Pelvic Health Experts Answer: What’s the Biggest Myth About Pelvic Floor and Aging?

If you’ve ever heard someone shrug off leaking, pelvic pressure, discomfort, or other pelvic floor symptoms with, “Well, that’s just part of getting older,” you’re not alone.

It’s an incredibly common assumption. And according to the pelvic health experts we’ve interviewed, it’s also one worth challenging.

Yes, our bodies change as we age. Hormonal shifts during perimenopause and menopause can affect pelvic tissues, and symptoms that were mild or nonexistent earlier in life may become more noticeable. But common doesn’t mean you have to simply live with symptoms that are affecting your comfort, confidence, or ability to stay active.

We asked pelvic health professionals across our Expert Spotlight series to talk about pelvic health through different stages of life. Again and again, their message was similar: your pelvic floor deserves attention beyond pregnancy and postpartum, and getting older doesn’t mean your options disappear.

Here are five myths their insights help us rethink.

Myth #1: “Pelvic Floor Problems Are Just a Normal Part of Aging”

This may be the biggest one.

Dr. Kaleigh Mulpeter, PT, DPT, PCES, works with people across many stages of life, including pregnancy, postpartum, and menopause. She explained that pelvic floor changes can happen as hormones, activity levels, and overall health evolve.

As estrogen levels decrease around perimenopause and menopause, she says, tissues in the pelvic area can become thinner and more sensitive. But her takeaway isn’t that women should simply resign themselves to discomfort.

“A pelvic PT or OT or a different pelvic-trained provider can help support you at any stage,” Dr. Mulpeter explains. “I think if you're having any issue like pain, leakage, heaviness anywhere in or around your pelvic floor, that's the time to reach out if you feel comfortable doing so and get some support.”

That distinction matters.

Changes with age can be expected. Being bothered by symptoms and believing there’s nothing worth exploring is different.

Dr. Beth Henigan, DPT, OMPT, PCES made a similar point when discussing menopause. Because symptoms may come on gradually, she says, it’s easy to think, I’m aging. This is just how things are now.

But she emphasized: There’s still so much you can do at those ages and stages.

For women who have spent years putting everyone else first, that can be an important mindset shift.

Your age isn’t a reason to stop asking questions.

Myth #2: “Pelvic Floor Care Is Mostly for Pregnancy and Postpartum”

Pregnancy and childbirth are often the first time women hear the words pelvic floor. But they’re far from the only times pelvic health matters.

Pelvic health continues to evolve throughout the lifespan, including during perimenopause and menopause. Dr. Rachael Cappuccino, PT, DPT sees this regularly in her physical therapy practice.

She shared that women in these stages may experience concerns such as pain with sex, leaking, and pelvic organ prolapse, which are the same symptoms pelvic floor therapists also address during pregnancy and postpartum.

Her practice’s message?

“It’s never too late. Postpartum is forever. It doesn’t matter how long ago you had your kids, we can always help.”

That’s especially important for someone who gave birth 10, 20, or 30 years ago and assumed the window for seeking pelvic health support had closed.

Pelvic health isn’t a six-week-postpartum topic.

It’s a whole-life topic.

Myth #3: “If My Pelvic Floor Is Changing, I Should Exercise Less”

Pelvic floor symptoms can make movement feel intimidating.

You might start second-guessing a long walk. Skip strength training because you’re worried about pressure. Stop running after noticing leaking. Or decide that being more sedentary is simply the safer choice as you get older.

But Dr. Ally Loupe, PT, DPT sees a different opportunity during perimenopause and menopause: helping women stay connected to movement rather than becoming afraid of it.

In her practice, she works with women who want to return to exercise and strength training but may be holding back because of leaking, prolapse symptoms, pain, or simply because strength training is new to them. As she explained, some women reach this “second season of life” knowing that they want to get stronger, but pelvic floor symptoms — or uncertainty about where to begin — can make taking that first step feel daunting.

Her approach is rooted in looking beyond the pelvic floor in isolation

“Yes, the pelvis is the hub, but it’s a whole body issue." -Dr. Ally Loupe

That whole-body perspective matters because movement doesn’t have to be an all-or-nothing decision. Experiencing leaking, heaviness, prolapse symptoms, or pain doesn’t automatically mean strength training is off the table. Instead, those symptoms can be information to pay attention to as you figure out what your body needs.

Dr. Loupe also encourages people not to automatically fear pain or discomfort, but to use symptoms as a cue to listen more closely to their bodies and notice what may need to change.

The goal isn’t to ignore symptoms or push through discomfort.

It’s also not to let fear convince you that movement is no longer for you.

With an individualized approach, that might mean modifying an exercise, building strength gradually, working with a pelvic health professional, or finding support strategies that help you feel more comfortable and confident while you move.

Getting older may change how you approach exercise. It doesn’t have to mean giving it up.

Myth #4: “My Only Choices Are to Put Up With It or Pursue Something Drastic”

When pelvic symptoms start interfering with daily life, it’s easy to imagine two extremes:

Do nothing.

Or:

Do something major.

In reality, pelvic health support can involve many different options.

