Can Stress Cause Pelvic Floor Dysfunction?
The Overlooked Link Between Stress and Pelvic Health
A man was seen in my office 1 year ago for fecal incontinence and bladder urgency. He successfully completed therapy and had been symptom-free since his final visit. He then returned to my office, noting a sudden onset of constipation, bladder urgency, and bladder leakage, which began about 2 months ago. After discussing what had been happening in his life, he revealed that his spouse had been chronically ill and that their lives had been suddenly disrupted by various doctor appointment, procedures, and overall uncertainty for her prognosis. He was under an immense amount of stress and nothing else about his lifestyle or routines had changed. This story begs the question…
Can stress actually affect the pelvic floor?
The answer to this is 100% yes! Stress is probably the most underrated contributor to pelvic floor dysfunction. If you’ve had a sneaking suspicion that stress may be playing a role in your symptoms, you’re on the right track. Let’s dive into how stress affects the body, how it influences the pelvic floor, signs your symptoms may be stress-related, and what you can do about it.
What Is The Pelvic Floor?
The Pelvic Floor is a group of muscles that sit at the bottom of your pelvis and span the area between your tailbone and pubic bone.
They function to support the organs above (bladder, uterus, rectum, and prostate). They also control bladder and bowel function, contribute to sexual function, and provide stability as an important part of your core.
Like any muscle group, the Pelvic Floor muscles can become tight, weak, poorly coordinated, and/or or overly active. When this occurs, we call it Pelvic Floor Dysfunction.
How Stress Affects The Body
Stress causes a physiological response on our nervous system that we often describe as “fight-or-flight.” Muscles tense, heart rate increases, breathing changes, and our nervous system is on high alert. The opposite of this is when our nervous system is in a Parasympathetic state known to many as “rest and digest.”
Stress will impact how your bowel responds - many time digestion is slowed and this can lead to constipation
Stress may interrupt your sleep, impairing your body’s natural repair process.
Many people unconsciously hold tension in areas like:
The jaw
Shoulders
Abdomen
Pelvic Floor
During prolonged periods of stress, the Pelvic Floor muscles tighten chronically.
How Stress Contributes to Pelvic Floor Dysfunction
Chronic muscle tension can lead to Pelvic Floor muscle overactivity. This makes it difficult for your muscles to relax. This will impair the muscles’ ability to coordinate with breathing and the rest of the core muscles.
Potential symptoms from these changes include:
Pelvic pain
Pain with intercourse
Difficulty achieving orgasm
Urinary urgency or frequency
Difficulty emptying bladder or bowels
Constipation
Tailbone pain
Lower abdominal discomfort
Signs Stress May Be Affecting Your Pelvic Floor
Symptoms worsen during stressful periods
You notice clenching or tightness in your pelvic area
You hold your breath or breathe shallowly when stressed
You experience tension in other areas of your body
Relaxation temporarily improves symptoms
You have a history of trauma
Strategies to Help Calm The Pelvic Floor
The first thing to do is to target your nervous system. A regulated nervous system means that when you experience stress or anxiety, your body has the ability to calm itself. Here are some examples of ways to address your nervous system:
Mindfulness or Meditation
Diaphragmatic breathing
Taking a walk in the fresh air
Body awareness/scanning
Establish good habits:
Toileting habits that promote fully emptying the bladder and the bowel
Hydration and nutrition to keep the bladder happy and the bowel moving
Optimize sleep: aim for 7-9hrs of sleep and address sleep concerns, like chronic snoring or sleep apnea, with your physician
Mobilize
Stretch and get your body moving each day. Intermittently weave movement into your day in digestible amounts - 5-10min here and there.
Get your hips and ribcage to open with some mobility exercises such as happy baby, 90/90s, thread the needle, cat-cow
How Pelvic Floor Therapy Can Help
Sometimes it’s tricky to pinpoint what’s driving your symptoms. A Pelvic Floor Therapist can help by:
Identifying if the muscles are overactive or uncoordinated
Teaching relaxation and downtraining strategies
Addressing breathing patterns
Evaluating the whole body (hips, spine, posture, and PELVIC FLOOR)
Creating a personalized plan to restore normal function
As you can see, kegels are now where to be found on this list. Pelvic PT should focus on overall function and ensuring your Pelvic Floor can coordinate and work with all areas of your body. Kegels will add tension to the pelvic floor muscles and often worsen symptoms in these cases.
To those of you who resonate with my patient’s story in the beginning, know that stress can absolutely influence your pelvic floor and contribute to Pelvic Floor Dysfunction. This is not in your imagination but it IS in your nervous system! Because stress can affect many different areas of your body, the solution needs to be multi-factorial and comprehensive.
✨If you’ve been struggling with any symptoms of pelvic floor dysfunction, I’d love for you to consider working with us and getting you relief. We have both in-person and virtual options available, for your convenience.
