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I have issues with my pelvic floor when coughing and running

By Pelvic Floor Health
on November 15, 2019

I have issues with my pelvic floor when coughing and running 

Can you please provide some advice? I am 41 and have two children but my youngest is 7 now.

Pelvic Floor Answers

The approach to menopause is a time when many women who may have never experienced bladder weakness previously,  find they have issues particularly when sneezing, coughing, running and jumping on trampolines.

Like other muscles, the pelvic floor muscles weaken with lack of use and it can be difficult to know which are the right muscles to switch on and how much is enough exercise to make a difference.

The initial cause of bladder weakness is usually pregnancy itself - the constant pressure bearing down on the pelvic floor muscles, this is exacerbated by each pregnancy. The body naturally produces hormones during pregnancy that allow the pelvic to soften to prepare for childbirth.

The drop in oestrogen leading up to menopause can result in a similar effect where the pelvic floor muscles soften or lose their muscle tone. This can affect otherwise physically fit women. Heavy lifting, straining and coughing can also lead to what is often referred to as stress incontinence.

Smart Balls are a simple and effective method of toning the pelvic floor muscles, and correcting and preventing bladder weakness in women of all ages and life stages. There is no magic to them, they are a weighted ball that when inserted vaginally rest and move across the pelvic floor muscles. The muscles naturally contract to hold the balls in place. So apart from when you start using the balls, there is no real effort required other than inserting and removing the Smart Balls.

Like any exercise regime, Smart Balls are ideally worn for short periods of time (such as from 30 minutes if your muscles are quite compromised) and building up until you can wear the balls for up to several hours a day. We don't recommend going straight into wearing them for hours the first few times as the pelvic floor muscles can get fatigued and you can take a few days before you can hold them in if you go to hard out at the start. (Same principle as not running a marathon the first day you take up running.

Once you have done the 6-8 weeks of regular work out, you can then shift to a once or twice every couple of weeks to keep your tone on.

Smart balls come with instructions for use. 

We recommend always using a hypoallergenic lube with your Smart Balls for comfort and ease of use. Start with the single ball Smart Balls Uno and then progress to the double balls Smartball Duo. These can be purchased in a set with everything you need to get started.

Smart Balls are made in Germany from skin friendly, non porous silicone and are designed to be used and reused over several years as needed, can be washed in hot soapy water and rinsed and stored away from sharp objects.

Check out the Pelvic floor blog for other FAQ's and  women's questions answered

Ask a Question. Bladder prolapse is making me want to go to the bathroom constantly

By Pelvic Floor Health
on July 24, 2016

I have a bladder prolapse, it is in the 'front' of the wall, felt most when I lean forward and when it is bad I feel like I am constantly wanting the bathroom.


I have been referred to your website by a friend.
I am 31, small built, 45kg 160cm, and had a baby 2 years ago. I have a small prolapse...apparently not really enough for the gynecologist to do more than mention it in passing. But I feel it at least weekly, some weeks almost constantly. I gather it is a bladder prolapse, as it is in the 'front' of the wall, felt most when I lean forward and when it is bad I also sometimes feel like I am constantly wanting the bathroom.
The joys of children, huh! I had a long, difficult labour. My condition is such that it is highly unlikely anything will be done medically, and to be honest I don't think I trust them to do it anyway. It is never painful, just an uncomfortable pressure.
I have been doing pelvic floor exercises since before my son was born, and currently would do them at least 2-3 times a day...this maintains the prolapse some weeks fairly well, while other weeks it is just not enough (I really notice if I forget to do them for a couple of days though!).
I am a student, so really need to be sure whatever I purchase is going to be the best option for me.
 Could you please help me work out whether Smart Balls or Natratone would be helpful and worth the investment?
 I don't have much spare time, so would tend towards the smart balls as they don't require as much time commitment on my part, but noticed your website recommended Natratone more for prolapse.


Pelvic Floor Answers

Thank you for your email. We do recommend Natratone for a prolapse as it works a greater grouping of core muscles and also improves the brain-pelvic floor muscle connection to ensure you are activating the correct muscles as you exercise.
The exercises using the Natratone require 5 minutes, twice a day (allow 4 hours at least between your first and second set of exercises )at least 3 times a week, however we recommend getting in to a daily routine and continuing either with or without the Natratone device for at least 3 months and for women with prolapse you can keep going. So if you are able to make time for this.
Natratone is designed to last, so while you are making a bit of an investment your can keep using it for years.

Some women with prolapse find that they are not able to comfortably wear SmartBalls because of the pressure on the vagina. If you are getting quite an intense or regular feeling of the pressure it could be that SmartBalls wont work for you. Unfortunately they cannot be returned, so the Natratone is less of a risk and also the most suitable product for you in this instance.

Ask a Question. I suffer very badly from urinary urgency and frequency at the same time.

By Pelvic Floor Health
on June 18, 2016

Are these smart balls suitable for strengthening my pelvic floor despite all my bladder and kidney problems?


I have very bad incontinence partly due to childbirth, followed by a total hysterectomy which has caused a prolapse and now I have recently found out that my left kidney has stopped working due to scar tissue damage restricting flow.
I now have a stent in this kidney and find I suffer very badly from urgency and frequency at the same time. Are these smart balls suitable for strengthening my pelvic floor despite all these problems? And roughly how big are they in size?

Pelvic Floor Answers

Thank you for getting in touch with Pelvic Floor Health, it sounds like you are going through a very tough time.
For you we would recommend using the Natratone, not the SmartBalls as the balls may apply extra pressure due to their weight, which may not be helpful.
We always recommend the Natratone as the better option for women who have a prolapse.

Natratone is a series of active exercises, with the Natratone device inserted in the vaginal opening, retraining your brain to recognise where your pelvic floor muscles are and correctly engaging them. It also tones and strengthen your pelvic floor muscles as you do the exercises. Gentle and very effective.
This will help you to regain some control over both urgency and frequency- flow control.

Urgency- or Over Active Bladder- can often be a combination of both physical issues and how the brain has been trained.
For example, if you feel the urge to go to the toilet and go straight away, the body becomes accustomed to this action which reinforces both the urgency and frequency and and the time between needing to go can get closer and closer together.
It is also possible your bladder is not emptying fully and so you feel constantly needed to go.
It is possible over time, provided you have good pelvic floor strength, to retrain your brain to resist the urgency and to go less frequently as a result.

There is no quick fix or easy solution to this, however with persistence you are likely to be able to regain some control and confidence.

I recommend that you read through the information in FAQ's about Over Active Bladder.

You can also seek help for this from a Women's health physio - they usually have one attached to a hospital but can be hard to get appointments with, however as you are already in the medical system and have had significant surgery, you may get in more quickly.

I would recommend getting the Natratone exercises underway and following some of the steps in the Over Active Bladder including increasing your water intake and reducing sugar, coffee and alcohol intake as these aggravate OAB, keeping a diary and and doing the recommended steps to reduce OAB -all included in that article.

I hope you find this information helpful and please feel free to get back in touch if you have any other queries.

Ask a Question. Bladder leakage and frequency

By Pelvic Floor Health
on June 19, 2015

I am in my 20's and find sometimes when I'm wearing the balls I still leak urine when sneezing I was wondering is this normal?

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