How to Tone up Your Perineum

Weakened, poorly coordinated, or damaged perineal muscles can provoke a number of different medical issues: urinary or faecal incontinence, prolapse, pelvic pain, discomfort during sexual encounters… These issues affect a significant part of the population, regardless of gender. One study estimates that pelvic floor troubles impact between 25% and 50% of women (Mitchell et al., 2025 ; Kepenekci et al., 2011).

Perineal rehabilitation aims to restore muscle tone, neuromuscular coordination, endurance, and sensory and proprioceptive perception in the area. It’s a key step in both preventing and resolving perineum related problems. Targeted muscle strengthening, posture, breathing, abdominoperineal coordination, and bodily awareness all play an essential role in ensuring good perineum health (Dumoulin et al., 2018).

The perineum is the name used to describe the region of our body situated at the base of the pelvis, defined at the front by pubis, on the sides by the ischial tuberosities, and behind by the coccyx. The urethral orifice and the vagina runs through this area in women, the scrotum in men, and the anus in all cases.

The pelvic floor refers to the group of muscular, tendinous and fascial structures that form a ‘muscular hammock’ that join together the left and right side of the pelvis in order to support the pelvic organs (bladder, uterus, rectum). It also contributes to ensuring stability between the pelvis and the spine (Roch et al., 2021).

The structure remains fundamentally the same in both sexes, but the orifices and certain muscle bundles may differ in their insertion or orientation.

The perineum/ pelvic floor has many important physiological roles:

• Supporting the pelvic organs: the muscular hammock keeps the organs in place by holding them in position in the face of intra-abdominal pressure. Muscle weakness or fascial deterioration can cause a prolapse.
• Urinary and faecal continence: the sphincter muscles and the levator ani, ensure that the urinary and faecal tracts remain closed until voluntarily relaxed. They are involved in both exertion and general muscle tone. (Bø, 2014).
• Posture and breathing: the thoracic diaphragm, transverse abdominal muscles, and the pelvic floor are all closely connected. On one hand, inhaling and exhaling influence the position of the pelvis, on the other hand, a well toned pelvic floor ensures dynamic breathing and good posture.
• Stability: During exertion, coughing or increased intra-abdominal pressure, the perineum synchronises with the diaphragm and deep abdominal muscles to stabilise the pelvis and lumbar spine.
• Sexual and sensory function: The perineum is a key element in sexuality, contributing to orgasmic contractions, pelvic proprioception, and erection in men.

Beyond physiology, the perineum has an essential sensory and emotional dimension. In the sexocorporal approach, this area is viewed not only as a support structure, but also as a way of perception, connection, and embodiment. Muscle tone, relaxation, and mindfulness regarding the perineum have an influence on your body image, sexuality, and the ability to feel. Thus, having too tense, or a hypertonic perineum can cause pain (dyspareunia, vaginismus, hyper-reactivity), physical tension, and a reason to avoid sexual relations. What’s more, too relaxed a perineum can lead to a loss of sensation, decreased pleasure, a feeling of physical ‘emptiness’ and impact sexual confidence.

The sexocorporal approach aims to restore the perineum to its ‘living’ state, not overly contracted, nor absent, that will help to improve feeling during sex or intimate moments. It puts the emphasis on body consciousness (perceive, feel and inhabit the perineum), emotions (what these muscles evoke for you, what physical memories are linked to it), and sexuality as a global bodily practice (breathing, movement, sensory perception, touch, pleasure).

Thus, controlled contraction and relaxation of pelvic floor muscles help to increase the sensitivity of the pelvic region, improve orgasms, and reduce pain during sex (Jorge et al., 2024). The perineum is therefore seen as a sensory crossroads, where muscle tone, perception, breathing, and relaxation all have a role in feeling pleasure. To sum things up, taking care of your perineum doesn’t just ensure that it’s ‘working properly’ in a medical sense, but it also allows for heightened connection between the body, emotions, and pleasure (Desjardins, 1996).

In a woman’s lifetime, the perineum can be really put to the test: pregnancy, giving birth, hormonal changes, menopause, high impact sports, weight gain (Li et al., 2015). It’s estimated that between 30 and 50% of women suffer from problems linked to perineal weakness, that can cause problems such as urinary incontinence or a prolapse (Zumrutbas, 2025). In men, these issues can also arise, especially after prostate surgery, or in the case of prolonged sedentary behaviour (Notenboom-Nas et al., 2023).

Thus, perineum/ pelvic floor rehabilitation is a key process at certain points in our lives, depending on certain profiles:

• Postpartum: After childbirth, the pelvic floor may have undergone distension, hypertension (long labour) and trauma (tearing, episiotomy).
• Menopause: The decrease in oestrogen affects muscle trophicity and vascularisation of the perineum, which can lead to weakness, incontinence and sexual dysfunction.
• Pelvic surgery (for example, a prostatectomy in men): After radical prostatectomy, pelvic floor strengthening is recommended to speed up the return to continence (Strączyńska et al., 2019).
• High impact sports: Jumping, carrying heavy loads, and intra-abdominal hypertension put strain on the pelvic muscles and require appropriate and regular muscle training in this area.
• Chronic pelvic pain/ dyspareunia/ vaginismus: Hypertonicity of the perineum can cause various disorders that require appropriate rehabilitation to enable relaxation (van Reijn-Baggen et al., 2022).
• General ageing: With age, there is a decrease in muscle mass and strength, including in the pelvic floor muscles.

Pelvic floor strengthening exercises (pelvic floor muscle training, PFMT), are often recommended nowadays as first-line treatment for the prevention and management of incontinence and prolapses. These exercises allow for significant improvement in muscle tone and quality of life (Dumoulin et al., 2018). What’s more, these exercises can be performed at any point in the day.

