Pelvic floor health for women who lift weights
Whether you lift at the gym, at work, or while chasing toddlers, heavy lifting asks a lot of your pelvic floor. You don’t need to stop. Lifting builds muscle and strength you’ll want for decades. Train your pelvic floor alongside everything else you train.
How lifting and your pelvic floor connect
When you lift something heavy, the pressure inside your belly rises. Your pelvic floor muscles tighten to meet that pressure and keep your bladder, uterus, and rectum supported.
If those muscles can’t keep up, you might leak when you strain, or feel pressure or a bulge. Jobs that involve heavy lifting are one of several things linked to prolapse. Pregnancy, vaginal birth, age, weight, constipation, and the tissue you were born with all play a bigger part. Some sagging of the vaginal walls is common on exam and usually causes no symptoms. Most women with prolapse see little or no change over a year or so.
So weightlifting isn’t bad for your pelvic floor. What matters is whether your pelvic floor is strong and coordinated enough for the load you put on it.
When to get checked out
Talk to a doctor if you notice:
- Leaking during lifts, especially squats, deadlifts, or overhead work
- Pressure or heaviness in your pelvis during or after a session
- A feeling of a bulge in your vagina
- Needing to bear down hard to move the weight
These are common and treatable. You don’t have to push through them.
What can help
There’s no single fix, and you don’t have to quit your sport first. We’ll talk through your goals and pick what fits your life. You don’t have to try one treatment and fail it before you can choose another.
Options include:
- Pelvic floor physical therapy. A pelvic floor therapist works on strength, relaxation, coordination, endurance, and timing. They’ll also look at your breathing, your hips and core, and how you brace. In a large trial, women with prolapse who did one-on-one pelvic floor training had fewer symptoms at a year. See pelvic floor physical therapy for prolapse.
- Better breathing and bracing. A common fix is learning not to hold your breath under load. You can learn to squeeze your pelvic floor just before the hardest part of a lift, the same way you would before a cough or sneeze. Therapists call this “the knack.”
- Changing your lifts for a while. You might lower the weight or swap a movement for a few weeks while you build capacity, then work back up.
- A pessary. This is a soft, removable support you wear in the vagina. Some women use one to stay active and keep lifting while they work on the rest. Women who use a pessary along with pelvic floor exercises tend to do better than with exercises alone.
- Surgery. If the bulge still bothers you, surgery is an option. Prolapse is more likely to come back after surgery in women under 60, so if you’re young and plan to lift for decades, we’ll weigh that together.
We have pelvic floor physical therapists in the office, plus a regional network across northeast Wisconsin and the Upper Peninsula of Michigan. Most insurance plans cover pelvic floor PT, and our team can help you check yours.
Your next steps
Keep lifting, and make your pelvic floor part of the program. If you have symptoms, schedule a visit. Write down which lifts cause leaking or pressure and what weight you’re moving. That tells me where to start.
Learn more about pelvic organ prolapse
References
- Barber MD. Pelvic organ prolapse. BMJ. 2016. doi:10.1136/bmj.i3853
- Committee on Practice Bulletins-Gynecology, American Urogynecologic Society. Pelvic organ prolapse (ACOG Practice Bulletin No. 214). Obstet Gynecol. 2019.
- Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014. doi:10.1016/S0140-6736(13)61977-7
- Bo K, Frawley HC, Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2017. doi:10.1007/s00192-016-3123-4
- Wallace SL, Miller LD, Mishra K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol. 2019. doi:10.1097/GCO.0000000000000584
- Hooper GL, Moynihan L, Leegant A, et al. Vaginal pessary use and management for pelvic organ prolapse (AUGS-SUNA joint clinical consensus statement). Urogynecology. 2023. doi:10.1097/SPV.0000000000001293
- Carberry CL, Tulikangas PK, Ridgeway BM, et al. AUGS best practice statement: evaluation and counseling of patients with pelvic organ prolapse. Urogynecology. 2025. doi:10.1097/SPV.0000000000001641