5 tips for reducing leaks


During the menopause, the fluctuating levels of oestrogen can have an impact on your pelvic floor making it weaker. This in turn can cause women to leak with around 50% of all menopausal women reporting having this symptom.

Whilst leaking is common, it is not normal (as continence pads would have you believe)! And it is treatable!

So what can you do to help strengthen your pelvic floor? Our resident Women’s Health physio – Róisín O’Bentley – is here to give you some helpful tips!

1 – Don’t hold your breath!

The pelvic floor works with your diaphragm and abdominal muscles: When we breath in the diaphragm contracts, your ribs expand and your pelvic floor lengthens and relaxes. The opposite is true when we breath out: the diaphragm relaxes, the ribcage retracts and the pelvic floor (and abdominals) contract to “squeeze” the air out of our lungs.

If you hold your breath when lifting something heavy, or running, or straining, we’re putting more load on a muscle that is in a relaxed state, which, if already weakened from a reduction of oestrogen, can cause leaks or even prolapses.

To avoid this, whenever you’re having to exert yourself, do it on an out breath: lifting your child up? Lift on an out breath. Running? Take smaller in breaths and longer out breaths. Straining on the loo? Breath slowly out when pushing.

2 – Good ribcage movement

The body and all its muscles love to move! Often stiffness if one area can impact another area and cause pain or other problems. The ribcage works in tandem with the pelvic floor, so a stiff chest can reduce the efficacy of the pelvic floor.

So get your rib cage moving: Gentle twists, stretches and deep breaths throughout the day can make a huge difference!

3 – Wear comfy clothes

Wearing tight clothing, having a tight belt around your waist or holding your stomach in all day can reduce your abdominal muscles’ ability to contract and expand with the breath, therefore creating discord between your core muscles and pelvic floor.

By simply wearing more comfortable clothes and avoiding tight waste bands and not holding our tummies in, it allows for your core muscles and pelvic floor to work in synergy with each other, thus allowing everything to work for effectively.

4 – Do your kegels with your breath

Pelvic floor exercises (a.k.a kegels) are a great way to help strengthen your pelvic floor (not sure how to do them? read my blog here for advice), however I see many women hold their breath and quickly do their squeezes. But as mentioned above, the pelvic floor works with the diaphragm, and when one is relaxed, the other is contracted and working hard. By squeezing when our lungs are full of air means the pelvic floor cannot contract optimally and therefore can’t strengthen properly.

By squeezing on an out breath, you are encouraging your pelvic floor to work more functionally – i.e work more in line with how it is supposed to.

5 – Core exercises can help your pelvic floor, but remember to breath!

As previously mentioned, the abdominals, pelvic floor and diaphragm all work in conjunction with one another, so by strengthening one area, you will unwittingly strengthen another – just remember to do any core strengthening work with your breath!

Pilates can be a great way to help strengthen your core and pelvic floor. At the White House, we have a dedicated pilates class for women, which focuses on the core and breath work. Contact the team for more information.

If you would like further information about getting a stronger pelvic floor, or if you would like a full body assessment and pelvic floor MOT to help you laugh, cough or run with confidence, book in with Róisín today

Jackie Gibbon

Specialist Women's Health Physiotherapist

Jackie qualified as a Physiotherapist in 2003 and has worked in the NHS ever since. In 2012, she decided to specialise in Women’s Health Physiotherapy after the birth of her eldest son, as she (herself) required the help of Physiotherapy during pregnancy and post-partum.

Jackie Gibbon

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