Do you know what perineum is? Some exercises can prevent surgery!

Have you heard of the perineum? Do you know what it is for? The perineum, also called the pelvic floor, is not something new, however, it is difficult, at some point in our lives, to stop to think about its importance. Unfortunately, there is still a lot of ignorance on the subject and, therefore, myths and taboos are still widespread. Did you know that if the perineum is not exercised, the woman may suffer problems in the future and need to undergo surgery? So that this doesn’t happen to you, I brought some exercises for you to practice and avoid surgery of the perineum.

The perineum is a fundamental part of our body and yet, as I said before, it is a great unknown. Few women (and even fewer men) know where it is located, what its functions are, and what they can do to control these muscles. Regardless of whether we had children or not, whether we are pregnant or in menopause, it is important to know more about the perineum. After all, it plays a key role in many of our vital functions, although you are not aware of it.

In today’s text we will talk about:

  • What is the perineum
  • Perineum functions
  • Perineum x pregnancy
  • What happens when the perineal musculature is weakened?
  • Perineum Surgery or Perineoplasty
  • How to Avoid Perineum Surgery
  • Start now

What is the perineum?

The pelvic or perineal floor is the set of muscles that aligns the lower part of the pelvis. Yes, exactly, the muscles that are between the pubis and the coccyx, around the vulva and the anus, and that are in two planes:

  • A superficial one whose most important function is sexual, although it also helps support the pelvic organs.
  • And a deeper one, called deep or posterior perineum, formed by the muscles that effectively maintain these organs, control the sphincters and improve the quality of sexual intercourse.

Perineum functions

Often, we are not aware of the true value of things until they stop working. If you have not had symptoms that indicate any change in your pelvic floor, you may not be aware of how important it is to your daily life. Here are some functions of the perineum:

  • The pelvic floor controls the sphincters to urinate and defecate properly.
  • Toned perineal muscles improve the quality of intercourse.
  • The perineum is very important at the time of delivery, as it helps the baby’s head to rotate and produces a reflex contraction in the uterus (expulsive reflex) that makes the pregnant woman want to push.
  • The perineum has the function of supporting the bladder, uterus, vagina and rectum.

Perineum x Pregnancy

Caring for the perineum during pregnancy can reduce perineal pain during delivery and protect mothers from perineal trauma (possible injuries that can occur to the genitals during delivery) especially episiotomies, that is, the cut that is made in the tissues of the perineum that surround the vagina, performed by many doctors during childbirth. For this reason, midwives recommend that, during pregnancy, women should perform perineal massages.

What happens when the perineal musculature is weakened?

As with other muscles in the body, the pelvic floor musculature suffers trauma during pregnancy, childbirth and certain surgeries. In the case of women, menopause blocks the release of hormones, such as estrogen, which also contributes to weakening the region. There is also a process of natural aging of muscle fibers that leads to loss of tone and the ability to contract and this causes several problems, which generate discomfort and undermine self-esteem. When there is an imbalance in the perineal musculature, pathologies and discomfort can occur, such as:

  • Fecal and urinary incontinence: it is the inability to control the elimination of feces.
  • Organ prolapse: also known as a fallen bladder, is the externalization of organs through the vaginal or anal canal. It happens due to the weakening of the pelvic floor muscles and ligaments that have the role of supporting these organs.
  • Sexual dysfunction: pain during intercourse and difficulty in reaching orgasm.
  • Gestation and delivery: during pregnancy, the pelvic floor muscles are under greater pressure because they support, in addition to the pelvic organs, the baby and the embryonic attachments.
  • Vaginal sagging.

Perineum Surgery or Perineoplasty

When the injuries in the perineum are very serious, perineoplasty is performed, a surgical intervention that aims to reconstruct the muscles of the perineum, located in the female intimate area. Most of the time, the laceration of the muscles is caused by consecutive normal births. At the time of birth, obstetricians can cut some muscles in the perineum so that the baby can come out more easily.

Because of this procedure, the vagina becomes a little more enlarged, causing loss of sensation by friction and vaginal flatus during sexual intercourse; and making orgasm difficult for women. Laceration of the musculature of the vagina can also be caused by old age.

The most common complaints of patients suffering from perineal insufficiency are decreased pleasure during penetration and the exit of air or urine during or shortly after intercourse, in addition to eventual pain resulting from penetration.

Perineoplasty is, therefore, a plastic surgery performed on the external part of the vagina, causing the muscle to resume its normal functions. In certain situations, perineoplasty can be used to “tighten” the vagina and increase the sexual pleasure of the partner.

Why exercise the perineum?

Perineum exercises are vital for a person and can be done discreetly anytime, anywhere. These exercises are important to increase control over the bladder and the intestine and strengthen the pelvic floor, which supports the vagina, uterus and intestine. That is why keeping the pelvic floor in good working order is so valuable for women, no matter their age or stage of life.

If done correctly and routinely, exercise can help prevent urine loss while you are pregnant and after the baby is born. Another great benefit of stronger pelvic floor muscles is that you will experience more pleasant orgasms, which lead to a more satisfying sex life.

How to Avoid Perineum Surgery

As it is an invasive procedure, surgery should always be considered as a last resort. But how to avoid problems in the perineum and a subsequent surgical procedure? Simple: preventing it. And when we talk about prevention, we are not just mentioning pregnant women or menopausal women, but all women who want (and should) know their own bodies and avoid future problems.

Perineal massage

In regions of the East, it is carried out by adolescents since their first menstruation as a way of getting to know their own bodies. In the West, it is indicated especially for pregnant women, menopausal women and women who suffer from vaginal dryness.

