Breathing and the pelvic floor: the little-known connection that can change everything

When we talk about the perineum, we often think of strengthening exercises, rehabilitation, or urinary incontinence.

However, one key factor is often overlooked:

⇒ breathing.

This may seem surprising. After all, what does the lungs have to do with the pelvic floor?

In reality, they work together constantly, and understanding this mechanism can sometimes make all the difference.

The pelvic floor never works alone

The perineum is part of a system that some specialists refer to as the “abdominal compartment.”

This system includes:

→ the diaphragm
→ the deep abdominal muscles
→ the back muscles
→ the perineum

Imagine an elevator: when the diaphragm descends during inhalation, the perineum naturally follows this movement. When you exhale, these structures gradually rise again.

⇒ Everything works as a team.

What happens when you have trouble breathing?

Many people breathe primarily with the upper chest, others hold their breath during physical exertion, and some constantly pull their stomachs in.

These habits can alter the pressure exerted on the pelvic floor.

Over time, this can contribute to:

→ poor muscle coordination
→ excessive tension
→ perineal fatigue
→ certain urinary disorders

Of course, breathing is not the only factor. The functioning of the perineum depends on many factors.

Why is the diaphragm so important?

The diaphragm is the primary muscle involved in breathing.

With each inhalation:

→ it moves downward
→ abdominal pressure increases slightly
→ the pelvic floor follows the movement

With each exhalation:

→ it moves upward
→ pressure decreases
→ the pelvic floor returns to its initial position

When this mechanism is disrupted, the pelvic floor may be be placed under greater strain.

The trap of constantly holding your stomach in

On social media, some trends encourage people to:

→ constantly hold their stomach in
→ keep their abdominal muscles contracted all day long
→ continuously tighten their pelvic floor muscles

However, the body was not designed to function this way.

A healthy pelvic floor should be able to:

✔ contract
✔ relax
✔ adapt to movement

At Sugar, our view is that an effective pelvic floor is not one that is constantly under tension, but one that can respond appropriately when needed.

Breathing, exercise and the pelvic floor

This topic becomes particularly important during physical activity.

When a person:

→ holds their breath
→ strains forcefully
→ lifts heavy loads

⇒ abdominal pressure increases significantly.

The pelvic floor must then absorb these forces.

This is why certain sports or poorly performed exercises can contribute to:

→ urinary leakage
→ feelings of heaviness
→ certain pelvic discomforts

Can you learn to breathe better?

Yes.

And it is often simpler than people imagine.

Healthcare professionals specialized in pelvic floor health frequently work on:

→ diaphragmatic breathing
→ pressure management
→ coordination between breathing and muscle contractions

This approach is often integrated into modern pelvic floor rehabilitation programs.

The role of pelvic floor rehabilitation

Contrary to a common misconception, pelvic floor rehabilitation is not only about “tightening” the pelvic floor muscles.

It also aims to:

→ improve body awareness
→ enhance movement coordination
→ manage abdominal pressure
→ restore balanced and harmonious function

In some cases, devices such as pelvic floor probes may complement this work when used in an appropriate therapeutic setting.

The financial aspect: prevention rather than compensation

Some people only seek treatment after several years of symptoms.

However, the earlier a condition is addressed, the simpler the solutions are generally.

Prescribed pelvic floor rehabilitation is mostly covered by the French national health insurance (CPAM).

In the long term, learning to better use your pelvic floor may help prevent certain complications or a worsening of symptoms.

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To conclude…

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We breathe around 20,000 times a day.

Yet few of us ever stop to consider how this breathing affects the pelvic floor.

What if part of the solution wasn’t about doing more exercises… but simply about better using the mechanisms your body already has?

At Sugar, our view is that understanding the link between breathing and the pelvic floor often allows rehabilitation to be seen from a completely different perspective: less brute force, more coordination.