Your Cart is Empty
The Pelvic Floor in Women and Men
Foreword
This pelvic floor guide draws on my decades of experience as a midwife, certified pelvic floor therapist and psychotherapist — with extensive hands-on practice treating pelvic floor issues in women and men, including the psychological aspects that are often overlooked. Thanks to numerous links to clinically relevant topics, effective medical devices and proven exercises, this guide offers real added value compared with AI-generated articles.
The pelvic floor is a hidden treasure. Understanding it — and harnessing its strength — is a win for everyone. It’s a complex system of muscles and connective tissue that closes the body at the bottom, and it does far more than most people realise.
Often ignored in everyday life, it is nevertheless crucial for overall wellbeing: it is literally our foundation. It supports upright posture, helps with lifting and carrying, seals our body openings and plays a central role in continence and sexuality.
To do all this, the pelvic floor muscles must contract, release and also respond reflexively. A healthy pelvic floor is a centre of strength — physically and emotionally.
It’s worth paying attention to this “fundamental” region early — not only once symptoms appear.
Contents:
Anatomy and function of the pelvic floor
The female pelvic floor: what’s different
The male pelvic floor: what’s different
Symptoms of pelvic floor dysfunction
Common causes
What is pelvic floor training?
Pelvic floor and psyche — a deep connection
Specialists who can help
Anatomy and function of the pelvic floor
To understand the pelvic floor (also called the perineum), it helps to look at the bony pelvis — the pelvic ring. It’s an elliptical structure at the base of the trunk: the pubic bone and symphysis in front, the iliac wings to the sides, and sacrum and coccyx at the back. The pelvic floor is “suspended” between these points.
Although the word “floor” suggests a flat plate, the pelvic floor is more like a shallow bowl facing downward. Ideally it’s both strong and elastic — think of a trampoline.
The state of the pelvic floor affects the whole body: if it’s too weak or too tight, posture, breathing, movement and even emotional experience can be impacted. Conversely, posture and breath influence the pelvic floor. Two quick examples: with shallow breathing the diaphragm and pelvic floor barely move; with locked knees the body — pelvic floor included — tends toward tension.
In all bodies, the pelvic floor performs essential tasks:
- It closes the trunk at the bottom and supports internal organs like the bladder and bowel.
- It helps control urinary and bowel function.
- Together with abdominal and back muscles, it enables upright posture and gait.
- It plays a key role in sexual sensation and pleasure.
The female pelvic floor: what’s different
Anatomy: The female pelvic floor is adapted to pregnancy and birth. It contains a higher proportion of connective tissue, which tends to increase with each birth (muscle fibres can remodel into connective tissue). Unlike muscle, connective tissue can’t be “trained” much; it improves mainly with time and hormonal processes.
The female pelvis is wider with a more open pubic angle so the baby’s head can pass during birth. The pelvic floor must span a larger area and surround three openings — urethra, vagina and anus — a bigger challenge for strength and elasticity.
It also responds to hormonal fluctuations over the cycle. Around menstruation and ovulation it’s often softer and less stable.
Function: In women, the pelvic floor supports bladder, bowel and uterus — and during pregnancy the growing baby. It enables vaginal birth and is central to sexual pleasure via erectile tissue around the clitoris and the anterior vaginal wall. Pregnancy and recovery postpartum place special demands on it.
Good to know:
– Certain sports (e.g., trampoline) or poor movement patterns can overload the vagina and pelvic floor.
– Birth injuries and scars can make training and body awareness more difficult.
The male pelvic floor: what’s different
Anatomy: In men, the pelvic floor is more compact because the bony pelvis is narrower. It surrounds two openings: urethra and anus. It contains less connective tissue and relatively stronger muscle.
Function: It is central to erection and ejaculation. Contraction reduces venous outflow and increases pressure within erectile tissue. After prostate surgery it’s crucial for continence. Well-conditioned muscles help prevent incontinence and support prostate function.
In short, the pelvic floor — female or male — is much more than a “muscle plate”: it’s a dynamic centre linking posture, breath, sexuality and wellbeing.
Symptoms of pelvic floor dysfunction
The most common sign is incontinence — usually urinary. Stress incontinence is widespread: with sneezing, coughing or laughing (sudden pressure on the bladder) urine may leak. Women are affected particularly after childbirth or in menopause; in men it often appears after prostate surgery.
Bowel incontinence is less common, but can also occur when the pelvic floor is weakened.
