Inside Look: The Muscles That Control Your Pelvic Floor


The Muscles That Control the Pelvic Floor

Your body is a marvel. With 60,000 miles of blood vessels that could circle the Earth two-and-a-half times if stretched out, your body is constantly at work churning out new cells (25 million of them every second, in fact). It also hosts trillions of microorganisms, which help regulate everything from hormones, to mood, to body weight.1,2

Nerve impulses travel from to and from your brain at speeds of up to 250 miles per hour and, if your brain were a computer, it could perform 38 trillion operations per second, leaving the world’s most powerful supercomputer in the dust.

All this action keeps you running like a fine-tuned machine 24 hours a day, seven days a week.

Then there are your muscles—sophisticated structures that convert energy into motion and keep blood flowing throughout your body (you can thank your heart muscle for that). Muscles make up approximately 40% of our body weight and, without them, we quite literally could not function.

Which brings us to our topic of discussion: the muscles of the pelvic floor—specifically, the female pelvic floor.


Supporting Your Lady Parts (and More): The Pelvic Floor Muscles

Supporting Your Pelvic Floor Muscles

The pelvic floor is a system of muscles, ligaments, and connective tissues that support the organs of the pelvis, including the bladder, bowel, uterus, and vagina.

Damage to these muscles is common in women. Stress and strain from pregnancy and childbirth—and hormonal changes from menopause—can weaken the pelvic floor muscles and lead to bladder leakage, pelvic organ prolapse (POP), and reduced sexual satisfaction. A striking one in three women will experience some form of bladder leakage at some point. Sadly, 50 percent of women don’t report the issue to their doctors, instead of suffering in silence.

Pelvic organ prolapse is also a common problem associated with weakened pelvic floor muscles. It occurs when an organ in the pelvis (such as the bladder or uterus) drops from its normal position and pushes against the walls of the vagina. Several organs can be involved in prolapse, including the bladder, small bowel, rectum, uterus, vagina, and urethra.

Millions of women will develop prolapse at some point. It’s important to know that stress incontinence, the most common form of UI, is often associated with pelvic organ prolapse.

To make sense of problems like UI and pelvic organ prolapse, it helps to have a basic understanding of a woman’s pelvic floor anatomy—let’s take a closer look.

Pelvic Floor Anatomy: An Inside Look

The funnel-shaped pelvic floor is made up of thin but strong muscles that close off the pelvic cavity from below. The pelvic floor supports the pelvic organs—in women, these include the bladder, cervix, uterus, vagina, and the last part of the rectum (the large bowel, or colon).

The muscles of the pelvic floor include:

  • Levator ani: A broad sheet of muscles which are attached to the sacrum, a triangular bone at the base of the spine. The levator ani is further broken down into three separate paired muscles:
    • Puborectalis (important for maintaining fecal continence)
    • Pubococcygeus
    • Iliococcygeus (which joins behind the anus to form a sheet of strong connective tissue called the levator plate that supports the pelvic organs while a person is at rest)
  • Coccygeus: A smaller pelvic floor muscle located at the rear (posterior) of the levator ani.

Anatomy of the Pelvic Floor

The levator ani and coccygeus muscles pair together to form the pelvic diaphragm, sealing off the pelvic cavity.

Together, the pelvic floor muscles form a wide sling like a hammock. They extend across the fan-shaped pelvic bone, connecting to the pelvic organs (cervix, uterus, bladder, vagina, urethra, lower rectum) through strong muscle fibers that are further reinforced by fibrous tissue.

Gaps in the pelvic floor muscles called “hiatuses” allow organs to pass through. The urethra, for example, has to reach the outside of the body to allow for urination. The two openings in the pelvic floor muscle system include the:

  • Urogenital hiatus, through which the urethra and vagina pass
  • Rectal hiatus, through which the anal canal passes

Enough anatomy for you? Let’s talk about the function of these muscles.

What Have You Done for Me Lately? The Function of the Pelvic Floor Muscles

The importance of the pelvic floor cannot be overstated. This sheet of muscle helps form part of the body’s core muscles, which are responsible for maintaining posture and intra-abdominal pressure and for holding organs in place.  The pelvic floor muscles work together with the deep abdominal muscles and the back muscles to keep the body erect.

