Pelvic Floor in Women: Everything You Need to Know

Often overlooked in anatomy, the pelvic floor is nevertheless essential for many functions: continence, organ support, sexuality, and more. Here’s everything you need to know about the pelvic floor!

We help you understand how this intimate area works:

• Understanding the anatomy: What is this muscle tissue, and what is the role of the pelvic floor?
• Identifying the risks: Pelvic floor and pregnancy, sport, illness... What causes a weakened pelvic floor?
• Taking action and strengthening it: Kegel exercises, physiotherapy, or pelvic floor recovery at home with the connected Emy Trainer pelvic floor trainer.

What is the pelvic floor?

The pelvic floor is a group of muscles, ligaments and membranes. Extending from the back of the pubis to the coccyx, this “hammock” plays a fundamental role:

• supporting and holding the genital organs in place.
• ensuring the proper functioning of continence mechanisms.
• regulating sexual response.

How does the pelvic floor work?

Dr Marine Lallemant, head of clinic in obstetrics and gynaecology and specialised in pelvic floor medicine, explains it to us. In practical terms, a triple system holds the pelvic organs in place:

• pelvic muscles: the support system on which the pelvic organs rest.
• ligaments: suspension and anchoring of the pelvic organs to the pelvic bones.
• fascia: cohesion between these organs.

To maintain good balance, this system must combine flexibility and strength. If the pelvic floor muscles or ligaments loosen, or if there is high intra-abdominal pressure, the risks are serious.

Organ prolapse (prolapse), urinary incontinence (urine leakage), or even anal incontinence... The most severe cases may even require surgery.

Women and men both have a pelvic floor!

While women are generally more aware of their pelvic floor, many men do not realise they have one. Although it is less vulnerable for anatomical reasons, a local injury (such as prostate surgery) can weaken it.

That is why we strongly recommend pelvic floor recovery in advance to help anticipate the risk of post-operative incontinence. After surgery, sessions can also help prevent incontinence and erection problems.

What pelvic floor dysfunctions are there, and what impact do they have?

A weakened pelvic floor can lead to health problems that seriously affect quality of life. When the pelvic floor muscles lose their natural tone, several conditions can appear:

• Stress urinary incontinence: an involuntary loss of drops of urine during a sudden movement, sport, or laughter.
• Overactive bladder: a strong, frequent urge to urinate that is hard to control.
• Prolapse: a gradual descent of an organ through the vagina, causing pain or a feeling of pelvic heaviness.

The many demands placed on the pelvic floor

Three successive openings make the female pelvic floor particularly vulnerable: the urethra, the vagina and the anus. In addition, the pelvic floor muscle group is under constant strain. Lifting, laughing, sneezing, running... It even contributes to postural support.

Pregnancy

First of all, pregnancy and childbirth can severely damage the pelvic floor. These events are in fact one of the main causes of incontinence because:

• The baby’s weight puts pressure on the pelvic floor for several months.
• During a vaginal birth, the baby’s body passing through can stretch the pelvic floor.

That is why you should have a pelvic assessment with a gynaecologist or midwife after childbirth, whatever the birth method.

It is also best to pay attention to your pelvic floor before becoming pregnant. A few strengthening exercises ahead of time will prepare these muscles for 9 months of pregnancy

Note: Are you already pregnant? Replace pelvic floor strengthening with awareness and relaxation exercises for the pelvic floor. They should help make childbirth easier.

Lifting heavy loads

Lifting heavy loads, meaning bending down and straightening up with effort, places a lot of strain on the pelvic floor. Stretching it this way can cause urine leakage, or even incontinence.

Smoking

Next, when smoking causes recurrent coughing fits, stress urinary leakage can occur. Coughing repeatedly and in bursts puts the pelvic floor under strain, significantly weakening it.

Constipation

Then, difficulty passing stools and the many straining efforts can traumatise the pelvic floor. Once weakened, it no longer supports the organs properly and urine leakage can appear.
Note: constipation is defined as fewer than 3 bowel movements per week over a long period.

Learn more about my pelvic floor

Menopause

Menopause is also a critical period for pelvic floor tone. Hormonal changes and tissue ageing can lead to pelvic floor relaxation. Not to mention vaginal dryness... Pelvic floor recovery could help with all of these discomforts.

Sexual intercourse

Finally, a pelvic floor with poor tone reduces sensation during sexual intercourse. If it is stretched, the vagina grips the man’s penis less tightly, leading to reduced sensation for both partners.

How can you take care of your pelvic floor?

Like any muscle, you need to look after your pelvic floor and train it throughout your life. After recovery with a physiotherapist or midwife, continuing at home helps maintain your progress over time.

The Emy Trainer solution for strengthening your pelvic floor

First, you can use a connected biofeedback pelvic floor trainer such as the Emy Trainer pelvic floor trainer.

Healthcare professionals often use biofeedback. Unlike electrostimulation, this method does not rely on sending an electric current.
The patient contracts the muscles of their pelvic floor themselves to tone them more quickly and for longer.

French medical innovation, Emy Trainer helps women of all ages recover their pelvic floor on their own at home, while having fun.

Its mobile app offers 32 adaptive mini-games based on standard medical pelvic floor recovery protocols.

You can also recover your pelvic floor at home, without the Emy Trainer vaginal device.

Download the app for free to access several mini-games and set your training reminders.

Practising a physical activity

Next, gentle and regular physical activity will help keep your pelvic floor toned. If your pelvic floor is weak, choose gentle sports such as yoga, Pilates or cycling. On the other hand, avoid sports with repeated impact or jumping (CrossFit, trampoline, running, and so on).

