‘At 29, I realised nobody had ever taught me how my pelvic floor actually works’ | Health News

I knew how contraception worked. I knew what a Pap smear was. I knew, roughly, where my uterus sat. But at 29, as a woman facing health issues while living alone and working in a big city, I couldn’t have pointed to my pelvic floor, let alone explained what it did.I didn’t know it helped me urinate, have bowel movements, or hold my organs in place. Like a lot of women, I only started learning about it when something felt off in my own body: a sudden urgency to reach a bathroom. I went looking for answers about a symptom. What I found was an entire system of the body that no one had ever mentioned to me, not in school, not in a gynaecolog’s office, not in the endless stream of ‘women’s health’ content I’d consumed over the years.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
Rate of pelvic floor disorders 56.7%
What’s surprising is that this isn’t uncommon. A 2024 study titled ‘Female Pelvic Floor Disorders in Northern India: Uncommon or Underreported?’ published in Cureus states that in Uttarakhand, “it was found that the prevalence of pelvic floor disorders was 56.7%.” The study stressed why pelvic floor disorders are underreported in our country, with authors mentioning, “Pelvic floor disorders in females are common but hidden. Its prevalence varies with the area, ethnicity, and population being studied.”
Another 2019 study titled ‘Prevalence of Pelvic Floor Dysfunction among Women in South India’ published in the International Journal of Nursing Education noted that 54.7 per cent of women in Tamil Nadu “were identified to have any one of the pelvic floor muscle dysfunction.” It added, “The present finding was supported the studies conducted in rural India with prevalence of pelvic floor dysfunction ranging from 38% to 50.8%.”
It wasn’t just me
Mehak Malhotra, 33, knew about the pelvic floor in the abstract, through her work, but says no one explained during her pregnancy or after her vaginal delivery how much it would shape her recovery. She developed mild urinary leakage postpartum and, because she understood it was linked to childbirth, didn’t dismiss it – she raised it at a follow-up visit, was given targeted pelvic floor exercises, and recovered fully. Still, she wishes the education had come earlier. “The postpartum period is already physically and emotionally challenging,” she told , “so even a minor problem can feel overwhelming at that time.”
Hiteshree M Dudani, 27, had picked up fragments of pelvic floor knowledge from blogs and Instagram reels – never anything systematic. Her symptoms began as lower back pain after a termination for medical reasons (TFMR). A physiotherap told her it was normal. Gynaecologs and other women told her the same: that this was simply something she’d have to live with for the rest of her life. It took eight months, a chance conversation with a physiotherap friend, and an eventual referral to a pelvic floor special for things to shift. She learned her body had been guarding itself after trauma, was taught how to release that tension – and within a week, her symptoms began improving. “The solutions were so simple,” she said, “and yet I had continued to suffer for eight months because I was told this is normal, and every woman goes through it.”Story continues below this ad
Nupur Vig, 34, started experiencing urinary incontinence at just seven weeks pregnant and lived with it for eleven weeks. It didn’t feel normal to her, but her gynaecolog and other mothers around her insed it was. A friend eventually pushed her toward a pelvic floor physiotherap, who explained what was actually happening. Her advice to other women now is, “If it doesn’t feel normal, it isn’t. Early intervention is key. It does not have to be a huge problem for you to go see a doctor. Pain or inconvenience is a sign that you need help.”
Three different women, three different triggers – childbirth, pregnancy, and pregnancy loss – and the same pattern each time: symptoms appearing, being waved off as normal the people they trusted most, and real relief only arriving once someone finally pointed them toward a pelvic floor special.
This raises an obvious question: why are we taught, in granular detail, about periods, pregnancy and contraception – but almost nothing about the muscles doing so much of the work underneath it all?
Why don’t women know about their pelvic floor?
