Exercises & Breathing Techniques for PCOS

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects individuals with ovaries, and it can bring about various challenges, including its impact on the pelvic floor. These challenges may manifest as pelvic pain, urinary incontinence, or other discomforts. However, there are exercises and breathing techniques that can help alleviate these symptoms and promote pelvic floor health.

Diaphragmatic Breathing

• A simple yet effective technique that utilizes your body’s natural mechanics to gently stretch the pelvic floor muscles
• Visualize your abdominal cavity as a balloon: the top represents the diaphragm, the sides encompass your abdominal and back muscles, and the bottom corresponds to the pelvic floor muscles
• As you inhale, your diaphragm descends into the abdominal cavity, exerting a gentle pressure on the top of this “abdominal balloon,” thereby providing a subtle stretch to the pelvic floor at the bottom of your abdomen
• To ensure that you’re using good breathing mechanics, try this: lie down and place one hand on your chest and the other on your belly/abdomen
• When you inhale, focus on breathing into your belly, observing your belly hand rising while keeping your chest hand relatively still
• As you exhale, your belly hand should return to its initial position
• This practice helps you avoid shallow chest breathing, which can limit lung expansion and prevent pelvic floor relaxation

Breathing Techniques for Pelvic Health

Breathing is a fundamental aspect of pelvic floor health. As mentioned earlier, diaphragmatic breathing plays a crucial role in gently stretching the pelvic floor muscles. However, there are more breathing techniques you can incorporate into your routine to further support pelvic health:

1. Pursed Lip Breathing

• This technique involves inhaling through your nose for two counts and then exhaling through pursed lips for four counts
• Helps improve lung capacity and oxygenation while promoting relaxation

2. Box Breathing

• A method of taking slow, deep breaths in a structured pattern
• Inhale for a count of four, hold for a count of four, exhale for a count of four, and then hold for a count of four before starting the cycle again
• This controlled breathing technique helps regulate your breath and reduce stress. It can enhance overall relaxation and mindfulness, which is beneficial for pelvic floor health
• Continue the cycle of inhaling for a count of four, holding for a count of four, exhaling for a count of four, and then holding for a count of four before starting the cycle again
• Repeat this pattern for several minutes to experience its calming effects

Incorporating these breathing techniques into your daily routine can further enhance your pelvic floor health and overall well-being. Proper breathing not only provides gentle stretching to the pelvic floor, but also helps reduce stress and tension in the body, which can contribute to a healthier pelvic region.

Pelvic Floor Stretches

Incorporating pelvic floor stretches into your routine can further enhance pelvic health. These stretches can be performed 5-7 days a week as part of an ongoing program to maintain a healthy pelvis and pelvic floor muscles.

Here are some effective stretches to consider:

1. Happy Baby

• Begin by lying on your back and bringing your feet towards the ceiling, keeping them wider than hip-width. Breathe deeply into the sides of your ribcage and your belly. You can adapt this stretch by using a yoga belt or a bed sheet looped behind your knees if you can’t reach your feet yet.

2. Deep Squat

• For this stretch, hold onto a kitchen counter, a chair, or a corner of the room for support
• Keep your feet flat on the ground, slightly wider than your hips
• Lower your hips as far as possible while breathing into the sides of your ribcage and visualizing the pelvic floor opening

3. Cat/Cow Stretch

• Begin on all fours, inhale to arch your back, allowing the abdomen to sink downward without moving your shoulders or hips
• Exhale as you round your spine, directing the tailbone downward, resembling an angry cat
• Repeat this motion 10-20 times

4. Figure Four Stretch

• This stretch targets the hip and the muscles at the back of the hip, which are connected to the pelvic floor
• Lie on your back, cross your right ankle over your left knee, and lift your left knee towards your chest
• Hold for 30 seconds, then switch to the other leg
• Repeat three times on each side.

5. Child’s Pose

• Modify this stretch by using a pillow behind the knees or in the front fold of the hips, if needed
• Maintain an easy breath into the sides of the ribs, and visualize relaxation and “letting go” in the pelvic floor

6. Adductor Stretch

• Lunge to the left by bending your left knee while keeping your right leg straight
• Press your hips back as if you were sitting in a chair, and avoid letting your left knee go beyond your left foot

5. Hamstring Stretch

• Prop one foot up onto a stool or chair with the knee straight
• Hinge forward at the hips to lean over the stretching leg while keeping your spine straight
• Hold this position for 30 seconds and repeat on each leg for three sets

Incorporating these pelvic floor stretches into your daily routine can be an essential step toward mitigating pelvic floor symptoms associated with PCOS and promoting overall pelvic health. Remember that consistency is key, and consult with a healthcare professional or physical therapist for personalized guidance on managing PCOS-related pelvic floor concerns.

Additional Pelvic Floor Exercises

In addition to the previously mentioned exercises, there are more specific pelvic floor exercises that can be beneficial for individuals with PCOS:

1. Kegel Exercises

• Kegels involve contracting and relaxing the pelvic floor muscles
• They are an appropriate exercise for people who have underactive pelvic floor muscles
• To perform a Kegel exercise, contract your pelvic floor muscles (as if you were trying to stop the flow of urine) and hold for a few seconds before releasing
• Repeat this 8-12 times, 3-4 times per day, gradually increasing the duration of the contractions

2. Bridge Exercises

• Lie on your back with your knees bent and feet flat on the floor
• Lift your hips off the ground while squeezing your glutes and engaging your pelvic floor muscles
• Hold for a few seconds before lowering your hips
• This exercise strengthens the pelvic floor and the glute muscles

3. Squats

• Excellent for overall lower body strength, including the pelvic floor
• Stand with your feet shoulder-width apart, and slowly lower your body as if you were sitting in a chair
• Keep your back straight, and make sure your knees don’t go beyond your toes
• Return to the starting position and repeat

4. Pelvic Tilts

• Lie on your back with your knees bent and feet flat on the floor
• Tighten your abdominal muscles and push your lower back into the floor while tilting your pelvis upward
• Hold for a few seconds before releasing
• This exercise helps stabilize the pelvis and strengthen the lower back

5. Pilates and Yoga

• These practices can be excellent for improving pelvic floor strength, flexibility, and overall body awareness
• Many Pilates and yoga poses specifically target the muscles of the pelvic floor and can be adapted to your fitness level

The Importance of Pelvic Floor Health with PCOS

Understanding the significance of pelvic floor health is crucial. The pelvic floor is a group of muscles, ligaments, and tissues that provide support to the pelvic organs, including the bladder, uterus, and rectum. It plays a pivotal role in various bodily functions, including bowel and bladder control, sexual function, and even stability for the lower back and spine.

When PCOS enters the equation, hormonal imbalances can disrupt the pelvic floor’s function, leading to various symptoms. These may include pelvic pain, urinary incontinence, pelvic organ prolapse, and pain during sexual intercourse. 

By combining these exercises and breathing techniques, individuals with PCOS can take proactive steps to manage and alleviate pelvic floor symptoms, ultimately improving their quality of life and overall health. Remember to consult with a healthcare professional or a physical therapist for personalized guidance and recommendations tailored to your specific needs and conditions.

Dr. Amanda Olson teaches internationally on various pelvic health topics and has written various articles on pelvic floor dysfunction and running. She authored the book: Restoring the Pelvic Floor For Women. Dr. Olson is the president and chief clinical officer of Intimate Rose where she develops pelvic health products and education. She is passionate about empowering women and men with pelvic health issues including pelvic pain, incontinence and postpartum issues.