4 exercises to rehabilitate your perineum

The perineum is a complex set of muscles, ligaments and fascia in a diamond shape that extends from the pubis to the coccyx. It is a sort of hammock that forms the pelvic floor which provides support for the genitals, rectum, bladder and viscera. If men and women have a perineum, it is particularly known in women due to pregnancy and then childbirth: under the effect of hormonal impregnation, the weight of the fetus and during expulsion, it is stretched. For a majority of women who have given birth, it is essential to undergo perineal rehabilitation . Why, how is perineal rehabilitation carried out? In today's article, we talk to you about rehabilitation and we offer you 4 exercises to re-educate your perineum.

Why strengthen and re-educate your perineum?

The perineum is an essential muscle for the body that is put to the test during pregnancy and childbirth, but also during menopause. This is why it is essential to strengthen and retrain it after childbirth!

The essential role of the perineum

The perineum has three major roles in the proper functioning of your body:

• pelvic floor : it supports your genitals, rectum, bladder and viscera;
• role in urinary and anal continence : being able to contract it allows you to hold back urinating and defecating;
• role in sexual pleasure (yours and that of your male partners during penetration): the perineal muscles tighten the outer third of the vagina and increase its angle, which accentuates the sensations and perception of coital movements.

This is why it is essential to have a strong perineum!

Pregnancy and menopause: two turning points for the perineum

While we hear little about the perineum in men, it has a very special place in women and for good reason: it is put to use during pregnancy and childbirth and menopause weakens it.

Due to the hormonal fluctuations that shake up women's bodies during pregnancy, the weight of the baby pressing on the pelvic floor, the space taken up by the baby that disrupts the organs in the abdominal region, and the trauma of childbirth, the perineum is your ally during pregnancy. It emerges from this difficult and often very relaxed episode. This results in the risk of organ prolapse or even protrusion for new mothers: under the pressure of the organs, they leave the body and need to be replaced with surgery!

Besides pregnancy and childbirth, menopause is a second turning point for the female pelvic floor. When estrogen levels decrease during menopause, the tissues of the vulva, vagina, and urethra can thin and lose their elasticity, vaginal lubrication decreases, and the pelvic floor muscles become thinner and less flexible. In addition to causing pain during intercourse , this can lead to postmenopausal women experiencing the need to urinate more frequently and even experiencing incontinence — a potential symptom of menopause .

The importance of rehabilitation

Pelvic floor rehabilitation, which involves working the muscles of your pelvic floor to strengthen them , aims to limit all of the symptoms mentioned above. By strengthening your pelvic floor, you limit the risks associated with:

• Pelvic organ prolapse: Also called pelvic organ prolapse, this is a condition where pelvic organs, such as the bladder, uterus, rectum, or vaginal vault, can protrude or descend into the vagina. Strengthening and strengthening your pelvic floor can help reduce this risk;
• Pain during sex (or conversely, the feeling of no longer feeling anything): tense or contracted pelvic floor muscles can cause pain during sex. This can be linked to anxiety, stress, chronic muscle tension or problems relaxing the pelvic floor muscles, particularly after pregnancy. Retraining your perineum and teaching it to contract again can allow you not only to limit pain related to sex but also to feel more pleasure;
• Urinary and anal incontinence: the perineal muscles play a role in the contraction of the urethra and the sphincter and their proper functioning helps prevent incontinence.

Devices and objects to strengthen the perineum >

When to start rehabilitation?

Women are generally prescribed perineal rehabilitation sessions at the end of their stay in the maternity ward. If this is not your case (perhaps simply because your practitioner forgot), you can request it from the gynecologist or midwife who is following you during the postnatal visit 6 to 8 weeks after giving birth. These sessions are reimbursed by Social Security at 100%. If you need additional sessions, they will be reimbursed, this time, at 60%. Also note, perineal rehabilitation can be supplemented by abdominal rehabilitation.

💡 Strengthening your pelvic floor isn't just for women who have recently given birth! You can strengthen your pelvic floor muscles and exercise them throughout your life, either as a preventative measure or whenever you experience pelvic floor weakness.

How does perineal rehabilitation work?

Pelvic floor rehabilitation sessions take place with a midwife or specialized physiotherapist who has received the necessary training. Don't hesitate to ask your gynecologist or midwife for a recommendation. We've also created a directory of caring practitioners recommended by other women in our community to help you make your choice.

🌈 Postpartum, we offer Louvz's perineum repair serum on our e-shop. You can use it to promote healing one week after giving birth and then massage it in three weeks after giving birth—provided your scar is clean.

I want the perineum repair serum

There are three perineal rehabilitation techniques, most often used together. The specialist decides which method(s) work best. The first is manual. The therapist uses only their fingers: they insert them into the vagina to exert pressure on the perineum, test its resistance, and strengthen it. You should contract your perineum for a few seconds in response to the request.

The second is the electrostimulation technique. It uses a probe connected to a device and inserted into the vagina (or even the anus) to send a low-intensity current to stimulate the nerves of the perineum. It is particularly suitable for those who suffer from pain after an episiotomy or tears.

The third technique is the most recent. It's called biofeedback. It also uses a probe, but without electrical stimulation. You can visualize the effectiveness of your perineal contraction using a curve displayed on a screen or through light signals.

🌈 On our e-shop, we offer a perineal strengthening probe without electrostimulation. Connected to an app, it helps you strengthen your perineum.

I want the reinforcement probe

4 exercises to re-educate your perineum

In addition to this perineal rehabilitation in the doctor's office once or twice a week in the months following childbirth, the work continues at home through perineal exercises to be practiced for about ten minutes per day. Here are four exercises to try to re-educate your perineum.

