Pregnancy, childbirth, menopause and the muscle loss that comes with normal aging can all affect the health of a woman’s pelvic floor. A weakened pelvic floor can lead to urinary incontinence (UI), and left untreated, it tends to get worse. But there’s good news. Interventions exist that help women regain pelvic floor function and strength, often significantly.

Awareness is the first step. Roughly half of women 50 and older experience urinary incontinence. Most just live with it. They manage the leaks quietly, wear pads, avoid discussing the topic. That’s starting to shift. National guidelines (WPSI) now call for healthcare providers to ask every woman, at her annual well-woman visit, whether she has UI, how much it bothers her, and whether she wants treatment. Simply being asked changes things.

Once a problem is identified, there’s a lot that can be done. General lifestyle habits matter: avoiding or quitting smoking, watching diet and fluid intake (caffeine, alcohol and carbonated drinks can all irritate the bladder), maintaining a healthy weight, staying active, and resolving constipation when it’s present.

The pelvic floor is a muscle group like any other, which means it can be trained. Even a pelvic floor that’s already weakened can improve. Pelvic floor muscle training, or PFMT, involves a structured program of exercises done consistently over several weeks or months. On their own, most women struggle to do it correctly — research suggests only about a quarter can. With a healthcare provider’s guidance, results improve substantially, and women who complete a supervised program are far more likely to see real improvement.

Smartphone apps and connected devices have made daily PFMT practice more accessible, but the options vary widely in quality. Look for something FDA-cleared, backed by published data, and built to keep a healthcare provider in the loop.

Axena Health’s Leva Pelvic Health System, for instance, uses real-time visualization of pelvic muscle movement to guide feedback during training — one of the features that sets it apart.

Talking openly with a healthcare provider remains one of the most useful things a woman can do for her pelvic floor. PFMT can start early, to build strength ahead of time, or later, to restore function that’s already been lost. Every woman’s situation is different, but effective options exist for most.