The pelvic floor is the 4th pillar of women's health: a group of muscles that supports the pelvic organs and helps you stay continent. It completes the three classic pillars of health – diet, sleep and physical activity.

In brief

  • The pelvic floor is the muscular base that supports the bladder, uterus and rectum: it is the 4th pillar of women's health, alongside diet, sleep and physical activity.
  • Pregnancy, childbirth, the menopause and high-impact sports can weaken it, leading to urinary leaks, a feeling of heaviness or reduced intimate sensation.
  • Emy Trainer, a CE-marked medical device designed by Fizimed with healthcare professionals, supports pelvic floor rehabilitation at home using biofeedback, with exercises based on the PERFECT scheme.

What is the 4th pillar of women's health?

The 4th pillar of women's health is the pelvic floor, a group of muscles and tissues that stretches from the pubic bone to the coccyx. Alongside the three classic pillars of health (a balanced diet, restorative sleep and regular physical activity), the pelvic floor keeps the pelvic organs in place and is essential for bladder control and intimate wellbeing.

Eat well. Sleep well. Move regularly. For decades, medicine and prevention have repeated this trio of health pillars:

  • a balanced diet
  • restorative sleep
  • regular physical activity

Yet when we look at the female body honestly and with scientific rigour, one essential group of muscles has long been left in the shadows. It literally carries women's bodies, their freedom of movement and their confidence. Women's health does not rest on three pillars, but on four: the 4th pillar is the pelvic floor.

Where is the pelvic floor and what does it do?

The pelvic floor sits at the base of the pelvis, between the pubic bone at the front and the coccyx at the back. Its muscles form a kind of hammock that supports the bladder, uterus and rectum. The pelvic floor muscles help you control your bladder and bowel, absorb the pressure on your abdomen when you cough, laugh or lift something, and contribute to intimate sensation.

What weakens the pelvic floor?

The pelvic floor can weaken over the course of a woman's life, particularly during pregnancy and after childbirth, during the menopause as hormone levels fall, or with repeated high-impact sport. The most common signs of a weak pelvic floor are urinary leaks when you exert yourself, a feeling of heaviness in the lower abdomen or reduced intimate sensation. According to the International Continence Society, one in three women experiences urinary incontinence (Cardozo et al., ICS, 2023).

If symptoms persist, talk to your GP, a midwife or a pelvic health physiotherapist.

What do pads and connected devices really do for the pelvic floor?

When the pelvic floor weakens, two responses are very common: absorbent pads, which manage leaks day to day, and consumer connected devices, which offer exercises without their effectiveness always being assessed in clinical studies.

What do incontinence pads do?

Pads and liners absorb liquid when urinary leaks occur. They provide everyday comfort and reassurance, but they do not act on the muscle tone of the pelvic floor: they manage the symptom without strengthening its anatomical cause. A pad absorbs the leak; it does not rebuild the foundations.

What about consumer connected devices?

Many connected devices offer playful exercises and in-app scores to support pelvic floor training. Their effectiveness is not always documented by clinical studies, and not all of them are medical devices. Before choosing a device, check that it is a CE-marked medical device and that a clinical study on it has been published.

Your intimate health deserves answers that live up to it: the pelvic floor is rebuilt with science and the high standards of healthcare professionals.

How can you strengthen your pelvic floor effectively?

Strengthening your pelvic floor relies on voluntary, repeated contractions of the pelvic floor muscles, done regularly and preferably with guidance from a healthcare professional such as a midwife or physiotherapist. Pelvic floor rehabilitation can take place in a clinic or at home. Among the methods used, biofeedback lets you see the activity of your pelvic floor in real time during your exercises.

The PERFECT scheme, recognised in pelvic floor rehabilitation, structures training around several parameters: contraction strength, endurance, number of repetitions and fast contractions.

What is Emy Trainer?

Emy Trainer is a connected pelvic floor trainer using biofeedback, developed by the French Femtech company Fizimed with healthcare professionals. This CE-marked medical device captures your pelvic floor contractions through 360° pressure sensors and sends them to the Emy app, so you can see straight away whether you are activating your pelvic floor, at home and on your own. The exercises in the app are based on the PERFECT scheme.

Emy Trainer must not be used during pregnancy or in the 7 weeks following childbirth.

What does the clinical study on Emy Trainer show?

The clinical study on Emy Trainer was carried out at Strasbourg University Hospital (CHU de Strasbourg) with women experiencing stress urinary incontinence (Jochum et al., 2021).

  • Regulatory status: CE-marked and patented medical device, fitted with 360° pressure sensors.
  • Protocol: exercises based on the PERFECT scheme, recognised in pelvic floor rehabilitation.
  • Results: after 3 months of using Emy Trainer, 98% of patients reported an improvement in their quality of life and 91% an improvement in their urinary symptoms (Jochum et al., 2021, CHU de Strasbourg).

Find out more about Emy Trainer

Where can you find reliable information about the pelvic floor?

The 4th pillar of women's health should no longer be a taboo subject or left to unreliable internet forums, so the information about it has to be beyond reproach. To help you understand your body and take control of your health, we have worked with doctors to write a free information and patient education booklet.

Key takeaways on the 4th pillar of women's health

  • The pelvic floor supports the bladder, uterus and rectum and helps you stay continent: it is the 4th pillar of women's health.
  • Pregnancy, childbirth, the menopause and high-impact sports can weaken it; urinary leaks or a feeling of heaviness are worth discussing with a healthcare professional.
  • Emy Trainer supports pelvic floor rehabilitation at home using biofeedback: after 3 months of using Emy Trainer, 98% of patients reported an improvement in their quality of life (Jochum et al., 2021).

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 – pubmed.ncbi.nlm.nih.gov/34861424
  • Pelvic Floor Muscle Rehabilitation Using Biofeedback, Diane Kaschak Newman, July 2014, Urologic Nursing 34(4):193-202 – pubmed.ncbi.nlm.nih.gov/25233622
  • Clinical study: our clinical data

Pelvic Floor and Intimate Health FAQ

What is the pelvic floor and what does it do?

The pelvic floor is a group of muscles and tissues that closes off the bottom of the pelvis, between the pubic bone and the tailbone. It supports the pelvic organs (bladder, womb, rectum), helps you control your bladder and bowel, and plays a role in sex. Like any muscle, it can weaken (pregnancy, childbirth, menopause, repeated strain) or, on the contrary, become too tight.

How can you strengthen your pelvic floor?

To strengthen your pelvic floor, you need to voluntarily contract the pelvic muscles (as if trying to hold in gas or the urge to urinate) only when you exhale. Do progressive exercises lying on your back or on all fours, making sure not to hold your breath or tense your buttocks. You can combine these contraction exercises with a connected biofeedback device used at home, such as Emy Trainer. This device, inserted into the vagina, tracks your muscle contractions in real time and lets you do fun exercises on your smartphone while measuring your progress.

How can you tell if you have a weakened pelvic floor?

A weakened pelvic floor is mainly recognized by urinary leaks or involuntary gas during an effort such as laughing, coughing, or jumping. It can also cause a feeling of heaviness or pressure in the lower abdomen, as well as reduced sensation or discomfort and pain during sex. These topics are common in consultations: there is no need to feel embarrassed about bringing them up. Only a manual assessment by a midwife or physiotherapist will make it possible to accurately assess the tone of your muscles and confirm the need for rehabilitation.

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