Will weight lifting make my prolapse and leakage worse?

I love adding weights into my hypos flow- it ticks more of my exercises boxes and is great for training the pelvic floor too.

We often worry that doing weights will make our prolapse and leakage worse but the research suggests otherwise.

I've dug out two studies that show weightlifting to be beneficial for prolapse and pelvic floor dysfunction.

"Symptoms of pelvic organ prolapse in women who lift heavy weights for exercise: a cross-sectional survey"
Published in the International Urogynecology Journal, December 2019.

The study surveyed 3,934 women over 18 who lifted light (≤15 kg), moderate (16–50 kg), or heavy (>50 kg) weights for exercise, or who didn't lift at all. Participants completed an online survey about risk factors for pelvic floor dysfunction, physical activity history, and pelvic floor symptoms, using a validated question from the Pelvic Floor Distress Inventory (PFDI-20) to identify POP symptoms. Springer

Key findings:

Of the 3,934 participants, the total prevalence of POP symptoms was 14.4%. Physically active women lifting weights of 15 kg or less were more likely to report POP symptoms than women lifting over 50 kg — 59.7% vs 15.2% respectively (adjusted odds ratio 2.1). 

The conclusion was that physically active women who lift heavy weights for exercise do not have an increased prevalence of POP symptoms, and that advice on the contribution of heavy weight lifting to the development of POP requires further investigation. Resear

10-Week Combined Aerobic & Resistance Training Study (2025, published in Healthcare)

A study of 30 postpartum women with pelvic floor dysfunction underwent a 10-week combined aerobic and resistance training programme. The results showed it significantly improved the maximum value of fast-twitch muscle fibres (type II) and the average value of slow-twitch muscle fibres (type I), while also reducing resting tension. The conclusion was that combined aerobic and resistance training effectively improves pelvic floor muscle strength in postpartum women. nih

What I have found with my own weightlifting journey is that my symptoms only got worse when I pre-contracted my pelvic floor muscles when lifting. This is because I have a high tone pelvic floor.

What I do instead is exhale on exertion. In my flows we exhale when lifting the weights and then apnoea and lift during that phase. This allows for a gentle activation of the pelvic floor muscles rather than an over gripped muscles. 

The rest breaths inbetween help relax the pelvic floor. It's a perfect combination. 

We're increasing engagement through the muscles chains which can make it harder to perform the apnoea but that gives the pelvic floor and core more challenge- which is what we want to build that strength.

If you’re already practicing hypopressives and want to add some weights into your flows then check out Keep It Up Club. My monthly membership with over 150 flows designed to improve your symptoms and keep you on track with your practice. Choose from on-demand or live class packages.

And if you haven't tried hypopressives yet and want to check out my beginners workshop