Dr Snehal Kohale, a fertility special and gynaecolog, has felt the framing itself is the problem. Pelvic floor health, she told , has horically been folded into conversations about pregnancy, childbirth or ageing – which unintentionally teaches women that it’s a topic to think about later, not now. In reality, the pelvic floor is a group of muscles and connective tissue involved in bladder and bowel control, organ support, sexual function and overall pelvic stability. When it isn’t functioning well, the result can be anything from urinary leakage to pelvic organ prolapse, sexual dysfunction or chronic pain.Story continues below this ad
There’s a second, quieter reason the topic stays buried: shame. Dr Kohale pointed out that many women simply normalise what they’re experiencing – leaking urine during a workout, pain during sex, straining on the toilet – filing it under “things you just live with” rather than symptoms worth mentioning to a doctor. According to Dr Prathima A, a consultant obstetrician-gynaecolog and urogynaecolog at Motherhood Hospitals, Bengaluru, symptoms such as leakage or pelvic pressure often come with embarrassment, and because they tend to develop gradually, many women assume they are simply a normal part of getting older. Added to that is a genuine knowledge gap among patients and, at times, healthcare providers.
It’s worth noting that this isn’t just a cultural failing; it’s a documented policy gap. Dr Kohale explained that the UK’s NICE Guideline NG210, which covers women from age 12 onward, explicitly recommends better public awareness of pelvic floor dysfunction – its symptoms, risk factors, prevention and when to seek help – and specifically calls for education for girls aged 12 to 17 on pelvic floor anatomy and muscle function. In other words, health bodies already agree that this should be taught early. It mostly isn’t.
Pelvic floor health has nothing to do with age but everything to do with knowledge (Source: AI Generated)
It’s not just a postpartum issue
If there’s one myth doing the most damage, it’s this: that pelvic floor dysfunction is something that happens to mothers.
“Pelvic floor dysfunction is not exclusively a postpartum condition,” Dr Kohale says. “A woman does not need to have been pregnant or to have given birth to experience pelvic floor-related symptoms.” The fact that NICE guidance applies from age 12 is itself the point — this is a lifespan issue, not a postnatal one.Story continues below this ad
Dr Prathima said she sees it regularly in her clinic. “We frequently see younger and even nulliparous women – women who have never given birth – with pelvic floor disorders,” she said, ling urinary urgency, overactive bladder, pelvic pain, painful intercourse and constipation among the presentations. The causes are varied: high-impact sport, weightlifting done with poor technique, chronic constipation, chronic cough, obesity, prior pelvic surgery, connective tissue conditions, stress – even conditions like endometriosis. “You don’t need to have delivered a ba to have pelvic floor dysfunction,” she said.
Dr Saurabh Singh, therapy head at Marengo Asia Hospitals, Gurgaon, said that everyday lifestyle patterns are doing a lot of the damage in younger women specifically: chronic stress that builds muscular tension, improper exercise routines, prolonged sitting, poor posture, habitually holding urine or stool, and even excessive core-bracing during workouts. None of it announces itself. It accumulates quietly, “with no obvious warning signs,” until it doesn’t.
Dr Anuja Chandrana, a pelvic health physiotherap and board-certified neurological clinical special, is even more direct about where modern lifestyles go wrong. In her view, the single biggest contributor to pelvic floor dysfunction in younger women is simply sitting for long hours – compounded a lack of mobility-focused movement, low fluid and fibre intake leading to constipation, and an “unregulated nervous system” driven chronic stress.
The symptoms nobody connects
This is the part of the conversation where most women start recognising themselves — often uncomfortably.Story continues below this ad
Across every expert I spoke to, a similar l emerged: urine leakage with coughing, sneezing, laughing or exercise; a sudden or frequent urge to urinate; difficulty inserting a tampon; constipation and straining; a sense of pelvic heaviness or pressure, especially after standing or lifting for too long; pain during sex; and unexplained lower back or tailbone pain.
