Do You Have a Weak Pelvic Floor? This Is What an OBGYN Recommends You Do First

If you’ve ever been surprised by a cough or a sneeze and had a bladder leak, you’re not alone. Many individuals experience symptoms of a weakened pelvic floor, a condition that can develop gradually due to age, childbirth or a sedentary lifestyle. But here’s the good news: starting today, you can take steps to strengthen it. And where’s the best place to start? According to Daniel Gomez, M.D., M.B.A., FACOG, FACS, a Florida-based minimally invasive gynecological surgeon, the best thing you can do is schedule an appointment with a certified pelvic floor physical therapist. “I always recommend a consultation with a pelvic health specialist,” he says. “These professionals hold doctorate-level degrees and specialize in pelvic floor disorders, offering tailored exercises and strategies to strengthen those muscles.”

The pelvic floor is a hammock of muscles and tissues that support the bladder, uterus and rectum in females, and the bladder and bowel in males. When it weakens, you might notice symptoms like involuntary urine leaks during a cough or workout, a bulging sensation in your vagina or even trouble fully emptying your bladder or bowels. Gomez explains that these signs can stem from a variety of culprits: “Increasing age, having given birth—especially multiple times—higher BMI, chronic constipation or even persistent coughing can all play a role in pelvic floor dysfunction.” For some, it’s a matter of genetics, too, with research suggesting Latino and white females may face a higher risk of prolapse than African American females.

When Should You See a Specialist? 

“Isolated small leaks can be normal,” notes Gomez, “but if it’s frequent, worsening or keeping you from living your life—like avoiding outings without a pad or panty liner—that’s a red flag.” Some even resort to “splinting” (using a finger to assist bowel movements), a sign of advanced weakness that deserves attention.

The science ties a weakened pelvic floor to excessive strain. Chronic constipation or coughing, for instance, increases abdominal pressure, stretching nerves like the pudendal nerve over time. The result? A pelvic floor that struggles to hold up—literally.

Working with a pelvic floor specialist can help you reduce your symptoms and improve your quality of life. Think of it like physical therapy for any other injury—except this targets a hidden powerhouse. Pelvic floor therapy often includes moves like Kegels (when done correctly) or breathing techniques to rebuild strength and coordination. Gomez emphasizes early action: “Not all cases require surgery, and early identification is key.” 

How Nutrition Plays a Role

When it comes to pelvic floor health, what you eat matters, too. “Nutrition plays a key role in pelvic floor health,” notes Gomez. In fact, research has shown that individuals with a disordered eating pattern—including overeating, restrictive eating and alternating between both of these—may be more prone to experience symptoms of pelvic floor disorders compared to those with a balanced eating pattern. All the more reason to prioritize a balanced, nutritious diet and a healthy relationship with food.

Gomez recommends adjusting eating habits for specific symptoms. For urinary leakage tied to bladder prolapse, reducing bladder irritants like caffeine, alcohol or spicy foods can ease symptoms. “Patients who have rectoceles—a type of pelvic organ prolapse that occurs when the rectum bulges into the vaginal wall—usually have chronic constipation,” so upping your fiber intake along with staying hydrated can make bowel movements softer and easier to pass, reducing strain on the pelvic floor.

“Adjusting diet helps not just with symptoms but also supports long-term recovery, even after surgical fixes,” adds Gomez. A fiber-rich plate doesn’t just keep things moving; it supports the structural integrity of those pelvic muscles over time.

Other Tips to Improve Your Pelvic Floor Health

Ready to take the first step? Start with Gomez’s top habit—booking that pelvic floor therapy consult. Then work on these expert-approved tips:

• Talk to your doctor: Your primary health care provider can help spot early signs during a routine exam, even if you’re shy about symptoms. “Communicate anything causing concern,” Gomez urges, “even if it may be embarrassing.”
• Never miss an annual exam: “Not all cases require surgery, and early identification and treatment is key,” says Gomez. Annual checkups can catch issues before they become too severe. 
• Move often: Regular movement, such as a daily 30-minute walk, can help maintain a healthy weight and relieve pelvic pressure. A 2024 study showed that yoga may improve pelvic floor strength and reduce incontinence. Just be cautious with high-impact exercises, as they could strain an already compromised pelvic floor.
• Fuel up on fiber: Load your plate with fiber from foods like fruits, veggies and whole grains, and stay hydrated to prevent constipation. The 2020-2025 Dietary Guidelines for Americans recommends getting between 25 and 34 grams of fiber daily, depending on age and sex.

Looking for inspiration?

20 High-Fiber Snacks to Make Forever

The Bottom Line

A weak pelvic floor doesn’t have to hold you back from living the life you envision for yourself. Schedule a visit with a pelvic floor specialist so you can feel stronger and ready to tackle that walk (or sneeze) confidently. And prioritize a high-fiber diet and good hydration to support healthy digestion and pelvic floor health.