Before you begin

This may seem obvious, but we'd like to clarify it upfront. If you're being treated by a professional for pelvic floor rehabilitation due to specific issues, ask for their permission and advice before practicing additional exercises.

Furthermore, if you experience any pain during the following exercises, it is recommended that you consult a healthcare professional and discuss it with them for personalized advice.

Perineal rehabilitation probes > 

1. Kegel contractions

Kegel contractions, also known as Kegel exercises, are designed to strengthen the pelvic floor muscles. These exercises were developed by gynecologist Arnold Kegel (hence their name) to counteract weak pelvic muscles.

How to do Kegel contractions to strengthen your pelvic floor muscles?

The first step is to identify the pelvic floor muscles you need to work: to do this, try to stop the flow of urine when you are on the toilet. The muscles you use for this are the pelvic floor muscles. 🚩 Be careful, this first step is not an exercise but a tool to identify your muscles, do not do it repeatedly: holding in your urine or stopping the flow of urine tends to increase the risk of urinary tract infections.

To practice Kegel contractions:

1. Choose a comfortable position . You can do these exercises lying down, sitting or standing;
2. Contract your pelvic floor muscles : Squeeze them as if you were trying to stop urine or hold in gas. Keep your abdominal, buttock, and thigh muscles as relaxed as possible;
3. Hold the contraction for a few seconds , then gently release. Start by holding the contraction for 3 to 5 seconds, then gradually increase the duration as your muscles strengthen. Make sure to relax between each contraction.

Perform a series of exercises with a set number of contractions, then gradually increase the number of contractions over time (you can start with ten, for example). Practice these exercises several times a day , incorporating them into your daily routine. You can increase the difficulty by using weighted beads for more sensation.

🌈 On our e-shop, find weighted perineal beads from Lelo to help you with your Kegel exercises. Made of silicone and ABS plastic, they help strengthen and tone your perineum. Pair it with a water-based lubricant from MyLubie for gentle exercises.

2. The bridge

The bridge exercise is an exercise that can help strengthen the pelvic floor muscles , particularly the gluteus maximus muscle. Although this exercise does not specifically target the perineum, it can help strengthen the pelvic area as a whole.

To practice the bridge exercise and strengthen your perineum:

1. Lie on your back with your knees bent and your feet flat on the floor, hip-width apart. Place your arms at your sides, palms facing down. We recommend practicing on a floor mat or on your bed if your mattress is firm: the softness of a mattress may destabilize you;
2. Contract your abdominal muscles to stabilize your spine. Make sure your back is in contact with the floor;
3. As you inhale, push your hips toward the ceiling , lifting your pelvis off the floor. Continue rising until your body forms a straight line from your shoulders to your knees. You should feel a contraction in your glutes and lower back muscles. Don't force the high position: make sure to maintain a straight body line and avoid excessively arching your lower back;
4. Hold the position for a few seconds , continuing to breathe normally. You can contract the gluteal muscles to maximize muscle activation;
5. As you exhale, slowly lower your hips back to the starting position

Repeat the movement for the desired number of repetitions and gradually increase the repetitions over time: for example, you can start with a small number of repetitions (e.g., 10 to 15).

3. Squats

The squat is a versatile exercise that involves multiple muscle groups, including the lower body muscles and pelvic floor. It can contribute to overall strengthening of the pelvic area, including the perineal muscles.

To practice the squat exercise and re-educate your perineum:

1. Stand with your feet shoulder-width apart, toes turned slightly outward;
2. Contract your abdominal muscles: this helps stabilize your spine. Keep your back straight and your shoulders back;
3. As you inhale, slowly bend your knees and hips to lower into a squat position. Lower as low as you can while maintaining proper form. Make sure your knees do not extend past your toes.
4. As you descend into the squat, deliberately engage your pelvic floor muscles , including your perineum. Imagine tightening and slightly lifting this area while maintaining the squat position.
5. Briefly hold the lowest squat position , continuing to engage your pelvic floor muscles.
6. As you exhale, push through your heels to return to the starting position. Make sure to fully extend your hips at the top of the movement.

Repeat the movement for the desired number of repetitions. Start with half a dozen squats and increase as you feel comfortable with the exercise. To make the exercise more challenging, you can also decide to add weights.

4. The butterfly

The butterfly stretch, also known as the butterfly stretch, is primarily a stretching exercise that targets the groin and inner thigh muscles. While not specifically designed to strengthen the pelvic floor, it can help improve flexibility in the pelvic area. Since the butterfly stretch is a stretching exercise, you can definitely do it in combination with the squat or bridge exercise.

To practice the butterfly exercise and strengthen your perineum:

1. Sit on the floor with your back straight. Bend your knees and bring them as close to your body as possible;
2. Place the soles of your feet together, one against the other, letting your knees open to the sides;
3. Hold your feet together with your hands , either by grasping your ankles or placing your hands on your feet;
4. Allow your knees to naturally open out to the sides while letting your elbows gently press into your inner thighs to help deepen the stretch. Be careful not to force the stretch. If you feel pain, reduce the range of motion;
5. Breathe deeply and hold the position for 15 to 30 seconds, continuing to breathe regularly;
6. Slowly return to the sitting position by gently closing your knees.

Repeat the exercise several times , doing sets of stretches to improve flexibility.

🦥 Need more exercises? Check out fitgirl Lucile Woodward's video:

She gives you exercises, tips and shows you how to do them to avoid injury.