Pelvic Floor Exercises for Women

Estrogen is your pelvic floor's best friend. And it is leaving.

During perimenopause, estrogen levels fluctuate and ultimately decline. This hormone maintains the collagen content, blood flow, and muscle tone of your pelvic floor. When it drops, the tissue thins. The muscles weaken. The connective tissue loses elasticity. This is why urinary incontinence affects up to 50% of postmenopausal women, even women who had uncomplicated deliveries or no pregnancies at all.

A systematic review and meta-analysis found that pelvic floor muscle training significantly reduced urinary incontinence symptoms in postmenopausal women with moderate to large effect sizes. The evidence is not ambiguous. These exercises work.

But here is what most programs get wrong. They prescribe Kegels alone. A separate meta-analysis found that combined exercise programs, pelvic floor training alongside general resistance and aerobic work, produced better outcomes than isolated pelvic floor exercises. Your pelvic floor does not work in isolation. It co-contracts with your transverse abdominis during a deadlift. It braces with your diaphragm during a sneeze. It lengthens during a deep squat. Training it to fire only during a Kegel is like teaching someone to swim on dry land.

Anterior pelvic tilt, which affects many desk-bound women, changes the resting position of the pelvic floor and reduces its ability to contract effectively. The pelvic tilt exercises on this page address this postural component directly. Fix the alignment, improve the contraction.

Pelvic floor exercises for pregnant women overlap substantially with exercises for perimenopause. Both populations are dealing with hormone-driven changes to the same tissue. The progression is different, but the principles are identical: strengthen the system, not just the muscle.