How Pilates can improve your sex life — and the other surprising benefits.

Pilates strengthens the pelvic floor — and the evidence on sexual function is compelling.

The pelvic floor is a group of muscles that support the bladder, bowel and uterus. For both men and women, a strong pelvic floor matters significantly as we age — and Pilates is one of the most effective exercises for strengthening it.

The link between pelvic floor strength and sexual function is well established in the research literature. A 2016 study published in the Journal of Sex & Marital Therapy (Halis et al.) found that healthy women who practised Pilates showed measurable improvements in sexual functioning, alongside reductions in depression. A 2025 controlled prospective study published in BMC Urology found statistically significant improvements across all domains of the Female Sexual Function Index (FSFI) after a 12-week Pilates programme, with scores improving substantially compared to controls. A 2022 pilot study in Urology showed FSFI total scores increasing from 12.0 to 29.3 after 12 weeks of Pilates (p<0.0001).

The mechanism works in both directions. Stronger pelvic floor muscles directly improve sexual sensation and function. At the same time, Pilates reduces depression and improves mood — both of which are known suppressors of libido and sexual satisfaction when impaired.

For men: Men also have a pelvic floor, though it works differently. A 2024 study published in BMC Urology found that Pilates combined with pelvic floor muscle training produced statistically significant improvements in post-prostatectomy incontinence. The principles that benefit women’s pelvic health apply equally to men, though the exercise prescription differs.

Pilates supports healthy bone density — with important caveats about how it’s practised.

Over 3 million people in the UK are affected by osteoporosis. By the age of 50, approximately 50% of women and 25% of men will experience the effects of osteoporosis or its precursor, osteopenia. Weight-bearing exercise that applies controlled stress to the bones is one of the most effective non-pharmacological interventions available.

The Reformer’s spring resistance is particularly well suited to bone health work because it allows load to be adjusted in precise increments, providing appropriate bone stimulus without the impact risk of running or jumping. Standing Pilates and resistance-based Reformer work directly stimulate bone maintenance and can help slow density decline.

The Royal Osteoporosis Society describes Pilates as an excellent choice for those living with osteoporosis when correctly practised, noting that a large proportion of the Pilates repertoire includes weight-bearing exercise that helps support bone density and that Pilates effectively reduces fall risk and improves overall quality of life.

Pilates improves balance and reduces fall risk — and the evidence here is robust.

Falls are the leading cause of injury in people over 65 in the UK. Hip fractures from falls carry significant mortality and morbidity risk, particularly in people with osteoporosis. Balance and coordination are trainable — and Pilates is one of the most effective interventions available for both.

The balance benefits of Pilates are driven by several mechanisms simultaneously: improved core strength providing a stable base, enhanced proprioception (the body’s awareness of its position in space), better peripheral vision awareness from coordination exercises, and reduced compensatory movement patterns that make people more vulnerable to falling.

Balance work is integrated into every Applied Pilates programme at The Sogunro Practice — not treated as a separate module for older clients. The full apparatus provides an unmatched range of balance and coordination challenges that progress from supported to freestanding as confidence builds.

The mental health benefits of Pilates are measurable — and growing in the research literature.

While Pilates is not traditionally thought of as a mental health intervention, the evidence base has grown substantially. Multiple systematic reviews now confirm that Pilates produces meaningful improvements in depressive symptoms, anxiety, stress and quality of life — across clinical and healthy populations alike.

The mechanism is understood: Pilates releases endorphins through physical activity, requires focused attention that interrupts anxious thought patterns, provides social connection in small group settings, and builds self-efficacy through visible physical progress. The controlled breathing emphasis also directly activates the parasympathetic nervous system, reducing cortisol.

Katie McMullan, advanced physio practitioner in MSK physiotherapy, notes: “There are so many benefits to Pilates including social interaction within classes. The endorphins released from exercise enhance mood and give you a new-found confidence.”

At The Sogunro Practice, the maximum of 7 clients per session is not simply a quality-of-instruction measure — it is also what allows the social dimension of group exercise to function properly. Every person is known by name, history and progress. That continuity has a direct effect on confidence and motivation.

Pilates contributes to weight management — not despite being “gentle”, but because of how it works.

Losing weight is rarely the primary reason people begin Pilates. But it can contribute to meaningful changes in body composition — and the mechanism is more interesting than it first appears.

The common assumption that only high-cardio exercise creates calorie deficit has been increasingly challenged. When performed correctly, Pilates builds muscle mass and improves metabolic rate. The sustained muscular control required — particularly in Reformer exercises — maintains significant muscle activation throughout sessions. The result is genuine calorie expenditure alongside muscle toning, without the joint load that makes high-impact exercise unsustainable for many people.

It is also worth noting that the confidence improvements described under benefit 4 have a documented relationship with sustained exercise behaviour. People who feel better about their bodies are more likely to maintain their exercise programme. The psychological and physical benefits of Pilates are not separate effects — they reinforce each other over time.