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The pelvic floor: structure, muscles and function
The pelvic floor is a true treasure. Understanding it and harnessing its power is a huge benefit for everyone. The pelvic floor is a complex system of muscles and connective tissue that forms the lower part of our body—and does far more than most people realize.
Often overlooked in everyday life, it is nevertheless crucial for our overall well-being: It literally forms our foundation. The pelvic floor ensures our upright posture, supports us when lifting and carrying, closes our body openings, and plays a central role in continence and sexuality.
To fulfill all these functions, the pelvic floor muscles must be able to contract, relax, and react reflexively. A healthy pelvic floor is a powerhouse—both physically and mentally.
It is therefore worth paying attention to this “fundamental” body region at an early stage – not only when symptoms arise.
Contents:
Anatomy and function of the pelvic floor in women and men
The pelvic floor and its foundation
To understand the pelvic floor, it's worth taking a look at the bony pelvis – the so-called pelvic ring. This is an elliptical structure in the lower part of our torso. At the front is the pubic bone, with the symphysis pubis in the middle, a fibrocartilaginous connection. To the sides are the iliac bones, and at the back are the sacrum and coccyx. The pelvic floor is suspended between these points.
Although the term "pelvic floor" suggests a flat structure, it's more like a downward-curved bowl. Ideally, it's strong yet elastic—comparable to a trampoline.
The condition of the pelvic floor affects the entire body: If it's too weak or too tense, it can affect posture, breathing, movement, and even emotional experience. Conversely, posture and breathing also affect the pelvic floor. Two simple examples: If I breathe shallowly, my diaphragm and pelvic floor barely move. If I stand with my knees straight, my entire body—including my pelvic floor—is more likely to be tense.
Common functions of the pelvic floor
Whether female or male: The pelvic floor performs fundamental functions for our body:
- It closes the torso at the bottom and holds the internal organs such as the bladder and intestines in place.
- It controls the excretory processes of the bladder and intestines.
- Together with the abdominal and back muscles, it enables us to maintain an upright posture and walk upright.
- It plays an important role in sexual experience and desire.
The female pelvic floor: special features
Anatomy: The female pelvic floor is adapted to the biological demands of pregnancy and childbirth. It consists largely of connective tissue, which increases with each birth—because muscle fibers can transform into connective tissue. Unlike muscle, connective tissue is difficult to train; it regenerates primarily through time and hormonal processes.
The female pelvis is wider, with a more obtuse pubic angle to allow for the fetal head to pass through during birth. The pelvic floor muscles must therefore span a larger area and encompass three openings: the urethra, vagina, and anus—presenting a significantly greater challenge in terms of strength and elasticity.
In addition, the female pelvic floor reacts to hormonal changes during the menstrual cycle. It is noticeably softer and less stable, especially during menstruation and around ovulation.
Function: In women, the pelvic floor supports not only the bladder and bowel, but also the uterus and, during pregnancy, the developing fetus. It enables vaginal birth and plays a key role in sexual desire – via the erectile tissue structures in and around the clitoris and the anterior vaginal wall. It is particularly stressed during pregnancy and postpartum recovery.
Important to know:
- the vagina and pelvic floor are heavily stressed by certain sports, such as trampoline jumping or by incorrect execution of movements
- Birth injuries / scars can make training or perception difficult
The male pelvic floor: special features
Anatomy: In men, the pelvic floor is more compact due to the narrower bony structure of the pelvis. It encloses only two openings: the urethra and the anus. Male pelvic floors consist of less connective tissue and contain more powerful, functionally developed muscles.
Function: The male pelvic floor plays a central role in erection and ejaculation. Targeted contraction reduces blood flow and increases pressure in the corpora cavernosa. The pelvic floor is also crucial for continence after prostate surgery. Well-trained pelvic floor muscles help prevent incontinence and support prostate function.
The pelvic floor – whether male or female – is much more than a "muscular floor": it is a dynamic power center that connects posture, breathing, sexuality and well-being.
Symptoms of pelvic floor weakness
The most common sign of pelvic floor weakness is incontinence – usually in the form of urinary incontinence. Stress incontinence is particularly common: When sneezing, coughing, or laughing – i.e., when sudden pressure is placed on the bladder – urine can no longer be reliably retained. While women are particularly affected after childbirth or during menopause, this form of incontinence often occurs in men after prostate surgery, such as a prostatectomy.
Bowel incontinence is much rarer, but it can also occur as a result of weakened pelvic floor muscles.
In women, pelvic floor weakness can lead to uterine prolapse or vaginal prolapse. Bladder or bowel prolapse is also possible—the latter can also affect men in individual cases.
A weakened pelvic floor also affects posture: many sufferers have a slumped posture, which can lead to chronic back pain – especially in the lumbar spine area.
Pelvic floor weakness can also cause discomfort during sex. Women often experience a loss of sensation or the feeling that the vagina is "too wide" – an indication of weakened pelvic floor muscles. The so-called "lost penis syndrome" describes a situation in which neither woman nor man feels much during intercourse. In men, pelvic floor weakness can be associated with erectile dysfunction or reduced sexual sensation.
