What’s in it for me? Everything you were never taught about “down there”
Many women grow up hiding tampons in their sleeves, whispering about periods, and quietly tolerating discomfort “down there” as if it’s just the price of having a female body.
When we leak a little urine, feel pain during sex, or discover a lump that turns out to be our bladder, we’re told it’s “normal” – something to manage with liners, surgery, or silence.
Vaginas are trending on red carpets, in museum exhibits, and even in candles.
The awareness alone is a positive.
Nevertheless, actual pelvic health care remains an afterthought.
In this Blink, you’ll uncover the often-ignored system at the center of so many physical and emotional struggles: the pelvic floor.
You’ll learn why pelvic dysfunction affects nearly one in three women, how to identify subtle warning signs, and what you can do – starting today – to restore strength, function, and confidence.
This is your crash course in reclaiming your body from the inside out.
What is the pelvic floor, anyway?
Sara Reardon started physical therapy school intent on becoming a sports therapist, inspired by her love of running.
But a two-week unit on pelvic floor therapy changed everything.
She discovered that the little-known pelvic floor muscles do much more than most people imagine – and yet they do everything from help us pee and poo to have sex and give birth.
So what is the pelvic floor?
In short, it’s a hammock-like layer of muscles at the base of the pelvis – the bony area around your hips, sit bones, and pubic bone.
These muscles control continence, support organs, assist with childbirth, and contribute to core strength.
What’s remarkable is how much these muscles do without conscious effort.
Every breath involves coordination between your diaphragm and pelvic floor.
They also contract automatically when you sneeze, laugh, or lift a grocery bag, keeping you stable and leak-free.
Even during sleep, they maintain a gentle tone to hold everything in place.
Problems arise when the pelvic floor becomes either too tight or too weak.
Tight muscles may lead to burning or difficult urination, painful sex, or constipation.
Weakness can cause leaking, frequent bathroom trips, or a sense of not fully emptying your bladder.
Because the pelvic floor connects with over 30 other muscles, issues here may also appear as back pain, hip problems, or even jaw tension.
Learning to examine your own pelvic floor empowers you to understand what’s happening in your body.
Lie down with your knees supported, and use a mirror for external observation.
With clean hands and trimmed fingernails, gently insert your index finger into your vaginal opening.
Try contracting and relaxing the muscles inside at different lengths, checking if you can hold the contraction for five seconds before fully relaxing.
Tenderness, tightness, or difficulty holding a contraction can signal areas to focus on – whether it’s strengthening or releasing.
Your pelvic floor deserves the same attention you’d give any other part of your body.
Learning to work with these muscles can be the key to reclaiming comfort, confidence, and control in your daily life.
Peak pelvic performance
Though pelvic floor issues are common, they’re not normal.
If you’re experiencing issues, seek treatment.
The good news is that not everyone needs formal therapy.
Many symptoms can improve with simple at-home changes.
It starts with the fundamentals, particularly posture.
The way you sleep, sit, and stand directly affects your pelvic floor muscles.
When sleeping on your side, stack your hips and place a pillow between your knees to keep your pelvic floor relaxed.
While sitting, keep your feet flat on the floor and avoid crossing your legs at the knees, which tightens these muscles.
Movement and breath are key, too.
Walking is one of the best low-impact exercises for pelvic health.
And how you breathe during exercise matters just as much.
Holding your breath during effort – whether lifting groceries or pooping – pressurizes your abdomen and forces that pressure downward onto your pelvic floor.
This force can weaken the muscles over time, contributing to prolapse, hemorrhoids, and leakage.
Instead, always exhale during exertion to protect your muscles from overwork and weakening.
Now, what about Kegels?
Kegels are the famous pelvic floor exercise often portrayed as a pelvic floor cure-all.
Kegels are emphatically not a cure-all – but they are important.
To perform a proper Kegel, sit tall with feet flat on the floor, and take a calming breath.
First, squeeze just the front muscles around your urethra as if stopping your urine stream, then relax.
Next, squeeze only the back muscles around your anus as if holding in gas, then relax.
Finally – and this is the actual Kegel – squeeze both front and back together while lifting everything up toward your pubic bone.
The sensation might feel like picking up a blueberry with your vagina or sucking a thick smoothie through a straw.
Equally important but rarely discussed is pelvic floor relaxation.
Without mastering relaxation, doing endless Kegels on already-tight muscles can worsen problems like painful sex, difficulty starting urination, or chronic pelvic pain.
Learning to consciously relax these muscles involves the opposite of a Kegel.
