How to have the perfect poo!

By Christien Bird, Women’s Health Physiotherapist, Founder of White Hart Clinic and Co-Founder of Menopause Movement  

Bowel dysfunction is a classic silent problem, causing misery in women’s lives which can be aggravated by changes into the menopause. Whether it be constipation, incomplete emptying, faecal incontinence (poor ability to control bowel movements), poor control over wind, rectal prolapse, haemorrhoids (piles), pain from anal fissures (a tear in the lining of the anal canal), bloating or a collection of these; it remains a very difficult topic to open up about, even with loved ones. 

For that reason, it’s important as HCPs that we talk more about the benefits of a regular happy bowel movement and how to achieve it. Women will feel better for it, and it can help to treat prolapse symptoms, improve bladder urgency and urinary leakage.   

Here are the 3 Top Tips, the 3 ‘P’s: Position, Patience & Pushing to share with clients. 


Nature intended us to squat behind a tree which means our knees are higher than our hips. The rectum is like waterslide with a kink, once your knees are up, you unkink the waterslide, which makes bowel emptying easier. Use a stool, a box or we’ve even had patient’s recommend using high heels! 


You need patience. You can’t just empty the tap. Take your time, rest, relax and naturally empty your bowels. If you rush you may not empty bowels effectively. It’s a little like squeezing the toothpaste tube from the top! Always wait until you ‘feel the call’ and if possible, don’t delay ‘answering’.  

Pushing  (Or, as we like to phrase it ‘to push or not to push’) 

Take a gentle breath, gently bear down & say the words ‘moo to pooh’. DO NOT STRAIN! If you can only empty your bowels effectively by straining, you should see your GP, or a pelvic health physio for a pelvic assessment. 

And finally, it’s good to always be aware of your stool and what they look like. The optimal stool is around a type 4 on the Bristol Stool Chart, torpedo shaped and banana consistency 

If women feel as though their bowels are unhappy or have noticed anything unusual, they should consult their GP. They may also want to consult a women’s health physiotherapist, experts in female pelvic health. 

Christien Bird is a women’s health physio, founder of White Hart Clinic and co-founder of the training platform & professional network for health and fitness professionals Menopause Movement