Causes of pelvic floor problems
The causes of pelvic floor problems are varied and affect both women and men. They are often the result of long-term stress on the pelvic structures or are triggered by sudden events.
The following factors are among the most common triggers for both sexes :
- Poor posture or a predominantly sedentary lifestyle without sufficient movement compensation weakens the supporting function of the pelvic floor in the long term.
- Physical strain – such as heavy physical work, incorrect lifting or unfavourable movement patterns in certain sports – can overtax the muscles or create incorrect tension.
- Surgeries or accidents in which the muscles or nerve tissue in the pelvic area are injured or irritated directly impact the function of the pelvic floor. In men, this particularly includes prostate surgery.
- Being overweight leads to chronic overloading of the pelvic floor, as the additional body weight permanently affects the support system.
- Chronic coughing – for example in respiratory diseases such as asthma or COPD – permanently increases intra-abdominal pressure and puts strain on the pelvic floor every time you cough.
- Constipation or strong straining during bowel movements can also lead to overload and long-term weakening of the pelvic floor.
- Genetic connective tissue weakness can also impair the stability of the pelvic floor and increase the susceptibility to prolapse or incontinence.
In women, there are also gender-specific causes:
- Pregnancy and childbirth are natural, yet physically demanding processes. The stretching and strain on the pelvic floor during this time can lead to weakness or changes in function, especially if no targeted rehabilitation is undertaken.
- During menopause, tissue quality and muscle tone change due to declining estrogen levels. These hormonal changes can further weaken the pelvic floor – often gradually and initially unnoticed.
What is pelvic floor training?
Effective pelvic floor training begins with conscious awareness and differentiated sensation of the involved muscle groups. Only what we can perceive in our own body can we specifically address and train.
Holistic pelvic floor therapy should be individually tailored to the specific symptoms and severity. It includes targeted exercises that take into account the anatomy and physiology of both women and men.
Pelvic floor training doesn't have to consist exclusively of active muscle exercises: Passive stimulation using suitable aids can also effectively support training. This type of training can be discreetly integrated into everyday life – unobtrusive, pleasant, and sensual at the same time.
I offer a selection of products specifically developed according to my therapeutic principles. All products are certified as medical devices and designed for effective, safe use.
The results of consistent pelvic floor training can be seen and felt: an upright, healthy posture, relief or prevention of back pain, stable continence, healthy pelvic organs and a vibrant sexuality.
Men in particular benefit from improved erectile function and potency through the activation and strengthening of the muscles around the prostate. Last but not least, a strong pelvic floor often has a positive effect on self-confidence: posture, appearance, and charisma change noticeably and visibly.
The pelvic floor and the psyche – a deeper connection
The pelvic floor is located at the center of our body – and equally crucial to our mental balance. A weakened or overworked pelvic floor can have a significant impact on our emotional well-being. Symptoms such as incontinence, a feeling of pressure, or organ prolapse lead many sufferers to shame, insecurity, and withdrawal from sporting or social activities. Sexual experience can also be impaired – through pain, lack of desire, or avoidance of intimacy – which, in turn, strains relationships and weakens self-image.
The function of the pelvic floor also influences our posture: If the muscles are too weak, it becomes difficult to stand upright. A slumped posture not only changes our mood – it also affects how we are perceived by others: less present, less powerful. Posture is always an expression of our inner state – and vice versa.
The connection is also clear in the other direction: Persistent stress, anxiety, or traumatic experiences often have a physical impact on the pelvic floor. Chronically increased muscle tension can lead to symptoms such as vaginismus , anal cramps, or pain during intercourse. The pelvic floor is not just a muscular structure—it also stores emotional tension and reacts sensitively to psychological stress.
Consciously addressing the pelvic floor therefore has many positive effects. Regular exercise not only improves physical function but also builds confidence in one's own body. Training strengthens inner stability, improves body awareness, and can lead to increased self-confidence – both physically and emotionally. The pelvic floor thus becomes a source of inner strength.
This connection has long been recognized in yoga teachings: The first chakra, the so-called root chakra (Muladhara), is located in the pelvic floor area. It represents primal trust, grounding, life energy, and security. Consciously working with this energy center—be it through breathing, movement, or meditation—can not only stabilize physical functions, but also promote mental balance and strengthen the feeling of being truly anchored in one's life.
Pelvic floor specialists
You can go to various specialists with your pelvic floor issues:
Medical practices
- Gynecologist
- Uro-gynecologist
- Proctologist
- Colo-proctologist
- Urologist
It depends on your complaint. Gynecological issues such as a foreign body sensation in the vagina, downward pressure, or urinary incontinence are the right place for you. Urinary incontinence and prostate problems should be treated by a urologist. If your problem is more related to digestion, you should consult a proctologist or coloproctologist.
Body therapy practices
- Physiotherapy, especially employees who have completed further training at the AG GGUP ( therapist list )
- Osteopathy
- midwives
- possibly alternative practitioners
You go to the midwives with pelvic floor problems during pregnancy and after birth; in these and all other cases, you also seek help with the other options listed.
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