Vol. 7 MYTREX AQUA QUTTO | Pelvic Floor Muscles: Things You Thought You Knew, But Didn't

How I, who worked in this field, only truly understood pelvic floor muscles after childbirth

1｜Confession

I knew about the pelvic floor muscles.

It was knowledge I possessed as a matter of course due to my profession. I knew where the muscles were located, why they were necessary, and why they weakened. I had explained their importance and methods using Kegel exercise devices collected from around the world.

But honestly, until I experienced urinary leakage myself after childbirth, it was always "someone else's problem."
Perhaps that's true for everything. Until you experience it yourself, you don't understand it, and it doesn't become your own problem.

That "oh" feeling the moment I sneezed. The slight panic when I couldn't stop laughing.

After childbirth, for the first time, the term "pelvic floor muscles" became about my own body.

Even I, who work in femtech, experienced this. That's why I want to write about this today for those of you who aren't concerned yet, and perhaps for those of you who are starting to become a little concerned.

2｜Where are the pelvic floor muscles located?

Even if you've heard the term "pelvic floor muscles," I think few people can actually visualize where they are.

Their location is the "floor" of the pelvis. As the name suggests, they are a group of muscles spread like a hammock at the very bottom of the pelvis. They firmly support the three important organs for women—the bladder, uterus, and rectum—from below.

They can't be seen from the outside and can't be touched.

While you can identify "here it is" for arm or thigh muscles, it's difficult to confirm whether your pelvic floor muscles are truly moving, even if you try to move them. They are muscles that "are there but go unnoticed."


However, these muscles actually do quite a lot.

First, they support organs. The bladder and uterus are kept in their correct positions because of the pelvic floor muscles. They also control urination and defecation. It's thanks to these muscles that you can hold it in when you need to go to the toilet. They also maintain posture—they work with the diaphragm and abdominal muscles to support the body's core from within.

And they are deeply involved in pregnancy and childbirth. I'll talk about this in more detail later.

Even though a single muscle does so much, it is almost never consciously recognized. It works silently every day.

3｜Today's women are not using them

Women of previous generations naturally used their pelvic floor muscles in their daily lives. Squatting to clean, carrying heavy objects, using Japanese-style toilets—such actions moved these muscles without conscious effort.

But what about today?

Sitting in front of a computer all day. Slouching while looking at a smartphone. Some days, working remotely means not stepping out of the house at all.

Sitting in a chair for long periods tends to tilt the pelvis backward. If this posture continues, the pelvic floor muscles shift from their original position and gradually weaken from disuse.

This isn't about being lazy or having low awareness. Our lifestyle itself has changed, reducing natural opportunities to use them. For us living in this era, these muscles are in a place where we must consciously move them.

4｜To those who think, "This doesn't concern me"

Many people may feel that urinary leakage is "an issue for the elderly" or "an issue for those who have given birth."

However, the numbers indicate otherwise.

A 2019 survey by P&G Japan targeting 40,000 Japanese women found that more than 1 in 2 women aged 20-60 experienced urinary leakage, with around 60% across all age groups. Furthermore, 63.4% of 20-somethings who experienced it had not given birth.

According to the Japanese Urological Association, over 5 million women experience "stress urinary incontinence"—urinary leakage when abdominal pressure increases, such as during sneezing or exercise—at least once a week.

And among those who are aware of experiencing urinary leakage, about 60% do not consult anyone.

They're concerned, but can't talk about it. They don't know where to seek advice. They try to convince themselves it's no big deal.

Many people like this are around you. Perhaps even yourself.

5｜What those trying to conceive should also know

The discussion of pelvic floor muscles isn't just about urinary leakage. It's also highly relevant for those considering pregnancy.

When the pelvic floor muscles are in good condition, blood flow around the pelvis improves. Improved blood circulation to the uterus and ovaries is said to be important for preparing the body during fertility treatments.

Pregnancy is even more challenging. As the abdomen grows, the weight of the uterus continuously bears down on the pelvic floor muscles. If they are already weak, it can easily lead to back pain and pelvic pain.

Then, during childbirth. As the baby passes through the birth canal, the pelvic floor muscles stretch significantly. If the muscles are flexible at this time, they can adapt well to these changes. The condition of the pelvic floor muscles is also said to influence the speed of postpartum recovery.

If the pelvic floor muscles remain weak after childbirth, the risk of persistent urinary leakage and prolapse of organs (pelvic organ prolapse) increases. This was precisely the timing of my own experience.

Fertility treatment, pregnancy, childbirth, postpartum, menopause—the pelvic floor muscles are present at every stage of life. That's why I believe it's much better to "prepare beforehand" than to "address it after it happens."

6｜So, what to do?

The most common way to train the pelvic floor muscles is through Kegel exercises. You "squeeze" around the vagina and anus, then slowly release. You repeat this. No equipment is needed, and you can do it while sitting.

However, it's also true that few people continue with them.

"I don't know if I'm doing it correctly," "I don't feel it working," "I stopped without realizing it"—because these muscles are hard to consciously control, it's common to think you're doing it when you're not, and it's easy to stop because you don't feel changes.

That's where EMS (Electrical Muscle Stimulation) comes in as an option. It's a technology that directly moves muscles with electrical stimulation, allowing you to approach muscles that are hard to consciously control from the outside.

MYTREX AQUA QUTTO, which fermata also carries, has a unique way of being used. It's waterproof, so you just place it in the bath and sit on it. You don't need to set aside special time. Your daily bath time becomes pelvic floor care. The stimulation intensity can be adjusted in 10 levels, so even those new to EMS won't be intimidated.

Integrating care into a routine that doesn't require constant conscious effort is what I love about this device.

7｜Now, when you're not yet concerned, is the perfect time

After reading this article, some of you may think, "I'm still fine."

That's probably true. However, the pelvic floor muscles are also muscles where it can be a little late once you start to become concerned.

As I experienced, even if you "think you know," it's difficult to internalize it as being about your own body. But if you're reading this now, perhaps you're a little concerned, or you want to know for someone else's sake.

There's a muscle working silently at the core of your body, though you can't see it.

Please try to pay a little attention to that muscle starting today.

You can start with your bath routine.

— Dr. Amina Sugimoto, PhD in Public Health (London School of Hygiene & Tropical Medicine) / Founder of fermata Inc.

MYTREX AQUA QUTTO is available at fermata EC.