In women, pelvic floor weakness can lead to uterine descent or vaginal prolapse. A cystocele (bladder prolapse) or rectocele is also possible — the latter can occasionally affect men.
A weak pelvic floor also influences posture: many people adopt a slumped stance, which can contribute to chronic low-back pain.
Sex can be affected too. Women may notice reduced sensation or a feeling of “too much space” — a sign of laxity. The so-called “lost penis syndrome” describes intercourse with low sensation for both partners. In men, pelvic floor weakness can be linked to erectile dysfunction or reduced sexual sensation.
Common causes
Causes are varied and affect women and men alike. Often they build up over time; sometimes they’re triggered by acute events.
In all genders, common contributors include:
- Poor posture or a mostly sedentary lifestyle without movement balance weaken support over time.
- Heavy physical work, poor lifting or unfavourable sport patterns can overload the muscles.
- Surgery or injury affecting pelvic muscles or nerves directly impair function — in men particularly after prostate procedures.
- Excess weight chronically loads the support system.
- Chronic cough (e.g., asthma or COPD) repeatedly spikes intra-abdominal pressure.
- Constipation or straining on the toilet can overburden and weaken the pelvic floor.
- Inherited connective-tissue laxity increases the risk of prolapse or incontinence.
In women, additional factors include:
- Pregnancy and birth — natural yet demanding processes. Without targeted rehab, they can leave weakness or functional changes.
- Menopause: falling oestrogen alters tissue quality and tone, gradually weakening support.
What is pelvic floor training?
Effective training starts with awareness: you can only activate muscles you can feel.
A holistic plan should be tailored to your symptoms and severity, addressing female and male anatomy alike.
Training doesn’t have to be only active exercises: passive stimulation with suitable tools can help too. This makes it easy to integrate training discreetly into daily life — comfortable and, if you like, sensual.
I offer a selection of products developed to meet therapeutic standards. All are certified medical devices designed for safe, effective use.
The payoff of consistent training: healthier posture, prevention or relief of back pain, stable continence, healthy pelvic organs and a vibrant sex life.
Men often benefit from improved erection quality by activating muscles around the prostate. A strong pelvic floor also boosts self-confidence — posture, presence and charisma all change for the better.
Pelvic floor and psyche — a deep connection
The pelvic floor sits at the body’s centre — and centrally influences our emotional balance. Issues like incontinence, pressure or prolapse often lead to shame, insecurity and withdrawal. Sexual life can suffer too — through pain, low desire or avoiding intimacy — which strains relationships and self-image.
Posture is affected as well: if the muscles are weak, staying upright is harder. A slumped posture alters mood and how others perceive us: less present, less powerful. Body posture always reflects inner state — and vice versa.
Conversely, stress, anxiety or traumatic experiences often show up directly in the pelvic floor. Chronically increased tone can contribute to problems like vaginismus, anal spasm or pain with intercourse. The pelvic floor isn’t only muscular — it also stores emotional tension.
To help release these physical and emotional tensions, we’ve developed a dedicated product line that supports you — regardless of gender: Theros® YoniSphere (usable vaginally and rectally) and Theros® ProstaSphere (rectal). Both tools enable a gentle, effective pelvic floor (perineal) massage, from outside and inside, addressing body and mind at the same time.
Regular practice doesn’t just improve physical function — it also builds trust and inner stability. It refines body awareness and supports self-confidence, physically and emotionally. In this way the pelvic floor becomes a true source of inner strength.
In yoga this link has long been recognised: the first chakra, the root chakra (Muladhara), lies in the perineal area. It stands for basic trust, grounding, life energy and safety. Working consciously with this centre — via breath, movement or meditation — can stabilise body and mind alike.
Specialists who can help
You can consult different professionals for pelvic floor issues:
Medical practices:
- Gynaecology
- Uro-gynaecology
- Proctology
- Colo-proctology
- Urology
Where to start depends on your symptoms: for gynaecological topics such as a foreign-body sensation, downward pressure or urinary incontinence, gynaecology or uro-gynaecology is right. For prostate issues, see urology. If your problem is bowel-related, proctology/colo-proctology is appropriate.
Body-therapy practices:
- Physiotherapy — ideally with pelvic floor specialisation
- Osteopathy
- Midwives
- Possibly naturopaths
Midwives are the right address for pelvic floor issues during pregnancy and postpartum; for all other cases, the other professions listed above can help.
Related guides you might like:
Leave a comment
Comments will be approved before showing up.
