Clear answers for intimate questions

Sixty-nine percent of UK women have never had an NHS professional talk to them about their pelvic floor. Here is the introduction: what these muscles are, what they do for bladder, bowel and vaginal support, and how they are trained.

Some prevention advice has Cochrane reviews behind it, and some has never been tested at all. Here is the honest audit of which is which, including the caveat nobody quotes about pelvic floor exercises.

Twin studies attribute around 40 percent of the variation in pelvic support to inherited factors, and two genes have been identified by name. This is not something you failed to prevent.

Menopause is independently associated with vaginal laxity: 52.6 percent of women reporting laxity had been through it, with adjusted odds of 2.23. Here is what falling oestrogen does to the tissue itself, and why dryness and looseness arrive together.

Levator ani avulsion affects 7.8 percent of spontaneous vaginal births and 51.1 percent of forceps deliveries. Here is what physically happens to muscle and connective tissue during a birth, and what recovery normally looks like.

Vaginal laxity is a real, physical change with identifiable causes, and it is not the same thing as prolapse. Here is what is actually happening in the tissue.