At 43, She Discovered Why Exercise Was Causing Urine Leakage
For almost two years, Priya Bhuvad, a 43 year old corporate professional, had been dealing with a problem that she found difficult to discuss. Whenever she exercised, jumped, danced or took part in activities involving physical impact, she experienced urine leakage.
She also noticed several other changes. At times, she felt that her bladder had not emptied completely. She experienced a feeling of vaginal looseness and reduced sensation during intercourse. However, she did not initially realise that these symptoms could be connected to weakness of the pelvic floor.
The pelvic floor consists of muscles and supportive tissues located at the bottom of the pelvis. These structures support organs such as the bladder, uterus, vagina and bowel and also play an important role in controlling urination and bowel movements. Factors including pregnancy, excess weight and menopause can weaken these muscles. Strengthening exercises can help improve pelvic floor function.
Despite maintaining an active lifestyle and having a demanding job, Bhuvad had not focused on pelvic floor exercises, core strengthening or rehabilitation following childbirth. She had undergone two normal vaginal deliveries, with the most recent one taking place six years earlier.
A medical examination eventually revealed several pelvic floor problems. Her urinary bladder was pushing into the vagina, while part of the rectal wall was also protruding into the vaginal area. Doctors additionally identified first degree uterine prolapse, a condition in which the uterus moves downward from its usual position towards the vagina.
Doctors repaired the front and back walls of the vagina and strengthened the tissue located between the vagina and anus. No surgery was considered necessary for the uterus because the degree of descent was minimal.
Six months after the procedure, Bhuvad reported significant improvement in urinary incontinence and other symptoms associated with pelvic floor dysfunction.
Dr Surabhi Siddhartha, consultant obstetrician and gynaecologist at Motherhood Hospital, Kharghar, Navi Mumbai, said many women consider urine leakage or a feeling of heaviness after childbirth to be a normal consequence of motherhood. As a result, they may continue experiencing these symptoms for years without consulting a doctor or performing exercises to strengthen the affected muscles.
According to Dr Siddhartha, women in their 40s frequently visit her hospital with pelvic floor problems that may have remained untreated since childbirth. Pregnancy and delivery can place considerable pressure on the pelvic floor. Without appropriate rehabilitation, the weakness may become more noticeable as women grow older and experience hormonal changes associated with menopause.
The prevalence of urinary incontinence has also been highlighted by studies conducted in India. A 2023 study involving 118 women between the ages of 20 and 70 found urinary incontinence in 27.1 percent of participants. Stress urinary incontinence was the most frequently reported type. This condition involves urine leakage during activities that increase pressure inside the abdomen.
Another study published in 2025 examined 500 women aged 40 and above and found urinary incontinence in 37 percent of participants. More than half of these cases involved stress incontinence.
For women affected by this condition, leakage may occur during everyday activities such as coughing, sneezing, laughing, exercising, jumping or dancing.
However, urinary leakage is not the only possible indication of pelvic floor dysfunction. Other symptoms can include a feeling of heaviness or pressure, a bulge in the vagina, difficulty emptying the bladder or bowel, a sudden or frequent need to urinate, discomfort during intercourse and ongoing pain in the pelvic region or lower back.
Although pregnancy is a significant risk factor, pelvic floor weakness can also occur in women who have never given birth.
Dr Anjali Talwalkar, a consulting gynaecologist associated with Cama and Albless Hospital in Mumbai, recalled the case of Kiran Kadam, a 25 year old unmarried woman who developed persistent pelvic pain after undergoing treatment for tuberculosis. She later experienced a long lasting irritating cough along with an allergic form of cough.
Further medical investigations eventually indicated weakness of the pelvic floor. She was advised to undergo intensive pelvic floor rehabilitation. Her recovery required patience, with regular exercises, physiotherapy and continued practice at home over several months.
Dr Talwalkar said that prolonged coughing had likely contributed to the weakness because of repeated increases in pressure inside the abdomen. Weight loss during her illness had also resulted in reduced physical conditioning.
She explained that people experiencing conditions that repeatedly increase pressure within the abdomen, such as chronic coughing or constipation, may place continuous strain on the pelvic muscles. Over time, this can contribute to weakness.
Apart from childbirth, several other factors may contribute to pelvic floor problems. These include obesity, frequent heavy lifting, long term constipation, hormonal changes and reduced physical conditioning.
This means that pelvic floor weakness should not automatically be associated with childbirth.
Lack of awareness remains another major concern, especially among younger women who may not expect to experience pelvic floor related symptoms. There is also a difference between being aware of pelvic floor exercises and performing them consistently.
A report from Motherhood Hospital states that more than 90 percent of women know about pelvic floor exercises, but only a small proportion perform them regularly.
The period after childbirth can provide an important opportunity to identify and address these problems. However, routine postpartum care often gives greater attention to issues such as feeding, contraception and general recovery, while assessment of pelvic floor health may receive comparatively less attention.