The specific role of the pelvic floor muscles is to hold up the pelvic organs against gravity, ensuring they stay in place when abdominal pressure increases from sneezing, coughing, laughing, or other physical exertion. They are especially vital for continence, giving us control over urination, defecation, and flatulence.

These muscles are also involved in orgasm, which is why weakened pelvic floor muscles can cause diminished sexual satisfaction during vaginal intercourse in women.

The pelvic floor muscles work in coordination—for example, by allowing the contraction of the bladder to force urine out, while simultaneously relaxing the muscles around the urethra to let urine flow. Similar coordinated muscle movements happen during defecation, childbirth, and vaginal intercourse.

When the pelvic floor muscles become weakened, intra-abdominal pressure increases (especially with exertion from coughing, sneezing, etc.), pushing down the weakened pelvic floor and causing the pelvic organs to descend lower than they normally would.

Over time, this can lead to urinary incontinence symptoms and/or which can range from minor (e.g., a minor bulge from an organ such as the uterus pressing against the vaginal wall) to serious (e.g., the actual dropping of the uterus into the vagina).

Tackling the Symptoms of UI and Prolapse

The good news is that, no matter what your age or stage of life, there are things you can do to strengthen your pelvic floor muscles to help prevent or mitigate certain types of UI (e.g., stress or urge incontinence) and pelvic organ prolapse.

These behavior changes include (but are not necessarily limited to):

  • Pelvic floor muscle exercises: Doing regular Kegel exercises with or without a pelvic floor biofeedback device can help strengthen the pelvic floor muscles and urinary sphincter over time. Benefits include a reduction or elimination of UI/prolapse symptoms and enhanced sexual experience.
  • Fluid consumption: Following a certain fluid schedule and avoiding dietary irritants like caffeinated and carbonated beverages and alcoholic drinks can help improve UI symptoms for some people.
  • Healthy lifestyle changes: Losing weight (extra weight puts more pressure on the pelvic muscles and organs), quitting smoking (smoking can degrade muscle fibers and cause coughing), and treating chronic cough (coughing creates intra-abdominal pressure) can help prevent the onset or reduce/eliminate symptoms of UI and prolapse.


Symptoms of UISymptoms of Prolapse

PeriCoach: An Innovative Pelvic Floor Biofeedback Device

Let’s talk more about Kegel exercises—one of the most effective ways to protect pelvic floor health.

Strengthening the pelvic floor muscles can help prevent bladder leakage (stress incontinence), as well as prolapse, and it can improve symptoms for women who already have these conditions.

Note that if you’re experiencing bladder leakage, it’s important to see your doctor to determine the cause, since some forms of UI can be caused by something other than weak pelvic floor muscles. For example, urge incontinence is often caused by damage to the nerves of the bladder or other parts of the nervous system, not necessarily weakened pelvic floor muscles.

The PeriCoach system was specifically designed to help women exercise their pelvic floor muscles. An insertable biofeedback device that guides you through pelvic floor (Kegel) exercises, PeriCoach is fitted with three biofeedback sensors that detect the contraction of your pelvic floor muscles when you squeeze against the device.

The PeriCoach System

Why Use a Pelvic Floor Exerciser?

Healthcare practitioners recommend pelvic floor muscle training as the first line of defense against UI and prolapse, yet at least 50% of women do not correctly contract their pelvic floor muscles with verbal or written instructions alone. PeriCoach helps ensure you contract the right muscles, for better results over time.

PeriCoach is paired with your smartphone via Bluetooth; as you squeeze against the device, that information is sent to your phone, allowing you to see your muscles working in real-time. PeriCoach is FDA-cleared, which means it has met rigorous safety standards. It is among the best pelvic floor trainers on the market and is an affordable way to improve the strength of your pelvic floor muscles over time.

Check out our step-by-step guide to doing Kegel exercises and learn more about how PeriCoach works and what real women are saying about this life-changing tool.