Dr Prathima explained that waking up repeatedly at night to urinate, recurring UTIs, or persent lower back discomfort are the kind of things that get quietly absorbed into a busy life rather than flagged as a pattern. “Many dismiss these symptoms as just ageing, as normal after childbirth, or as something everybody experiences,” she said. “These symptoms are actually your body’s way of telling you that something is wrong.”
Dr Kohale is careful to add an important caveat here: not every one of these symptoms means pelvic floor dysfunction. Urinary symptoms can stem from infections; pelvic pain can have gynaecological, gastrointestinal, musculoskeletal or neurological roots. The point isn’t self-diagnosis; it is simply refusing to let persent symptoms go unexamined. “Proper clinical assessment is important in place of self-diagnosis,” she said.
Pelvic floor isn’t always ‘weak’
Here’s the tw almost nobody expects: the pelvic floor doesn’t only fail being weak. Often, it fails being too tight to function at all.Story continues below this ad
Dr Chandrana has broken the pelvic floor’s job down into what she calls the “5 S’s” – support of the pelvic organs, sexual function, sphincteric control (relaxing to release, contracting to hold), lymphatic “sump and pump” drainage, and stability for the trunk and hips. Crucially, several of these roles depend on the muscles relaxing, not just contracting. “If they are tense and can’t move through their complete range of motion, they cannot get strong,” she said.
That tension has a name: hypertonic, or overactive, pelvic floor. Dr Singh described it simply as muscles that are “too tight or can’t tighten properly,” often the result of chronic stress, prolonged sitting, high-impact or improperly executed exercise, poor posture, or habitually holding urine or stool. Dr Chandrana said hypermobility syndromes and even jaw-related injuries are on the l of triggers — a reminder of how connected the body’s tension patterns really are.
The consequences of an overactive pelvic floor read like a mirror image of “classic” weakness symptoms: pelvic pain, painful intercourse, vaginismus, difficulty emptying the bladder or bowel, constipation, increased menstrual pain, and paradoxically, urinary urgency and incontinence too.
The most-repeated piece of advice across every expert I interviewed is this: stop assuming Kegels are the answer. “Kegels are probably the biggest misconception,” said Dr Chandrana. “A Kegel is simply a focused exercise on a small group of muscles… which will very often make dysfunction worse, especially if the person has a hypertonic pelvic floor.” Dr Singh asserted, “Not all women benefit from pelvic floor strengthening exercises — especially those women with overactive or tight pelvic floor muscles. In this case, Kegels can make symptoms worse.”Story continues below this ad
What helps
The reassuring part of this was how consently every clinician described the path forward, and how undramatic it actually is.
First: assessment isn’t scary. Dr Prathima described a pelvic floor consultation as mostly conversation, with questions about bladder habits, bowel patterns, exercise, stress, and medical hory, with a physical exam happening only when symptoms warrant it, and always with consent and clear explanation. “It is nothing to be ashamed of,” she said. Echoing a similar view, Dr Kohale said the goal of an assessment is to understand the problem, “in place of making the woman feel uncomfortable or judged”.
Second: treatment is individualised, not one-size-fits-all. Some women need strengthening; others need to learn to release tension and coordinate the muscles properly; many need both, alongside changes to posture, breathing and daily habits. Dr Singh recommended that women in their 20s and 30s avoid unnecessary straining, keep exercise balanced rather than purely strength-focused, and manage stress – with early physiotherapy input to prevent long-term issues. Dr Chandrana’s advice is similarly practical: don’t let yourself get constipated, build in mobility work several times a week alongside strength training, get up from your chair every 20–30 minutes, and actively tend to your nervous system.
Third, and maybe most important: this isn’t a niche concern. Dr Kohale has called for pelvic floor education to be a routine part of women’s healthcare, not something confined to postnatal appointments. Dr Prathima wanted it to be taught with the same seriousness as breast health or cervical cancer screening. “Pelvic floor health has nothing to do with age but everything to do with knowledge,” she says. “The sooner a woman knows about it, the healthier she will always stay.”Story continues below this ad
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.