To be more precise, perineum rehabilitation consists of performing repeated voluntary contraction and relaxation of the pelvic muscles. After contraction, relaxation lasting at least as long as the contraction is essential to allow the muscle to return to its resting tone and avoid chronic fatigue or hypertonia (van Reijn‑Baggen et al., 2022).

Training the muscle this way, paired with Kegel exercises, helps to significantly reduce the risk of urinary incontinence, with the results being more pronounced if the exercises are practiced over an extended period (Dumoulin et al., 2018 ; Bø, 2014). For example, for women who have gone through menopause, working on the perineum can help to maintain a healthy sex life and improve comfort levels during sexual encounters (Nazapour et al., 2017).

You’ll find more detailed information on how to do Kegel exercises here: https://www.wikihow.com/Do-Kegel-Exercises

This technique consists of providing a visual or auditory support showing the contraction of the pelvic floor via an internal (vaginal/rectal probe), or external sensor. This allows the patient to visualise the muscular effort used, optimise muscular activation, and correct their contraction technique. Biofeedback is particularly useful for patients that struggle to locate or correctly perform muscular contractions in their perineum.

Perineal electrostimulation transmits electric impulses via a probe or external electrodes in order to stimulate the pelvic floor muscles, particularly in patients who can’t voluntarily contract these muscles.

A vaginal cone (or weight) is a cone-shaped device that is designed to be inserted into the vagina, and requires the pelvic muscles to contract in order to stay in place. Ben Wa balls, whether vibrating or not, do the same thing.

High impact sports (like running, trampolining, or crossfit etc.) call heavily upon the pelvic floor and can, without warning, weaken it. Abdominal muscle contraction creates a pressure in the stomach that is transmitted upwards (coughing, sneezing, vomiting, etc.) or downwards (defecation, expulsion, etc.).

Pressure in the abdomen must be well managed, as the thoracic diaphragm, the transverse perineal muscles, and the pelvic floor are all mutually dependent on each other. Thus, thoracic breathing or excessive abdominal activation cause internal hypertension, pelvic floor overload, and muscle fatigue (Trinh Dinh & Baecher, 2013).

One recent study shows that professional female footballers often have very frequent urinary leakage during exertion due to deficits in control, relaxation, endurance and appropriate contraction (Sebastian-Rico et al., 2025). Evidently the aim isn’t to avoid sport, but rather to prevent any imbalance between the abdominal and perineal muscles, notably via Kegel exercises, as well as working on both posture and breathing.

In cases of perineal hypertonia or chronic pelvic pain, rehabilitation does not consist of ‘building muscle’ but rather relaxing, loosening up and coordinating. Reverse biofeedback (visualisation of relaxation) can be useful, combined with slow breathing techniques, meditation and Bodyscan exercises.

Visualisation enables women to recognise specific parts of the vagina, and therefore specific muscle areas. Authors Trinh Dinh and Baecher propose the image of a small cave, with the vulva at the entrance, the pelvic diaphragm on the left and right side walls, the pelvic floor at ground level, and, as a ceiling, the urethral area, its sphincter, and the bladder topped by the uterus. At the back of the cave, we also find the cervix, which varies in position with the cycle (Trinh Dinh & Baecher, 2013). Once these areas have been differentiated and clearly represented in the mind, it is easier to contract and relax specific muscles.

Contrary to popular belief, rehabilitation isn’t just ‘trying to hold your pee in’. A correct perineal contraction should be upward and tightening, i.e:

1. Closed orifices (urethra, vagina, and anus in women; urethra and anus in men),
2. An upwards trajectory (meaning the perineum moves slightly upwards),
3. Without contracting the glutes or adductors, and without holding your breath to avoid internal tension.

Contractions need to be coordinated with your breathing:

• On the inhalation: perineal relaxation (the diaphragm descends, the pelvic floor follows)
• On the exhalation: perineal contraction (the diaphragm rises, the perineum closes and lifts)
  

Before any form of exercise, you have to make sure that you’re performing the right actions: the contraction of the perineum must be isolated, hence the importance of first identifying the different muscle groups. When contracting the perineum, the abductor muscles and the gluteal muscles must remain relaxed. What’s more, it’s important to be fully relaxed in between contractions in order to avoid hypertonia. Follow-up with a physiotherapist or specialist midwife is recommended to ensure this work is carried out correctly.

Furthermore, in case of pain (irritation, postpartum scarring, haemorrhoids etc.), any exercise should be adapted accordingly, or taken up once everything is healed. Consistency is more essential than intensity. What’s most important is remaining motivated in the long term, and to continue with the exercises even after noticing an improvement.

Perineal rehabilitation can resolve incontinence, postpartum recovery, prostatectomy, perineal pain, and prevent prolapse. Regular muscle training, supported by biofeedback, electrostimulation, breathing and posture, is the first-line approach, validated in the literature (Dumoulin et al., 2018; Bø, 2014). Specialised support, continuity, regularity, and motivation are key to improving these disorders. The perineum is certainly a structure of support, movement and perception, but also of pleasure. Restoring its function also means regaining body confidence and quality of life.

What if taking care of your perineum became a truly pleasurable experience? The LOVE Team invites you to discover sex toys that combine well-being, tone, and sensuality! Ben Wa balls, vibrating love eggs or remote control stimulators: these fun accessories allow you to naturally contract your pelvic floor muscles while stimulating your sensations. Each vibration becomes an invitation to breathe, feel, and gently inhabit your body. By transforming perineal training into a sensual ritual, you strengthen your tone while cultivating a connection to yourself and your pleasure. Because strengthening your perineum also means learning to love yourself more deeply — from the inside out.