Sitting comfortably, exhale and imagine laying an egg, pushing out as if having a bowel movement, or birthing a baby.
Your perineum should bulge gently downward toward your seat.
Finally, your mental state profoundly affects your pelvic floor muscles.
Stress causes pelvic floor tension just as it creates jaw clenching or shoulder tightness.
Ensure you get regular stress relief through meditation, warm baths, or whatever helps you decompress.
Try a simple breathing exercise: take slow breaths into your ribcage while visualizing your pelvic floor gently dropping and releasing with each exhale.
The secret world of pee and poo
Sandra, a teacher nearing retirement, cherished her Saturday morning with her best friend – until frequent urges to pee started ruining everything.
She gave up coffee and started avoiding water.
But eventually, she couldn’t complete even one lap around the block without leaking.
Mortified, she considered giving up the walks she loved so much.
Nothing fixed the problem because the root cause wasn’t being addressed – her pelvic floor.
These muscles control both urination and bowel movements by tightening to hold things in and relaxing to let them out.
When they’re too weak, too tight, or uncoordinated, problems like Sandra’s emerge.
Occasional leaks can escalate to complete loss of bladder control.
Many women develop similar issues because they’ve never been taught the right way to pee.
Here’s the optimal way: sit down completely on the toilet with your feet flat on the floor, lean forward, and rest your forearms on your knees.
This position helps your pelvic floor fully relax so your bladder can empty properly.
Never push or strain when peeing, as your bladder wall is already a muscle designed to push urine out for you.
Adding extra pressure stretches your pelvic floor over time, leading to weakness and even prolapse.
Avoid doing Kegels while peeing, as this sends mixed signals to your brain and prevents complete emptying.
Go when you have the urge – every two to four hours is normal.
But definitely don’t ever go “just in case” – this trains your bladder to become overly sensitive.
Pooping, too, depends on good mechanics.
The proper pooping position involves sitting with your feet elevated on a stool so your knees are above hip level.
This relaxes your pelvic floor muscles and straightens the path for easier elimination.
While you’re going, don’t hold your breath – instead, exhale deeply.
Your poop should be soft like soft-serve ice cream – if it’s not, hydrate and increase the fiber in your diet!
If you’re constipated, it can help to support your perineum with upward pressure while bearing down.
No matter what, always go when you have the urge rather than delaying.
Sex and pregnancy
When Candace tried to have sex for the first time at sixteen, her partner kept hitting what felt like a “wall.
” Sadly, when she told her doctor about the pain, she was advised to simply “relax more.
” Like many women, she was left feeling broken, when in fact the issue was with her pelvic floor.
Painful sex and pelvic floor dysfunction can affect women at any age.
The pelvic floor must relax to allow penetration while staying engaged enough to create pleasurable sensation.
When these muscles are overly tight or in spasm, sex becomes painful or even impossible.
Causes can include chronic tension from holding urine too long, poor posture, or past trauma – physical, emotional, or sexual.
In each case, the pelvic floor responds to perceived danger by clenching protectively.
That’s why healing this pain-anxiety-tension loop requires addressing both the body and the nervous system.
Daily stretches like child’s pose, happy baby, and figure-4 can ease hip and pelvic tension.
Perineal massage can help relax the surface muscles.
To do it, gently press and stretch the vaginal opening with a lubricated thumb.
Remembering to breathe is key: deep, slow breaths help signal safety and support muscle release.
If something causes pain, pause rather than push through.
Pregnancy brings a whole new set of pelvic floor challenges.
Hormonal shifts, discomfort, and fears about harming the baby can create or worsen pelvic floor tension.
Finding pain-free sex positions – like side-lying or hands and knees – plus using pillows for support, helps keep intimacy possible.
Unless you are advised otherwise, sex is safe during pregnancy, and the baby remains well protected.
Childbirth profoundly affects sexual health, but preparation can minimize trauma to the pelvic floor.
Contrary to popular belief, strong pelvic floor muscles don’t push the baby out – the uterus does.
The pelvic floor must relax and stretch to allow passage.
To prepare, begin perineal massage starting at thirty-four weeks of pregnancy.
Additionally, learning to breathe rather than hold your breath while pushing out helps prevent severe tearing.
Practice different pushing positions.
The lithotomy position – lying on back with feet in stirrups – limits pelvic mobility.
Instead, side-lying often results in less severe tears.
Movement during labor, warm compresses on the perineum, and avoiding breath-holding all protect the pelvic floor during this intense experience.
