Quick Answer
A weak pelvic floor can cause leaking with coughing, sneezing or exercise, a feeling of heaviness, or reduced sensation. These symptoms can look identical to those of an overactive or poorly-coordinated pelvic floor, so symptoms alone can’t tell you which one you have. A pelvic health physiotherapist can assess this directly, usually in one appointment, and that assessment is what actually determines whether strengthening exercises are the right next step for you.
For women, the postpartum period is not just a moment of immense joy and change; it can come with many challenges, particularly those associated with pelvic floor health. Symptoms associated with a weakened pelvic floor can have a significant impact on a woman’s quality of life.
I am a yoga, Pilates, and Hypopressives instructor, and I have been teaching these disciplines for many years.
Signs your pelvic floor may be weak
A weakened pelvic floor can cause a variety of symptoms that affect a woman’s physical and emotional well-being. Common signs include:
Urinary Incontinence: A large number of women experience involuntary urine leakage, especially while coughing, sneezing, or participating in physical activities.
Pelvic Organ Prolapse: The descent of pelvic organs, sometimes linked to weakened pelvic floor muscles, can cause feelings of pressure or a bulging sensation in the vaginal region.
Bowel Dysfunction: Difficulty in regulating bowel movements, leading to bowel incontinence or constipation, can sometimes be linked to a weakened pelvic floor.
Sexual Dysfunction: Pelvic floor weakness can lead to painful or uncomfortable sexual intercourse for women.
Diastasis Recti: Pregnancy can lead to the separation of abdominal muscles, which weakens the core and abdominal muscles, thereby causing a bulging or “pooch” appearance of the belly after childbirth.
Having one or more of these doesn’t confirm your pelvic floor is weak specifically, see the next section.
Why symptoms alone don’t confirm it’s weakness
These same symptoms, leaking, heaviness, reduced sensation, can also happen with a pelvic floor that’s overactive or tense, or one that isn’t coordinating well with your breathing, not just a weak one. That matters, because the right approach is different for each: a weak pelvic floor generally benefits from strengthening work, while an overactive one generally needs the opposite, release and coordination work first. Doing more strengthening exercises when the real issue is tension can make things feel worse, not better. This is exactly why an assessment, not guesswork from symptoms, is the most useful next step.
How Hypopressives Can Genuinely Help a Weak Pelvic Floor
An 8-week, supervised Hypopressives programme was studied in 117 women with pelvic floor dysfunction and urinary incontinence symptoms, split between a Hypopressives group and a control group. The Hypopressives group showed statistically significant improvements in pelvic floor muscle strength and in several validated symptom measures compared to control (Molina-Torres et al., 2023, Neurourology and Urodynamics).
This is a reasonably sized, controlled study, and it’s genuine evidence that a supervised Hypopressives programme can produce statistically significant improvements in pelvic floor strength and symptoms. In my own experience teaching Hypopressives, many women see this kind of change translate into real, sometimes dramatic, day-to-day improvement with consistent practice, though how much changes depends on your specific presentation. Hypopressives are a unique blend of breathing and posture exercises that work to reduce intra-abdominal pressure and strengthen core muscles, including the pelvic floor and transversus abdominis, from within.
When to see a specialist
See a pelvic health physiotherapist or your GP if your symptoms are getting worse rather than settling, if you notice a bulge or something coming down, if you’re leaking heavily or constantly rather than occasionally, or if you’re not sure whether what you’re dealing with is weakness, tension, or something else. An assessment, usually one appointment, is the fastest way to know what’s actually going on and what’s likely to help.
Getting started
To get the most out of your time and effort in the Hypopressives classes, it is important that you learn the Apnea breathing technique. It also ensures that you are carrying out your practice in a safe manner.
Simone runs weekly fundamental sessions where she will guide you through the technique either in a one-to-one setting or in a small group on Zoom, think of it as your personal introductory tour through all the technique’s steps, with feedback given to ensure you’re on the right path. While most people understand and can apply the technique after this session, don’t worry if you need a little extra time. Some clients, especially those with tightness in their ribs and thoracic spine, may benefit from an additional session.
Once you’ve learned the technique, Simone recommends at least three 15 to 20-minute workouts per week to really make an impactful change. After the initial session, you can start with the live and recorded classes to incorporate this routine into your daily lifestyle.
