When the pelvic floor weakens or becomes uncoordinated, you may have trouble controlling your bladder or bowels, causing you to leak urine or stool when you’re not attempting to go to the bathroom (such as when you cough, sneeze, or laugh), says Milhouse. Sex may also be painful, keeping you from orgasming from penetrative intercourse.

“I think too often our world has convinced us these symptoms are normal or are just a part of life, but sex being painful is not normal,” she says. “Sneezing and losing some urine after you’ve had a kid, that’s not normal.”

You may also experience pelvic organ prolapse, says Milhouse. When the pelvic floor muscles and tissue aren’t strong enough to support your pelvic organs, they may drop or press into the vagina, according to the National Institutes of Health. The uterus and cervix, for example, can lower into the vagina and potentially pop out of the vaginal opening.

“That can manifest as, ‘I feel like things are falling down through my vagina,'” says Milhouse. “You feel like a ball is just coming down—organs are actually descending, like a hernia, through the vaginal opening.” Rectal prolapse can also occur, during which your rectum slips outside of your anus, she adds. 

In individuals with a penis, pelvic floor weakness may also manifest as weak ejaculatory force, a sign that’s more discreet, says Milhouse.