Birth and after
Recovery after childbirth and the transition through menopause are two of the most under-supported phases of a woman’s life – especially when it comes to pelvic health.
Postpartum, the body undergoes massive hormonal shifts.
Estrogen and progesterone drop sharply, while oxytocin and prolactin surge.
Tissues are healing from stretching, tearing, or incisions.
Yet women are often cleared for full activity at six weeks – far too early for most.
Recovery needs to be gradual.
Start with “quick flick” Kegels lying down.
Squeeze the pelvic muscles as if stopping urine, hold for one second, and release.
In week two, progress to three-to-five-second holds while seated.
By week three, add standing exercises and gentle bridges – lie on your back, lift your hips, and engage your pelvic floor.
Only increase intensity if there’s no pain, pressure, or leaking.
Bowel and bladder habits also need attention.
Use a stool to elevate your feet when pooping, exhale as you bear down, and gently support the perineum or cesarean incision with a piece of toilet paper or your hand.
Don’t delay the urge to go – it worsens constipation.
To help urinate, use a peri bottle with warm water or sit backwards on the toilet to redirect flow and reduce stinging.
In midlife, another transformation begins.
During perimenopause and menopause, estrogen, progesterone, and testosterone decline.
This leads to thinner vaginal tissues, increased dryness, decreased muscle tone, and higher risk of prolapse, leakage, and painful sex.
These changes aren’t inevitable, and they’re not permanent.
To care for your pelvic floor in this stage, start with hydration and daily vulvar moisturizers.
Use lubricant during sex and consider topical estrogen if dryness or tearing occurs.
Walk daily and strength-train two to four times a week.
Incorporate long-hold Kegels – up to 30 seconds – into your routine, and squeeze your pelvic floor during coughs, sneezes, or lifting.
This reflex strengthens over time.
Avoid straining during bowel movements and consider internal supports like pessaries if prolapse symptoms appear.
Imagine feeling like you’re sitting on a golf ball.
Or that your underwear is made of sandpaper.
Or that your clitoris has turned into a live wire.
Managing the pain
Strange as they may sound, these sensations are surprisingly common.
About one in four women will experience unexplained pelvic pain in her lifetime.
Pain is the body’s alarm system, but with chronic pelvic pain, the signal often gets stuck.
The original cause may be long gone, but the pain lingers, becoming more intense over time and often bringing anxiety, muscle tension, and fatigue along with it.
The pudendal nerve is often the central player in this story.
Winding through the pelvic floor, it governs both sensation and function in some of the body’s most sensitive areas.
Too much pressure – say, from a bike seat, childbirth, or squats – and this nerve can become hypersensitive.
The result might be burning, stabbing, or numbness that makes even gentle touch feel unbearable.
Breaking the cycle starts with a four-step pain protocol.
Step one is to track the pain.
When, where, and under what conditions does it show up?
Over time, attentive logging can reveal subtle patterns.
Maybe tight jeans aggravate it.
Maybe it always shows up after a spin class, or right before a bowel movement.
Step two: pause the triggering activity.
Once a pattern emerges, it’s time to take a temporary break from whatever seems to be aggravating the issue.
That doesn’t mean quitting the things you love forever.
But it does mean listening to your body when it’s asking for rest.
Step three is all about relaxing the pelvic floor.
Chronic pain and muscle tension feed each other, so softening tight pelvic muscles is essential for easing symptoms.
Try deep breathing, gentle stretches, and manual muscle release using tools like massage balls or internal wands.
And finally, step four: return to triggering activities slowly and mindfully, staying just under your pain threshold.
Don’t rush back to your regular routine all at once.
Choose one specific trigger – like wearing jeans or sitting for long stretches – and reintroduce it in small, controlled increments.
If symptoms flare, stop and reset.
Caring for the pelvic floor isn’t about perfection – it’s about consistent, informed choices.
Perhaps the most radical element is to refuse to accept that pelvic pain is just a normal part of being a woman.
Relief is your right – and the time to claim it is now.
Final summary
In this Blink to Floored by Sara Reardon, you’ve learned that pelvic floor health is essential to core bodily functions, from going to the bathroom to sex, childbirth, and stability.
Many common discomforts “down there” stem from muscles that are too tight, too weak, or poorly coordinated.
Posture, breath, stress, and daily habits shape pelvic health, and symptoms like leaking, pain, or urgency aren’t just annoying – they’re signals worth addressing.
With tools like Kegels, pelvic floor relaxation, proper toileting mechanics, and intentional recovery after childbirth or menopause, you can prevent or reverse dysfunction.
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See you in the next Blink.