In the case of pregnant women, it is recommended that the massage be done from the 34th week of pregnancy and daily. The goal is to increase the adaptability of perineal structures to facilitate the baby’s passage with the least possible perineal damage. It also helps in perineal perception and relaxation, which is so important when the baby is expelled. Its practice decreases the episiotomy.

The massage can be done by doulas, physiotherapists or by the woman herself, at home, in the months before delivery. In addition to the exercises done with the finger, it is possible to count on the help of a device, called Epi-No. The object is like a bladder that inflates inside the vagina and can reach the size of a baby’s head. In addition to strengthening the region and decreasing the chances of natural laceration, the device also gives the mother security about her dilation and strength .


Pompoirism, also known as intimate gymnastics or Kegel exercise, is nothing more than the controlled movement of the pelvic floor and vaginal canal muscles. These contractions consist of “tightening” and “loosening” the muscle repeatedly until you gain enough strength to voluntarily control your vaginal canal. After a while of practice and as the woman gains strength, she begins to do pompoirism with accessories, such as Ben-wa balls, the cone and the mini-vibrator.

When exercising the perineum, pompoirism also brings a number of sexual benefits. Among them are: increased libido and lubrication in the vaginal canal, the feeling that the woman is more “tight”, because we can control the muscle as we want, it helps in the treatment of anorgasmia (difficulty in reaching orgasm), multiple orgasms and helps to delay ejaculation of the partner.

Pelvic Physiotherapy

Much like pompoarism, the treatment of pelvic physiotherapy consists of promoting the ability to contract and properly relax the pelvic floor muscles, strengthening this musculature in order to recover the functions of urinary and fecal continence. Improved sexual activity and support of the pelvic organs.

The exercises can be done with accessories, such as the vaginal cones or the ben wa – ball of pompoarism – (motor coordination and proprioception). As well as perineal massages, electrotherapy, electrostimulation and biofeedback resources. The duration of treatment varies according to the patient and his physiological responses, as well as the dysfunction he has.

Perineum exercises to do at home

Perineum exercise can be implemented in your daily life, and can be done anywhere and anytime. It is a gentle exercise, but very effective. Like any form of exercise, it is best to try different methods to get all the muscles in the perineum to work. See some of them.

How can I find my pelvic floor muscles?

  • Method 1 – Stopping the flow – The first step in performing pelvic floor muscle exercises is to identify the correct muscles. There are several ways that can help you correctly identify the different parts of the pelvic floor muscles. One way is to try to stop or slow the flow of urine in the middle of emptying your bladder. Stopping the flow of urine repeatedly in the bathroom is not an exercise, but a way to identify the muscles in the perineum.
  • Method 2 – Visualization – Another method to identify the pelvic or perineum floor muscles is to imagine stopping the flow of urine and holding the flatulence (wind) at the same time. This can be done lying down, sitting or standing with your legs shoulder-width apart.


Lie on your back with your knees bent and your feet flat on the floor, hip-width apart. Inhale, wrap the pelvic floor and lift your hips. Hold for up to 10 seconds (keep breathing!). Lower your hips down and release the pelvic floor. Do 10 repetitions.

Wall squat

Stand against a wall, with your feet hip-width apart. Inhale, wrap your pelvic floor, and lower yourself into a squat as if you are sitting in a chair. Hold for 10 seconds. Stand up and release the pelvic floor. Rest for 10 seconds. Do 10 reps

Jumping Jack

Start with your legs together. Contract your pelvic floor muscles as you jump and bring your arms up. Release your pelvic floor while jumping with your legs back. Repeat for 30 to 60 seconds.

Insect crunch

Lie on your back and extend your arms towards the ceiling. Inhale, wrap the pelvic floor and extend your right arm upwards and squeeze your right forward. Release the pelvic floor and move your arm and leg back to the starting position. Repeat with your left arm and leg. Do 10 repetitions on each side.


Tighten the pelvic floor muscles by pulling them up. Try to contract them and keep them that way while you count to 5 breathing softly. Then, relax them for another 5 seconds and repeat the series 10 times.

Try to progressively increase the time of contraction and relaxation. Start for 5 seconds in each case until you reach 20. The longer you can hold the muscle contraction, the stronger it will be.

The fast

Contract and relax your muscles as soon as possible until you get tired or about 2 or 3 minutes (whichever comes first). Start with 10 repetitions four times a day until you reach 50 repetitions per day.

Vaginal Cones

Another way to strengthen the perineum is to overload it. Weight exercises, like gym dumbbells, are the most efficient way to strengthen a muscle. There is a kind of “halter” for exercising the perineum. They are called vaginal cones, heavy capsules and anatomically shaped, specific for vaginal introduction and perfect fit, allowing these muscles to be exercised with load.
You can use the cone at different times during the day, washing dishes or doing some housework. The idea is to support the cone, without dropping it.

Ben Wa Polka Dots

Ben wa, also known as Thai balls, is a great option to strengthen the perineum. The exercise is carried out in two stages: the insertion of the balls one by one into the vagina using, as far as possible, only the contraction force; and expelling the balls from the vagina using mainly relaxation.

Start now

As I said before, prevention is the best way to avoid future problems. Don’t wait for a problem to appear in your body for you to seek help. Practice the exercises indicated to strengthen the perineum as soon as possible and enjoy the benefits they will bring to your life. In addition to improving your health, you will feel an improvement in your sex life and your self-esteem.

Leave a Comment