Warning signs and when to get help
These are the warning signs from our pelvic floor and Pilates for prolapse guides, word for word, including one line the Pilates page labels as our suggestion. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999.
Call 999 or go to A&E: a spinal emergency, not a pelvic floor problem
New problems with your bladder or bowels together with back pain or numbness can be a spinal emergency rather than a pelvic floor problem. Call 999 (911 in the US) or go to A&E if you have back pain with:
- pain, tingling, weakness or numbness in both legs
- a loss of feeling around your genitals or anus
- changes in your bladder or bowels, such as difficulty peeing, or peeing or pooing yourself
Source 53
From our pelvic floor guide: go to A&E or call 999
These can be signs of a serious problem with the nerves at the base of the spine (cauda equina syndrome), or of a serious infection. Don't drive yourself to A&E.
- Numbness around or under your genitals, or around your bottom.
- Finding it hard to start peeing, being unable to pee, or being unable to control when you pee, when this isn't normal for you.
- Not noticing when you need to poo, or being unable to control it, when this isn't normal for you.
- Sciatica in both legs, or weakness or numbness in both legs that is severe or getting worse.
Source 53
Not being able to pee
You can't pee at all.
If you cannot pee at all, get urgent help from a GP or NHS 111, and if it comes on suddenly with severe tummy pain, call 999 or go to A&E.
Source 1
A bulge that won't go back
A bulge that has come outside the vagina and is sore, bleeding or won't go back in: see a GP soon, and get help the same day if you also can't pee (our suggestion, from the NHS's advice to see a GP about any lump and our "can't pee at all" line; the NHS prolapse page gives no urgent line for this).
Source 1
See a GP
The NHS says see a GP if:
- you have a lump in or around your vagina
- you have any other symptoms of a pelvic organ prolapse, such as heaviness, discomfort or pressure, pain or numbness during sex, or changes in peeing or pooing
Source 1
Leaking, blood in your pee, or bleeding after the menopause
"See a GP if you have any type of urinary incontinence", the NHS says, and don't feel embarrassed: it's common. See a GP too about a lump or bulge in or around your vagina, or other signs of a prolapse such as heaviness, dragging or problems emptying your bladder or bowel. NHS continence services, with specialist nurses and physiotherapists, can diagnose the problem and start treatment.
Blood in your pee, or you think there may be: it can look pink, red or dark brown, and it must be checked because it can be a sign of cancer.
See a GP if you notice bleeding from your vagina after the menopause, "even if it's only a small amount or it's only happened once", the NHS says.
Source 1
See a pelvic health physiotherapist
In many areas you can refer yourself. See one if the exercises are hard to do, if your symptoms haven't improved after about 3 months of regular practice, or before you go back to running, jumping or heavier lifting.
Source 2
If yoga brings on symptoms
Stop, drop back to an easier level and rest if you feel heaviness, dragging, pressure or a bulge, or you leak, during or after an activity. If you see or feel a bulge when you squeeze, stop the pelvic floor exercises and get help.
Stop a pose that brings on leaking, heaviness, dragging, a bulge or pain, and make it smaller or leave it out. POGP says pain when you exercise the pelvic floor, or tummy or pelvic pain afterwards, needs advice from a specialist physiotherapist; meanwhile, stop adding squeezes and use the relaxation practice (our suggestion). For men's symptoms such as a weak flow or dribbling, see our pelvic floor exercises guide.
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Sources 2, 11
With a pessary
See your clinic for bleeding, pain or a smelly discharge, or if your pessary keeps falling out. If it's stuck, contact the clinic where it was fitted, your GP or the nearest A&E.
Source 45
After prolapse surgery: seek medical advice
- burning or stinging when you pee, or peeing often
- vaginal bleeding that becomes heavy or smelly, especially with a high temperature
- a painful, red, swollen, hot leg, or difficulty putting weight on your legs
- Chest pain, shortness of breath or coughing up blood can mean a clot in the lung: the RCOG says seek medical help immediately.
Source 48
Chest pain or fainting while exercising: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 54, 55
Head-down poses, bones and pregnancy
With glaucoma, or high blood pressure that isn't under control, skip headstands, shoulder stands and long head-down holds. With osteoporosis, swap deep forward folds for a flat-back hinge from the hips, and twist smoothly. In pregnancy, our yoga in pregnancy guide covers the changes. NCCIH advises beginners to avoid headstands, shoulder stands, the lotus position and forceful breathing.
Sources 56, 57
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.