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8 Steps To Optimizing Your Pelvic Floor Health At Every Age
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Most people never think about their pelvic floor until something goes wrong. Bladder leaks, painful sex, constipation, and even back pain can all be traced back to this critical (yet wildly under-discussed) group of muscles.
And according to Sara Reardon, PT, DPT (aka The Vagina Whisperer) it’s time we finally gave the pelvic floor the attention it deserves.
On the mindbodygreen podcast, Reardon, a board-certified women’s health physical therapist and leading voice in pelvic floor care, walks us through what these muscles do, how to assess your own pelvic health, and why caring for your pelvic floor is crucial at every life stage—from your first period to post-menopause.
Here are some of the biggest takeaways from our conversation.
1. What is the pelvic floor & why does it matter?
If you’re not totally sure where your pelvic floor is, you’re not alone. “Most people aren't even aware that they have one,” Reardon says. But this sling of muscles at the base of the pelvis is responsible for supporting your pelvic organs (like your bladder, uterus, and rectum), helping control when you use the restroom, and playing a key role in sexual and reproductive health.
Yet despite its many jobs, the pelvic floor often gets ignored until symptoms show up.
2. Common signs your pelvic floor needs support
Pelvic floor dysfunction can show up in many ways. Some of the most common symptoms include:
- Bladder leaks (especially when sneezing, laughing, or exercising)
- Difficulty holding it in when you need to pee
- Painful intercourse
- Constipation or straining during bowel movements
- Pelvic heaviness or pressure
These symptoms are incredibly common, especially during postpartum and menopause, but they’re not normal. As Reardon puts it, we need to stop normalizing dysfunction and start normalizing conversations.
3. Kegels aren’t a cure-all
Kegels get a lot of hype, but they’re not right for everyone. “It’s like saying if you have back pain, just do crunches,” Reardon explains. While kegels (aka pelvic floor contractions) can be useful for building strength, many people actually have too much tension in their pelvic floor and need to focus on relaxation instead.
If you’re leaking urine or experiencing pelvic organ prolapse, strengthening might help. But if you’re dealing with painful sex, frequent urination, or trouble emptying your bladder, it could be a sign your muscles are too tight, and kegels could make things worse.
4. Breathwork is your pelvic floor’s best friend
Surprisingly, one of the best tools for pelvic floor health isn’t a complicated workout—it’s your breath. The diaphragm and pelvic floor work together like the top and bottom of a soda can. When you breathe in, the diaphragm flattens and the pelvic floor relaxes. When you exhale, the pelvic floor contracts and lifts.
Holding your breath during workouts can create excess tension in the pelvic floor. Reardon’s tip? “Exhale on exertion.” Whether you’re squatting, lifting weights, or doing crunches, be sure to breathe out and gently engage your pelvic floor as you move.
5. Bathroom habits matter more than you think
It turns out your bathroom habits say a lot about your pelvic health. Here are a few key takeaways from Reardon’s expert advice:
- Don’t hover over toilets. Sitting fully helps relax your pelvic floor so your bladder can empty properly.
- Don’t power pee. Pushing urine out can strain the pelvic floor. Let your bladder do the work.
- Use a stool for pooping. A squatty potty or footstool helps get your body in the right position to empty without straining.
- Exhale as you poop. Just like in the gym, don’t hold your breath. It helps relax those muscles and reduces risk of prolapse.
6. Know your phase of life & adjust accordingly
Your pelvic floor doesn’t stay the same throughout life. Hormones, pregnancy, birth, aging, and menopause all impact how your pelvic floor functions. That’s why Reardon wrote her book, Floored: A Woman’s Guide to Pelvic Floor Health at Every Age and Stage, to help people understand what’s happening in their bodies and how to support those changes.
Teens & 20s: Early awareness matters
Your first period is an early window into your pelvic health. Reardon explains that if your menstrual cramps are extreme, your periods leave you doubled over, or inserting a tampon is painful, it’s worth investigating. These symptoms could signal pelvic floor tension or underlying conditions like endometriosis or adenomyosis.
As young people become sexually active, Reardon emphasizes that sex should not be painful. Discomfort, tightness, or inability to relax can be early signs of pelvic floor dysfunction—yet these issues are often dismissed or normalized.
Pregnancy & postpartum: A critical window
Reardon explains how pregnancy stretches and weakens the pelvic floor. Over nine months, the body undergoes enormous changes—more pressure on the bladder, increased blood flow, hormone shifts, and a growing uterus that pushes down on the pelvic floor like a hammock under tension.
Then comes birth. Whether vaginal or cesarean, delivery can lead to scarring, tearing, weakness, or nerve damage. And yet, postpartum care in the U.S. is largely limited to a single six-week checkup, usually with zero assessment of pelvic floor recovery.
“At six weeks postpartum, your pelvic floor is still functioning at less than 50%,” Reardon notes. “Yet women are told to resume sex, exercise, and their daily routines without any guidance or rehab.”
She strongly advocates for pelvic floor physical therapy during pregnancy and as a standard part of postpartum care, much like physical therapy after knee surgery or a C-section.
Perimenopause & beyond: Don’t wait to act
With age, hormone levels decline, and so does muscle tone. Estrogen receptors in the vulva and vaginal tissue become less active, leading to dryness, irritation, and changes in bladder sensitivity. You might notice you’re peeing more often, waking up at night to use the bathroom, or feeling less control overall.
Strength training becomes especially important here, not just for your glutes and core, but for your pelvic floor too. Reardon recommends resistance training, breathwork, and, in some cases, local estrogen cream to maintain tissue elasticity and reduce irritation.
Pelvic care doesn’t end with childbirth or menopause. It’s a lifelong relationship. The earlier you start paying attention, the better you’ll feel across every chapter.
7. What needs to change & how to start
Reardon is passionate about improving care, not just through education, but systemic shifts in how we approach birth, postpartum recovery, and menopause. She advocates for pelvic floor therapy during pregnancy, routine postpartum check-ins with pelvic PTs, and better support in the workplace and healthcare system.
Pelvic floor problems shouldn’t be brushed off, minimized, or treated as inevitable. They’re real, common, and, most importantly, treatable.
The takeaway
Pelvic floor health affects a wide range of aspects of life, from exercising to using the bathroom and being intimate. Whether you’re 18 or 80, it’s never too late (or too early) to start caring for this critical part of your core.