Watching your weight

Thirdly, there is a link between urinary incontinence and excess weight. To reduce pressure on the pelvic floor, weight loss (with professional support) could be a solution.

Thinking about your posture

Finally, strengthening your pelvic floor is not enough in the long term if your posture is poor. It is therefore essential to stand correctly and adjust your posture every day to avoid excessive pressure on the organs.

Which method should you choose to recover your pelvic muscles?

Pelvic floor recovery with electrostimulation

As an addition to standard pelvic floor recovery with your healthcare professional, electrostimulation can be a solution for women who want to keep up their exercises at home. In this case, electrical stimulation causes the pelvic floor to contract involuntarily.

This technique may not be very comfortable for some people who find electrical stimulation unpleasant.

Pelvic floor electrostimulation devices can be used with a healthcare professional and at home, whether in the form of a vaginal trainer or shorts (the latter targets the pelvic floor muscles and sends a multidirectional electric current.).

Simply put, these devices work like the electrodes placed on your abs to boost muscle tone. They must therefore be prescribed by a healthcare professional and used as part of medical follow-up with the rehabilitation specialist.

Strengthening your pelvic floor with biofeedback

Pelvic floor recovery through biofeedback is a self-training solution that helps you actively work your pelvic muscles (unlike electrostimulation, which is a passive recovery technique). With a biofeedback trainer, the goal is to strengthen your own pelvic floor yourself.

If we go back to the abs comparison, electrostimulation is like placing electrodes that send electrical stimulation to the muscle, whereas biofeedback is like doing your abs workout yourself. In other words, you are the one who makes the muscle work and contract.

The device is there only to capture and detect your pelvic floor contractions. It then sends this information to a computer (in a healthcare setting) or to a smartphone (if you are at home).

This technology gives you visual feedback on the contraction you have just performed. You can therefore see your voluntary pelvic floor contractions in real time.

Biofeedback trainers detect the contractions performed by the user and measure their progress. It is a tool that encourages awareness of pelvic floor contractions and learning, which ultimately boosts the connection between body and brain.

Manual pelvic floor recovery

The pelvic floor recovery method should above all suit women who will need several sessions before regaining a toned pelvic floor. Manual recovery is carried out by a healthcare professional and involves a vaginal examination and guiding the patient, through gentle pressure, on which muscle to focus their contraction on.
This technique helps target your efforts on the muscles that need to be worked the most.

Once the patient contracts their pelvic floor correctly, a second phase of gentle exercises begins. Using specific images, the patient becomes aware of the different areas of their pelvic floor and the pressure exerted on it during physical effort.

Finally, the healthcare professional teaches the patient quick lifting movements to do before these efforts so that they come to see this work as automatic.

Pelvic floor recovery at home

You can also do your pelvic floor recovery at home without a device, simply by downloading an app on your smartphone. With the Emy app, for example, you can train your pelvic floor contractions through different types of adaptive mini-games, based on the medical protocols used by healthcare professionals (long, short, quick contractions, contractions to hold over time, and more).

In short, biofeedback is a method commonly used by rehabilitation specialists and complements electrostimulation. In addition, biofeedback technology is not based on sending an electric current (unlike electrostimulation) and helps you see results more quickly and for longer in pelvic floor tone.

With the Emy Trainer medical innovation, you can now tone your pelvic floor at home while having fun. It took 2 years of research and development to create a biofeedback trainer with dimensions similar to those used by healthcare professionals, adapted to women’s needs and expectations.

They tested Emy Trainer and adopted it

“Since I started using Emy Trainer, I feel like I’ve got my life back! A few months ago, I was unable to contract my pelvic floor, and today I’ve regained my muscle tone. Five minutes a day is enough!”
Cécile, 35, Emy Trainer user

“I found Emy fun and playful. I am absolutely certain that women will keep doing their recovery with this device, which is completely innovative”
Odile Bagot, obstetrician-gynaecologist in Strasbourg

“At first, I noticed that I no longer had to change my sanitary pad several times a day. Today I would say the leaks have been divided by 5. When you think about the price of sanitary pads, that is an incredible saving.”
Marie-Pierre, 46, Emy Trainer user

“I first discovered the free app, which I already thought was great, and I was doing my exercises every day or every other day. Then, when I found out there was a trainer, I didn’t hesitate for long before buying it! Thanks to the app and the trainer, I was able to avoid an operation that could have been very major”
Eve, 62, Emy Trainer user

What you need to remember for your pelvic health

• An essential muscle: The pelvic floor is essential for both men’s and women’s health. It supports posture, continence and intimate function.
• Don’t wait for symptoms: Weight loss, good posture and stopping high-impact sports (jumping, running, etc.) help protect the pelvic floor.
• The medical reflex: At the slightest symptom, consult a healthcare professional (midwife, specialised physiotherapist, gynaecologist or doctor). Only they can carry out a full pelvic assessment and guide you towards the most suitable care.

Sources:

• Prospective evaluation of the connected biofeedback EMY Kegel trainer in the management of stress urinary incontinence, Jochum F et al., February 2022, Journal of Gynecology Obstetrics and Human Reproduction 51(2):102280. - link
• Pelvic Floor Muscle Rehabilitation Using Biofeedback, Diane Kaschak Newman, July 2014, Urologic Nursing 34(4):193-202. - link
• Pelvic floor recovery in the postpartum period, French National Authority for Health (HAS), December 2002, Clinical practice recommendations. - link