Everyone has a pelvic floor. Almost nobody talks about it, which is a shame, because it has been holding up a large part of your day, every day, without a word of thanks.
The lie
"A bit of leaking is just what happens."
The short version
- Your pelvic floor is a group of muscles at the bottom of your pelvis that supports your bladder and bowel. Men have one too.
- Leaking when you cough, laugh or sneeze is common, but it isn't something you have to put up with.
- Pelvic floor exercises are the first treatment. Squeeze as if you're stopping a wee and wind, at least three times a day, for at least three months.
- Not improving, or it's getting in the way of your life? See your GP. Help works.
Today's rep: Do one round of pelvic floor squeezes while the kettle boils today: 10 quick, then a few long holds. Jump to it
Common is not the same as normal
Leaking when you cough or laugh is common. You don't have to keep it.
"A bit of leaking is just what happens" is said in exactly the tone people use about a car that's started making a noise. It'll probably be fine. Everyone's does. Turn the radio up.
It is common. The NHS describes urinary incontinence as a problem that affects millions of people, and the most common kind, stress incontinence, means leaking when you cough or laugh.1 Pregnancy, childbirth and, in men, having the prostate removed are among the causes.1 But common means lots of people have it. It doesn't mean you have to keep it.
What it is
A trampoline of muscle holding up your bladder and bowel. Everyone has one.
Picture a trampoline stretched across the bottom of your pelvis. That's roughly your pelvic floor: a layer of muscle that holds up your bladder and bowel, and helps you decide when things leave. It's been doing that every day of your life, like a goalkeeper nobody notices until the ball goes in.
Like any muscle, it can get weaker, and like any muscle, it can be trained. The difference is that nobody has ever posted a picture of theirs with a fire emoji.
How to do them
The NHS explanation is the clearest one going: imagine you're stopping yourself having a wee and breaking wind, both at once.2 That squeeze, and the lift that comes with it, is your pelvic floor working.
- Quick squeezes. Squeeze, then let go. Try not to pull your tummy in or hold your breath. Repeat 10 times.2
- Long squeezes. Squeeze and hold, building up over time to 10 seconds. Repeat 10 times.2
- How often. NHS treatment programmes ask for a minimum of 8 squeezes each time, at least 3 times a day, for at least 3 months. Build up towards 10.1
- Be patient. It can take a few months before you notice a difference.2
The good news is that nobody can see you doing them. You can do them on the bus, in a meeting, or while the kettle boils, which by now has seen more of your training than anyone. Try not to make a face. You'll make a face.
Pelvic floor: the routine
- Imagine you're stopping yourself having a wee and breaking wind at the same time. That squeeze is your pelvic floor.
- Quick squeezes: squeeze, let go. 10 times. Try not to pull your tummy in.
- Long squeezes: squeeze and hold, building up to 10 seconds. 10 times.
- At least 3 times a day, for at least 3 months.
Not improving after 3 months, or it's affecting your life? See your GP.
Mostly for women
Men, you've had the important bit above. This part is about pregnancy and birth, so you can skip ahead. Or stay, and learn something your mates don't know.
During pregnancy and after a baby
Pregnancy and childbirth, especially a vaginal birth, are two of the most common reasons the pelvic floor weakens.1 The UK Chief Medical Officers' advice after having a baby is to start pelvic floor exercises as soon as you can, and keep doing them every day.3 The NHS suggests building up to 10 of each kind of squeeze, at least 3 times a day.4
If you leak when you jump or run, you don't have to stop exercising. Swap the jumping for marching or brisk walking while you rebuild, and keep doing the squeezes. And keep doing them long after the leaking stops, through the menopause and beyond. It's a muscle. Muscles you use stay useful.
If it isn't getting better, ask your GP about seeing a physiotherapist who specialises in pelvic health. It's a very ordinary request. They'll have heard it four times before lunch.
Men, this one's yours too
Same muscles, same squeezes, especially after prostate surgery.
Men have a pelvic floor too, and the same squeezes train the same muscles. If you've had prostate surgery, leaking afterwards is a known cause,1 and it's worth asking your GP or specialist nurse about pelvic floor exercises. Nobody at the five-a-side needs to know. They're all doing them in secret anyway. Probably.
An app, if that helps
If you need reminding, there's an app called Squeezy that sets reminders and talks you through the exercises. It costs a few pounds.5 It reminds you, which is more than your pelvic floor has ever done.
When to see your GP
See your GP if leaking is getting in the way of your life, if it isn't improving after three months of exercises, or if anything about it worries you. Treatments that don't involve medicines or surgery are tried first, and they often work.1 It's an everyday conversation for a GP. Honestly. They have it more often than you have toast.
Your rep for this chapter
Do one round of pelvic floor squeezes while the kettle boils today: 10 quick, then a few long holds. Nobody will know. Then save the routine to your phone, so it's there tomorrow.
The lie: "A bit of leaking is just what happens."
The short version
- Your pelvic floor is a group of muscles at the bottom of your pelvis that supports your bladder and bowel. Men have one too.
- Leaking when you cough, laugh or sneeze is common, but it isn't something you have to put up with.
- Pelvic floor exercises are the first treatment. Squeeze as if you're stopping a wee and wind, at least three times a day, for at least three months.
- Not improving, or it's getting in the way of your life? See your GP. Help works.
Your rep
Do one round of pelvic floor squeezes while the kettle boils today: 10 quick, then a few long holds. Nobody will know. Then save the routine to your phone, so it's there tomorrow.
Your browser forgets. Your photos don't. Save it, and the rep turns up in your camera roll at 7am when you're looking for something else.
Sources
1. NHS. Urinary incontinence, including the causes and treatment pages.
2. NHS. What are pelvic floor exercises?.
3. UK Chief Medical Officers. Physical activity for women after childbirth: birth to 12 months. 2019, updated 2026. The full guidelines add that more intense activity can resume gradually after the 6 to 8 week check, building up over at least 3 months.
4. NHS. Your post-pregnancy body.
5. Squeezy, a pelvic floor exercise app. £3.99 on iPhone and Android at the time of writing.