Here are a few important things to keep in mind when assessing pelvic floor health and the solutions you turn to, whether for healing or maintaining health.
1. Pelvic floor health only matters after you give birth.
In fact, every woman over 25 benefits from pelvic floor awareness, whether she has given birth or not.
The pelvic floor plays a role in:
- Bladder and bowel function
- Abdominal stability
- Sexual sensation
- Supporting the organs
Whether you are 35 or 65, whether you have given birth or not, whether you are in menopause or perimenopause, your pelvic floor muscles deserve your attention.
2. More Kegel exercises = a stronger pelvic floor.
In fact, relaxation is just as important as strengthening.
Pelvic floor health needs balance:
Contraction + Relaxation + Rest
Too much tension → pain, dysfunction
Too much weakness → leaks, prolapse
Some women need strengthening exercises. Other women need relaxation exercises. Many need both, done in the right sequence.
3. When to see a doctor and when to see a somatic coach?
See a doctor (gynecologist/urologist/proctologist) when you have:
- Urinary or fecal incontinence
- Pelvic organ prolapse
- Pelvic pain
- Injuries
- Post-accident or post-surgery recovery
- Medical diagnoses (dysfunctions, infections, unprotected sex, other conditions of the sexual organs, etc.)
Work with a somatic sexuality coach after you have your doctor’s approval, to:
- Notice and intensify body sensations
- Regulate the nervous system through somatic practices
- Improve the breath–body connection
- Support rehabilitative treatments (prescribed only by the doctor)
- Embody your sexuality more fully
- Support preventive well-being
- Communicate better in intimacy
- Better understand sexual (in)compatibility in the couple
Medical treatment and somatic coaching are complementary, not alternatives.
If you have ever approached a coach for medical reasons, the distinction between topics for a doctor and those for a coach is clear above.
4. Questions to ask your gynecologist before you start any pelvic floor training.
Before starting any pelvic floor training (with or without accessories), here is a list of questions to ask your gynecologist:
- Is my pelvic floor currently healthy?
- Do I need strengthening, relaxation, or both?
- Are there any contraindications for my specific history?
- Should I first see a pelvic floor physiotherapist?
- What symptoms should I watch for?
- How often should I come in while I’m training?
The doctor can also assess:
- Stages of prolapse
- Muscle tone (hypertonic/hypotonic)
- Tissue health
- Infection risk factors
Empowered health means collaborative care between you, your doctor, and the complementary practitioners you choose.
5. What is somatic coaching?
“Somatic” = related to the body
Somatic coaching helps you:
- Connect to your body’s sensations
- Release stored tension
- Regulate your nervous system
- Integrate experiences somatically
It is based on research showing that:
- Trauma is stored in the body (van der Kolk, “The Body Keeps the Score”)
- Breathing patterns affect emotional states
- Movement releases stagnant energy
- Sensory awareness improves embodiment
This approach complements (does not replace) medical care and psychotherapy.
The most common somatic practices:
- Breathwork
- Body scanning
- Gentle movement
- Sensory awareness (refined attention to bodily sensations)
- Tension-release exercises (whole-body shaking to release tension)
All of these help you, over time, feel more present and more comfortable in your body.
*Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult your doctor before starting any pelvic floor exercises. Your doctor knows your medical history and can guide you accordingly.
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