Pelvic floor physical therapy is one. A trained provider may look beyond simple strengthening to consider things like relaxation, muscle coordination, breathing, core and hip strength, movement habits, and the activities that bring on symptoms.

That’s important because another persistent pelvic floor myth is that everyone simply needs more Kegels.

Dr. Rachael Cappuccino calls “just do your Kegels” one of the biggest misconceptions she encounters. Some people need strengthening, but others need to learn to relax or coordinate the pelvic floor differently.

Depending on your individual needs, other options may also include discussions with a medical provider, pessaries, adjustments to everyday habits, or external pelvic support.

There isn’t one universally “right” tool.

And using support doesn’t mean you’ve failed.

Myth #5: “If I Leak, It Must Mean My Pelvic Floor Is Weak”

Leaking is often treated as shorthand for a “weak pelvic floor.” And as women get older and notice new or changing symptoms, it can be easy to assume the answer is simply to strengthen more.

But pelvic floor function is more complicated than strong versus weak.

Julia Neto, Prenatal and Postpartum Corrective Exercise Specialist, says one of the biggest misconceptions she sees is the assumption that pelvic floor symptoms always come from weakness.

“It’s much more common to have an overly tight pelvic floor, which is known as a hypertonic pelvic floor,” Julia explains. “And so even after birth, you can still have that problem and that can cause a lot of the same symptoms, things like leaking and pain and discomfort that come with a weak pelvic floor too.”

The difference matters because a tight pelvic floor may need something very different from a weak one. Rather than focusing only on squeezing and strengthening, some people may need to work on relaxing, lengthening, and coordinating those muscles.

As Julia puts it:

“There’s definitely a time and a place where Kegels the right exercise, but I just like to preach that it’s equally important to know how to release the pelvic floor as it’s to know how to engage it.”

That’s why leaking — or another pelvic floor symptom — isn’t enough on its own to tell you what your muscles need.

An individualized assessment can help determine whether the focus should be strengthening, relaxation, coordination, or a combination of strategies.

So if leaking becomes more noticeable as your body changes, don’t automatically assume you need to squeeze harder.

Sometimes the better first question is: What is my pelvic floor actually doing?

So, What Should Women Realistically Expect as They Get Older?

Perhaps the most useful message from these experts is that we can hold two truths at the same time:

Your pelvic floor can change as you age.

And:

You still deserve to feel informed, supported, and engaged in the life you want to live.

Dr. Henigan explains that menopause can bring structural and hormonal changes that affect muscle mass and tissues. An older prolapse, for example, may become more noticeable again. She describes those shifts as common and something women can anticipate, but emphasizes that this does not mean there’s nothing they can do.

Dr. Mulpeter likewise encourages people to reach out when symptoms such as pain, leaking, or heaviness begin affecting them, rather than assuming those concerns should simply be tolerated because of age.

That may mean your version of pelvic health at 60 looks different from your version at 30.

That’s okay.

The goal doesn’t have to be pretending your body never changes. It can be learning what your body needs now.

What You Can Do

If your pelvic floor has started to feel different in midlife or beyond, consider beginning with a few practical steps:

• Notice your patterns. Does heaviness happen after long periods of standing? Does leaking show up during certain exercises? Have symptoms shifted alongside perimenopause or menopause?
  
  Keeping track of when symptoms show up can make those patterns easier to spot. Our Pelvic Health Symptom Tracker can help you note what you’re feeling, what you were doing, and how symptoms change over time so you have clearer information to bring into conversations with your healthcare provider.
  
  
• Bring symptoms up with a qualified provider. You don’t need to wait until they feel “severe” to ask questions.
  
  
• Consider a pelvic floor physical therapist. Pelvic floor PT isn’t reserved for new moms, and care can be individualized to your body, symptoms, and goals.
  
  
• Keep movement in the conversation. Rather than automatically giving up activities you enjoy, ask what modifications, progression, or support might make them feel more comfortable.
  
  
• Explore the support tools available to you. Depending on your needs, that conversation might include a pessary, external pelvic support, or other strategies alongside professional care.

Most importantly, don’t let the phrase “that’s just aging” end the conversation before it starts.

Aging Doesn’t Mean Giving Up the Things You Love

At Hem Support Wear, we believe pelvic support should fit into real life—including the decades well beyond pregnancy and postpartum.

For some women, wearing a pelvic floor support garment can provide a feeling of support while walking, exercising, traveling, gardening, spending a long day on their feet, or simply going about everyday life. Our focus is on helping women feel supported and comfortable while wearing the garment, so they can keep participating in the activities that matter to them.

Because pelvic health isn’t about chasing a younger version of your body.

It’s about having good information, understanding your options, and finding the support that works for the body and life you have today.

And there is no age limit on that.

About the Hem Support Wear Team

Meet Cristin, Lauren, and Alexa: a small, mission-driven team passionate about helping women feel supported, seen, and strong—especially when it comes to pelvic health. Hem Support Wear was founded by Lauren Fleming, whose personal journey with prolapse sparked a mission to make healing feel less lonely and a whole lot more empowering.

**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.