We often talk about the pelvic muscle after childbirth, but this muscle is crucial at any age. It is the invisible foundation of your intimate, urinary, and sexual well-being.
Often confused with the pelvic floor (which is deeper), the perineum is the muscular "hammock" that closes the pelvis. When it's doing well, we forget about it. When it weakens, problems begin (leaks, slipping cup, discomfort). Here is the complete guide to understanding and toning it.
Article Summary
1- Anatomy: What exactly is the perineum?
The perineum is a set of muscles and ligaments shaped like a diamond or a hammock, stretched between the pubis (in the front) and the coccyx (in the back).
Its 3 vital missions:
- Support (Hammock): It carries the pelvic organs (bladder, uterus, rectum) and prevents them from descending (prolapse).
- Continence (Valve): It locks the urethra and anus to prevent leaks during exertion (coughing, laughing, sports).
- Pleasure (Contraction): It participates in sexual sensations. A toned perineum increases pleasure thanks to the muscles surrounding the clitoris and vagina.
2- Why does it weaken? (Causes and Risk Factors)
Weakening is not an inevitability linked only to childbirth. It is often the accumulation of pressure.
| Factor | Weakening mechanism |
|---|---|
| Pregnancy & Childbirth | The baby's weight presses on the hammock for 9 months. Childbirth stretches the fibers (sometimes to the point of tearing). |
| Menopause | The drop in estrogens naturally makes the muscles less toned and less elastic. |
| High-impact sports | Running, CrossFit, Trampoline... Each impact is a "battering ram" blow to the perineum if it is not locked. |
| Abdominal hyperpressure | Chronic constipation (pushing), chronic cough, carrying heavy loads. |
3- Warning signs
How do you know if your perineum needs help? Listen to these signals:
- 💧 Urinary leaks: A few drops when you sneeze, laugh, or jump (stress incontinence). This is never "normal", even after having a baby.
- discomfort Feeling of heaviness: A heaviness in the lower abdomen or vagina at the end of the day.
- 📉 My cup slips down: If your menstrual cup (even the right size) tends to slip towards the exit when you walk, it's often a sign that the perineum is no longer playing its "lock" role.
- 💨 Vaginal gas: Air noise during intercourse or sports (the vagina is less "closed").
4- The Kegel Protocol: Strengthening your perineum at home
Good news: like any muscle, the perineum can be strengthened. Here is the reference exercise (Kegel) to do incognito.
1. Identify: Contract as if you wanted to hold in gas and an urge to urinate at the same time. That's the perineum. (Warning: do not do this while actually urinating, it damages the bladder!).
2. The exercise:
- Contract hard (close the valves) for 5 seconds.
- Release completely for 10 seconds (rest is crucial).
- Repeat 10 times in a row.
Note: To go further, connected probes (biofeedback) or rehabilitation with a midwife are very effective.
5- Sports and Perineum: Good and bad habits
Should you stop doing sports? No, but you need to adapt.
- To avoid (if your perineum is fragile): Jumping jacks, jump rope, intensive running, crunches (classic sit-ups that push organs downwards).
- To favor: Pilates, Yoga, Swimming, Cycling, and hypopressive abs (which pull the stomach in and lift the organs).
- The reflex: Before each effort (lifting a box, coughing), remember to "lock" (contract) your perineum to protect your organs.
6- FAQ: Your frequently asked questions
- What is a hypertonic perineum? It is the opposite: a perineum that is too tight and cannot relax. This causes pain (dyspareunia) and makes inserting the cup difficult.
- When should I start rehabilitation? 6 to 8 weeks after childbirth, but it's never too late, even at 60!
The perineum is your hidden ally. Taking care of it means ensuring freedom of movement and self-confidence for life.
