The pelvic floor is one of the most important and most overlooked muscle groups in the female body. Despite playing a central role in bladder, bowel, and sexual function, as well as supporting the spine and pelvis, many women know very little about it until something goes wrong. As a physiotherapist specialising in women's health, I am passionate about changing that, one conversation at a time.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles, ligaments, and connective tissues that form a hammock-like base across the bottom of your pelvis. These structures support your bladder, uterus, and bowel, and work in coordination with your deep abdominal and back muscles to stabilise your spine and pelvis throughout every movement you make.

When Things Go Wrong

Pelvic floor dysfunction is extremely common. It is estimated that one in three women will experience some form of pelvic floor problem during their lifetime, yet the vast majority never seek help because they assume it is a normal part of being a woman or that nothing can be done. This is simply not true.

Signs of Pelvic Floor Dysfunction

  • Leaking urine when you cough, sneeze, laugh, or exercise (stress urinary incontinence).
  • A sudden, urgent need to rush to the toilet, sometimes with leaking before you arrive.
  • Pelvic heaviness or a sensation that something is falling out, which may indicate pelvic organ prolapse.
  • Pain in the pelvis, hips, or tailbone, particularly during or after intercourse.
  • Difficulty emptying the bladder or bowel fully.
  • Core weakness or ongoing lower back and hip pain.

Who Is at Risk?

While pelvic floor dysfunction can affect women of all ages, certain life stages and events increase the risk. Pregnancy and childbirth, whether vaginal or via caesarean section, place significant demands on the pelvic floor. Hormonal changes around menopause reduce tissue elasticity and muscle strength. High-impact exercise, chronic coughing, constipation, and prolonged heavy lifting can all contribute over time.

In Dubai, many women are highly active, whether running along the beach, attending gym classes, or practising yoga. It is important to understand that even very fit women can experience pelvic floor problems, and that these are not a sign of weakness or poor fitness.

Leaking when you exercise is not something you simply have to live with. With the right assessment and guidance, most women experience significant, lasting improvement.

The Myth of Kegel Exercises

Most women have heard that they should do pelvic floor exercises, commonly called Kegels. While strengthening exercises can be very helpful for many women, they are not appropriate for everyone. For some women, the pelvic floor is actually too tight, and adding more contraction worsens symptoms. An accurate assessment by a trained physiotherapist is the only way to know what your pelvic floor truly needs.

What a Physiotherapy Assessment Involves

A pelvic floor physiotherapy assessment typically includes a detailed discussion of your symptoms and history, assessment of posture and breathing mechanics, and, with your consent, an internal examination to evaluate muscle strength, coordination, and tension. This is a completely safe and professional process, and many women find it reassuring to finally have answers about what is happening in their body.

Whether you are postpartum, perimenopausal, or simply curious about your pelvic health, you deserve access to knowledgeable, compassionate care. I encourage every woman to treat pelvic floor health as the priority it truly is.

To learn more about your own pelvic floor health and what support might be helpful, please book a consultation with Dr. Smruti Rathod.