Like millions of women, childbirth left me with this mortifying problem that no one warns you about. Then I found these five tightening exercises to turn back my pelvic clock

Ever been terrified to sneeze because you have a well-founded suspicion that a bit of pee will come out when you do? I have.

Ever turned to the internet for advice only to be met with the one-size-fits-all solution of, ‘just do your Kegels, they’ll sort it all out’? I have.

And for months I treated these moments as isolated annoyances – awkward, inconvenient – but ultimately harmless. Without realising they were all symptoms of a big under-diagnosed issue: a lapsed pelvic floor.

I’m pretty sure mine occurred after the birth of my second child. But pelvic floor dysfunction is staggeringly common and goes far beyond the mums who sneeze and then pee themselves in Sainsbury’s.

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In the UK alone, a survey of 2,000 women conducted by the Royal College of Obstetricians and Gynaecologists (RCOG) found that than 60 per cent of women reported at least one symptom of poor pelvic floor health, with 25 per cent experiencing frequent urges to wee.

Yet than half (55 per cent) had never done pelvic floor exercises and nearly a quarter (23 per cent) didn’t even know how to.

And that’s because nobody talks about it. Which is crazy, given that this is a major health issue affecting lots of women – not just those who have given birth.

Common causes of pelvic issues include stress, lifting heavy weights and ageing muscles. Genetics also matter and some women naturally have connective tissue laxity, making them prone to prolapse or weakness.

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Even the simple habit of holding the urge to go to the bathroom can contribute to pelvic problems over time.

In short, pelvic floor health is influenced by a number of factors including lifestyle, hormones, biomechanics and individual anatomy. Yay.

For those unsure, the pelvic floor is a group of muscles and connective tissues that support and play a crucial role in certain bodily functions, including bowel and bladder control, sexual function andcore stability.

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When it works, you don’t notice it. When it doesn’t, it announces itself loudly – usually at the least appropriate moment, like standing in a queue or doing burpees at the gym.

I paid no attention to mine until after childbirth sadly, when I became acutely aware of a change: a sense of pressure, heaviness, and gravity within my pelvis. Like my organs could fall out at any minute if I spoke too loudly.

I mentioned it to my GP and received a breezy response: ‘That’s normal after birth and at your age (38),’ she said. Which I took as medical shorthand for,we are not going to explore this further.

So I carried on. I normalised the discomfort. The inconvenience. I delved into the obligatory Kegel exercises that every YouTube video tells you to do – which didn’t work, because the pelvic floor isn’t just a single muscle to ‘clench hard’.

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It’s a coordinated system that needsbothstrength and relaxation exercises. Improper exercises can actually make symptoms worse, particularly if you have tense muscles.

The thing is, no one warns you properly about the perils of a lapsed pelvic floor, not really. Yes, there are pamphlets, vague mentions, perhaps a cursory diagram that looks like a hammock. But what you’re not told is that your pelvic floor can go from quietly competent to wildly unreliable, fast.

In my desperation, I went to see a woo-woo pelvic health ‘specialist’ in east London, who informed me that the gym I frequented was wrong to tell me to do stomach crunches.

Then, slipping a gloved hand into my nether regions, she told me to ‘clench’, (classic) and concluded the session with a line I will never forget: ‘there’s trauma in there’. Yeah, no kidding.

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I started planning my outfits – dark jeans and skirts, just in case – and memorising the location of every public toilet in my postcode. I stopped trusting my own body in the way you stop trusting a flaky friend: with lowered expectations and constant contingency plans.

I told myself that it was just the way things were.

Thankfully, after months of not feeling like myself and bored of worrying about where the nearest loo was, I went to see NHS doctor and cosmetic gynaecologist, Dr Sima Al Asad at her female-led clinic in Knightsbridge (drsima.co.uk). This is what I found out, and what I wish someone had told me sooner.

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How to prevent pelvic floor issues

• Prevention starts with awareness. Many women do not think about their pelvic floor until they develop symptoms, but early care makes a huge difference.
• In your 20s and 30s, learning how to correctly engage and relax the pelvic floor is key. This can be guided by a pelvic health physiotherapist. Avoiding excessive straining during bowel movements, maintaining good posture and using proper technique when lifting or exercising helps protect these muscles. Core strength should focus on deep stabilising muscles rather than only intense abdominal workouts.
• Regular low-impact exercise such as walking, pilates, swimming and strength training supports overall muscle balance and bone health without overloading the pelvic floor. Managing weight, staying hydrated and preventing chronic coughing or constipation are also important.
• In your 40s and beyond, hormonal changes begin to influence tissue strength and hydration. Supporting vaginal and pelvic tissue health early, sometimes with local Oestrogen when appropriate, can help maintain elasticity and blood flow. Nutrition becomes increasingly important, including adequate protein, calcium and Vitamin D.
• Most importantly, never ignore early symptoms such as mild leakage, heaviness, or discomfort. No matter what your age. Addressing issues early with physiotherapy or medical support prevents progression and maintains long-term pelvic health.

The five exercises that will strengthen your pelvic floor

Glute bridges three to four times per week

These strengthen the glute muscles, improve pelvic stability and reduce strain on the pelvic floor. Focus on slow, controlled movements with good alignment.

Deep squats two to three times per week

When done correctly, these help improve pelvic mobility and functional strength. They also encourage natural engagement and relaxation of pelvic muscles.

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Heel slides or dead bugs three to five times per week

These are gentle core stabilisation exercises that train the deep abdominal muscles without excessive downward pressure. These muscles work closely with the pelvic floor.

Side-lying leg lifts or clamshells three to four times per week

These are hip stabilisers, which support pelvic alignment and load distribution during daily movement.

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Diaphragmatic breathing five to ten minutes daily

This is often overlooked but extremely important. Learning to coordinate breathing with gentle pelvic engagement improves muscle timing and reduces chronic tension or weakness.

It’s worth pointing out that every woman is different, so exercises should ideally be guided by a pelvic health specialist to ensure correct technique and avoid worsening symptoms.

Lastly, remember to talk about it. To friends. To partners. To other women. The shame of incontinence thrives in silence, and the moment you say, ‘Actually, this is happening to me, someone else will likely say, ‘thanks goodness, me too’. And suddenly you’re not alone – you’re just part of a very large, very under-diagnosed club.

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