Pelvic floor dysfunction is far more common than most women realise.
The pelvic floor is a group of muscles that sit at the base of the pelvis and support the bladder, uterus and bowel while also playing an important role in continence, core stability and sexual function.
When these muscles become weak, tight or poorly coordinated, a wide range of symptoms can occur — from bladder leaks to pelvic pain, reduced sexual sensation and lower back discomfort.
Research suggests up to one in three women experience pelvic floor dysfunction during their lifetime, with pregnancy, childbirth, hormonal changes and ageing all contributing factors (Haylen et al., 2010; Milsom et al., 2013).
The problem is that many women assume symptoms are “normal after babies” or “just part of getting older.”
They aren’t.
Recognising the signs early can help women access treatment and prevent symptoms from worsening over time.
1. Leaking urine when you cough, laugh or exercise
One of the most common signs of pelvic floor dysfunction is stress urinary incontinence.
This happens when pressure inside the abdomen rises during activities such as:
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coughing
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sneezing
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running
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jumping
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lifting
If the pelvic floor muscles cannot provide adequate support to the bladder and urethra, urine leakage can occur.
Urinary incontinence affects up to 50% of women at some point in their lives, particularly following childbirth or during menopause (Milsom et al., 2013).
The good news is that pelvic floor rehabilitation has been shown to significantly improve or resolve symptoms in many women (Dumoulin et al., 2018).
If bladder leaks are something you’re experiencing, text WEAKNESS to 0493 115 262 and we’ll send you our free pelvic floor weakness guide with exercises you can start today.
2. A feeling of heaviness or pressure in the vagina
A sensation of pelvic heaviness, dragging or vaginal pressure can indicate reduced pelvic floor support.
Women often describe this sensation as:
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feeling like a tampon is sitting too low
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pressure in the vagina
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heaviness after long periods of standing or exercise
This symptom may be associated with pelvic organ prolapse, where pelvic organs shift downward due to weakened support structures (Hagen & Stark, 2011).
Early strengthening and pelvic floor rehabilitation can improve support and reduce symptoms.
If you’ve noticed vaginal heaviness, our clinicians at Core Restore Co can assess pelvic floor strength and support to determine the most appropriate treatment options.
3. Difficulty fully emptying your bladder
Pelvic floor dysfunction is not always caused by weakness.
In some cases, the pelvic floor muscles are too tight or unable to relax properly, which can interfere with normal bladder emptying.
Symptoms may include:
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difficulty starting urination
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feeling like the bladder never fully empties
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needing to strain when urinating
This condition is often referred to as hypertonic pelvic floor dysfunction (FitzGerald & Kotarinos, 2003).
If this sounds familiar, text HYPERTONIC to 0492 115 262 and we’ll send you our pelvic floor relaxation guide.
4. Pain during sex
Pelvic floor muscle dysfunction can also contribute to painful sex (dyspareunia).
When pelvic floor muscles are overly tight or unable to relax, penetration may become uncomfortable or painful.
The pelvic floor is also involved in arousal and vaginal blood flow, meaning dysfunction can affect sexual experience in several ways (Basson, 2000).
Addressing pelvic floor muscle tone and coordination can significantly improve comfort during intimacy.
If painful sex has become an issue, a pelvic floor assessment may help identify the underlying cause.
5. Reduced sensation or difficulty reaching orgasm
Pelvic floor muscles play a key role in sexual sensation and orgasm.
During orgasm, the pelvic floor muscles contract rhythmically, contributing to pleasurable sensations (Levin, 2002).
Weak pelvic floor muscles may reduce:
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genital blood flow
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muscle contractions during orgasm
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overall sensation
Research suggests that strengthening these muscles may improve sexual function and orgasm intensity for some women (Bø et al., 2015).
We also have a guide on pelvic floor health and sexual function in perimenopause.
Text PERI to 0493 115 262 and we’ll send it to you.
6. Persistent lower back or hip pain
The pelvic floor is part of the body’s deep core system, working together with:
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the diaphragm
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the abdominal muscles
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the deep spinal stabilisers
When pelvic floor muscles are not functioning optimally, the body may compensate through other muscles, potentially contributing to lower back or pelvic pain.
Research has shown that women with chronic lower back pain are more likely to also experience pelvic floor dysfunction (Smith et al., 2006).
If you struggle with back pain, comment BACK PAIN and we’ll send you our Core & Lower Back Guide.
7. Tampons that won’t stay in place
A lesser-known sign of pelvic floor weakness is difficulty retaining tampons.
If the pelvic floor muscles are unable to provide sufficient support, tampons may:
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slip down
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feel like they sit too low
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fall out easily
While this symptom is rarely discussed, it can be an early indicator that pelvic floor support has changed.
Why pelvic floor dysfunction is often missed
Pelvic floor symptoms are frequently overlooked.
Many women:
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assume symptoms are normal after childbirth
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feel embarrassed discussing bladder or sexual issues
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don’t realise treatment options exist
However, pelvic health care now includes a range of interventions such as:
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pelvic floor rehabilitation
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targeted exercise therapy
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biofeedback
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lifestyle strategies
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advanced technologies like HIFEM pelvic floor stimulation (Emsella)
At Core Restore Co, treatment plans are tailored to each woman’s symptoms and goals.
When to seek pelvic floor treatment
You may benefit from pelvic floor assessment if you experience:
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bladder leakage
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pelvic heaviness
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pain during sex
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persistent pelvic tension
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lower back pain linked to core weakness
Early treatment can significantly improve quality of life and prevent symptoms from progressing.
Take the first step toward pelvic floor strength
If pelvic floor dysfunction might be affecting you, there are several ways to start.
Text WEAKNESS to 0493 115 262 and we’ll send you our free pelvic floor guide.
Want to try advanced pelvic floor strengthening?
Text TRIAL and we’ll send you the link to our Emsella trial offer.
If you suspect pelvic floor tension or tightness, text RELAX to 0493 115 262 for our pelvic floor stretch class.
Frequently Asked Questions
What causes pelvic floor dysfunction?
Common causes include pregnancy, childbirth, ageing, hormonal changes, chronic straining, heavy lifting and high-impact exercise.
Can pelvic floor dysfunction be reversed?
In many cases symptoms can significantly improve with pelvic floor rehabilitation, lifestyle adjustments and targeted treatment.
Are Kegels always helpful?
Not always. Some women have overly tight pelvic floor muscles, meaning strengthening exercises may worsen symptoms. Assessment is important.
References
Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy.
Bø, K., Hilde, G., & Tennfjord, M. (2015). Pelvic floor muscle training for female sexual dysfunction. International Urogynecology Journal.
Dumoulin, C., et al. (2018). Pelvic floor muscle training versus no treatment for urinary incontinence in women. Cochrane Database of Systematic Reviews.
FitzGerald, M. P., & Kotarinos, R. (2003). Rehabilitation of the short pelvic floor. International Urogynecology Journal.
Hagen, S., & Stark, D. (2011). Conservative prevention and management of pelvic organ prolapse. Cochrane Database of Systematic Reviews.
Haylen, B. T., et al. (2010). International urogynecological association terminology report. Neurourology and Urodynamics.
Levin, R. J. (2002). The physiology of sexual arousal in women. Journal of Sexual Medicine.
Milsom, I., et al. (2013). Global prevalence of urinary incontinence. International Urogynecology Journal.
Smith, M. D., Russell, A., & Hodges, P. (2006). Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy.
