterus/womb to push into the vagina. The vagina itself can also gradually fall toward the vaginal opening.

Kegel exercises improve pelvic muscle tone and can assist with keeping your menstrual cup in place, reduce light bladder leakage (LBL) and improve mild-moderate vaginal prolapse support.

How common is poor pelvic floor tone?

It is not uncommon – it is estimated 30-40% of people with a vagina experience vaginal prolapse in their lifetime.

What are the symptoms of poor pelvic floor tone?

It depends on the type of prolapse experienced but symptoms can include;

  • Pressure in the vagina – a ‘heavy’ feeling or feeling like tissue is ‘out of place’
  • A bump low in the vagina
  • Painful intercourse
  • Urinary tract infections
  • Urinary stress incontinence
  • Difficulty emptying the bowel or bladder or constipation
  • Tissue protruding from the back or front wall of the vagina
  • An enlarged vaginal opening
  • Pain after standing for prolonged periods

Kegel exercises can improve pelvic floor tone.

How to do Kegel or pelvic floor exercises?

It is important to find the pelvic floor muscle and not to tense your bottom, thighs or stomach muscles when doing the exercises. For your first attempt at locating the pelvic floor muscle, you may need to insert a finger into your vagina and ‘squeeze’, ‘clench’ or ‘pull-in’ your pelvic muscles. Your vagina should tighten and the pelvic floor muscle should move upwards. Make sure you are breathing normally and not holding your breath. Relax the muscle and return to your starting position.

  1. Lie, sit or stand and contract the pelvic floor muscle.
  2. Long contraction: Contact the pelvic floor muscles and hold for 10 seconds then relax for 10 seconds and repeat 10 times in a row. Your pelvic muscles may need some time to build up to 10 seconds so you may wish to start with 3 second contractions and 3 second relaxations.
  3. Elevator: Imagine your vagina as an elevator shaft with four floors. Contract the muscles slightly and stop at each level, holding for 4 seconds then release the muscles slightly stopping at each level and holding 4 seconds. Repeat 10 times in a row.
  4. Quick flicks: Tighten the pelvic muscles quickly and immediately relax them 10 times in a row.

Do these repetitions a minimum of 3 times a day or more if possible. It is more effective to spread these exercises over the day so it helps to do them at a set time each day for example before getting out of bed, after lunch, after dinner and before going to bed.

When will I see results?

It varies from person to person. Some people notice results with a few weeks but you may need to be patient. It takes time to build muscles and if you have made these exercises part of your daily routine and do not see an improvement within 2-3 months, please consult your healthcare professional who will help you determine if you are doing the exercises correctly or help you find an alternative treatment.

Can I use a menstrual cup with a weak pelvic floor?

It depends on the severity of loss of pelvic floor tone. Most people with mild to moderate loss of pelvic floor tone can still use a menstrual cup but are better suited to the Model 4 JuJu Cup, which has been designed for people with a low cervix and people with poor pelvic floor tone. 

Cone-shaped menstrual cups can slip lower in the vaginal canal and push through the vaginal opening when there is poor pelvic floor tone. The more rounded, bulbous shape at the base of the Model 4 JuJu Cup ensure the cup sits up above the pelvic floor sling better when compared to more conical shaped cups.

Pelvic Floor Menstrual Cup
Image: Rounder shaped Model 4 JuJu Menstrual Cup for poor pelvic floor tone