Why Trauma Survivors Experience Pelvic Floor Dysfunction—And How to Heal
How Trauma Affects the Pelvic Floor
When we experience perceived or actual danger, our body's natural response is to react with fight, flight, fawn, or freeze. Some of the physiological changes we may notice include increased heart rate, faster breathing rate, body temperature increase, and muscle tension. It can be more easy to acknowledge tension in the shoulders or grinding teeth, but what may not be as obvious is the involuntary tension that builds in the pelvic floor muscles. A study back in the 1999 by J Van der Velde and W. Everaerd looked at the response of the pelvic floor muscles, via vaginal elecromyography, as women were exposed to threatening images. Their research concluded, “it is the threatening content of the situation that evokes this involuntary activity of the pelvic floor."
Increased pelvic floor tension, repetitively or over a long period of time, will create a scenario where the muscles no longer relax well and stay perpetually in a guarded or “hypertonic” state. This tension restricts blood flow and oxygen to the tissue and can impact the function of neighboring structures such as nerves, connective tissue, and ligaments. This often results in pain, bladder/bowel dysfunction, and sexual discomfort.
What Pelvic Floor Therapy Can Do for Trauma Survivors
Pelvic Floor Dysfunction often develops following trauma and specifically people may experience one or more of the following symptoms:
Pelvic pain
Pain with sexual activity (Dyspareunia, Anodyspareunia)
Vaginismus
Chronic prostatitis
Constipation
UTI-like symptoms, without infection
Bladder or Fecal Leakage
Pelvic Floor Therapy addresses these symptoms by improving function of the musculoskeletal and neuromuscular systems. Our therapeutic goal is to empower patients to reconnect with their bodies, in order to reduce pelvic tension and restore function of the pelvic tissues. There are a number of ways we achieve this which include but are not limited to:
Hands-on/manual therapy
Mobility and movement based exercises
Breathwork and nervous system regulation
It’s important to know that not every Physical Therapist does this work, and therefore, seeking out someone with specialized training who can provide a safe space for body awareness and healing is key. Your therapist should be able to modify treatment in a way that allows you to feel comfortable and in control. At Restore Pelvic Health & Rehab, chronic pelvic pain makes up about 50% of our practice, and many of our patients come to us with a history of trauma. In fact, helping those with a history of trauma is one of my greatest passions and the reason I opened my practice.
Why Mental Health and Pelvic Floor Therapy Go Hand in Hand
“So many people live with unexplained pelvic floor issues without realizing the connection to their past experiences. Trauma work can be life-changing – not just for the mind, but for the body’s deepest, most vulnerable spaces.” - Brian Gong, LMHC, CAP, Founder of Mangrove Therapy Group in Delray Beach, Florida.
A dual approach to healing, with a trauma trained mental health therapist and a trauma trained pelvic floor therapist can be an absolute game changer for trauma survivors. When collaboration among these providers exist, it can ensure consistent progress in a safe and comfortable way.
To better understand the importance of this collaboration, consider this case scenario:
Maria, a 32-year-old trauma survivor, sought pelvic floor therapy after years of painful intercourse and chronic pelvic tension. She was hopeful that addressing the physical symptoms would bring relief. However, during her first few treatment sessions, she found herself feeling unexpectedly anxious, tense, and overwhelmed. Though her therapist used a trauma-informed approach, Maria’s body instinctively reacted with fear, making it difficult to tolerate even gentle techniques. Thankfully, Maria confided in her pelvic floor therapist that she was feeling uneasy and was concerned therapy “wasn’t working” for her.
Maria’s pelvic floor therapist helped her to find a mental health provider who could help her work through her past experiences, in conjunction with PT, and this is when things started to shift. Through therapy, Maria began to process the deep-seated emotional responses that had been stored in her body for years. She learned techniques to regulate her nervous system, gradually allowing her to feel safer in her own body. Working with her pelvic floor therapist and mental health therapist collaboratively, she was able to make real progress—reducing pain, restoring function, and ultimately being able to enjoy intimacy in the way she wanted.
This scenario highlights why healing from trauma often requires a team approach. Trauma isn’t just stored in the mind—it’s held in the body. When pelvic floor therapists and mental health professionals work together, patients can heal both physically and emotionally, leading to long-term relief and a better quality of life.
What You Can Do
If you’ve been living with the effects of trauma—whether it’s pain, discomfort, or feeling disconnected from your body—know that change is within reach. Your experiences do not define your future, and your body has the capacity to heal. There are people dedicated to walking with you along this journey. If you are local to South Florida, we would love to be considered as a future team member in your trauma and pelvic health healing 💜.
What Next?
I hope this information was helpful and maybe caused you to look at symptoms you have been ignoring. If you need help finding a pelvic floor therapist in Florida, we hope that you will consider us for either in-person or virtual appointments.
In the meantime, you can get more pelvic health content sent right to you, by completing the short form below👇
