Prevention and Management Options

How can I prevent pelvic floor dysfunction?

 

1. Physical activity and maintaining a healthy diet

Physical activity and a healthy diet can help prevent pelvic floor dysfunction.

The UK Cheif Medical Officers’ Physical Activity Guidlines recommend that adults aged 19 to 64 years should;

     

      • aim to be physically active every day;

      • engage in muscle strengthening activities at least two days a week;

      • engage in at least 150 minutes of moderate intensity activity (such as brisk walking or cycling) or 75 minutes of vigorous intensity activity (such as running) each week;

      • minimise the amount of time spent being sedentary

    Having a balanced diet can benefit the pelvic floor, in particular, by eating enough fibre, because this can improve stool consistency. See the Office for Health Imporvement and Disparities, The Eat Well Guide.

     

    2. Weight loss

    Being overweight or obese may increase pelvic floor dysfunction; a greater body weight results in increased abdominal pressure, which causes more downward pressure on the pelvic floor.

     

    3. Managing constipation

    It is important to avoid constipation as this puts extra strain on the pelvic floor msucles and can worsen prolapse symptoms.

    See the Pelvic, Obstetric and Gynaecological Physiotherapy (POGP) guidance for Improving Your Bowel Function.

     

    How can I manage pelvic floor dysfunction?

    There are various tretament options for symptoms of pelvic floor dysfunction, some more suited to the individual than others. The recommended first line of treatment is supervised pelvic floor muscle exercises. See the topic page for more information.

     

    Others include:

    Pelvic Floor Exercises

    Exercises to improve pelvic floor muscle strength, endurance, power, relaxation, or a combination of these.

    Physical Activity

    Yoga, Pilates, Walking, Swimming etc.

    Intravaginal Devices or Pessaries

    Removeable devices desogned to support the pelvic organs and reduce leakage.

    Bladder Training

    A behavioural therapy involving gradually increasing the time between toilet visits, used to help individuals gain better control over their bladder function.

    Other conservative treatments that have evidence of effectively strengthening the pelvic floor muscles and reducing symptoms of pelvic floor dysfunction include:

    Read this research that summarises the conservative treatment options for urinary incontinence in women. 

     

    Electrical or Magnetic Stimulation

    Targeted energy to activate and strengthen pelvic floor muscles, improve nerve signalling, and help manage dysfunctions such as incontinence and pelvic pain.

    Biofeedback

    Real-time feedback (visual or auditory) to help patients understand and control their pelvic floor muscle contractions, improving coordination and strength.

    Diaphragmatic Breathing Exercises

    Deep, slow breaths that engage the diaphragm that teach individuals to consciously relax and lengthen their pelvic floor muscles.

    Manual Therapy

    Hands-on technique which may include massage, soft tissue, nerve tissue or joint mobilisation or myofascial release.

    This content is based on guidance from the National Institute for Health and Care Excellence (NICE). It has been summarised and rephrased for informational purposes only. For the full, official guidelines, please visit the NICE website at https://www.nice.org.uk/guidance/ng210/chapter/Recommendations#preventing-pelvic-floor-dysfunction