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Can Stress Impact Your Pelvic Floor?

We’ve all heard the term: “stress, the silent killer.”

Stress is a perfectly natural response that our bodies evolved over time to keep us safe. It made sense when our ancestors were threatened by lions, for instance. Left unchecked, stress has detrimental effects on your body: short-term impacts like headaches, digestive issues or trouble sleeping.1

In the long term, those “smaller” issues can create chronic conditions like high blood pressure, heart disease, heart attacks or strokes, diabetes, gastrointestinal conditions like ulcerative colitis, and more.1

As women, we may not think about other effects of stress. Can stress impact your pelvic floor? Yes, it can, and here’s how.

Pelvic Health and Pelvic Pain

Your pelvic health is likely not something you think about every day. After all, your pelvic floor quietly does its job, acting like a hammock of muscles and tissue, holding the organs in place inside the bones of the pelvis. Your pelvic floor supports important functions like holding urination, bowel movements, sex, pregnancy, and delivery of babies.

That can change if you suffer from pelvic pain, in the lowest part of the stomach area as well as your pelvis. The symptoms can come from your reproductive, urinary or digestive system, or from those important muscles and connective tissue that hold everything together.2

The pain can be dull or sharp; constant or off and on; mild to severe; sharp and short term—known as acute pain; or last a long time and happen repeatedly. Chronic pelvic pain is any constant or off-and-on pelvic pain that lasts six months or more.2

Pelvic pain can also present itself in many ways, such as pain when urinating, pain during sex, back or hip pain, or gastrointestinal issues like bloating, constipation or irritable bowel syndrome.3

Can Stress Impact Your Pelvic Floor? 

In short yes—there are many factors that can impact how pervasive and intense you experience pain, including stress. Think back to the body’s reason for a stress reaction: the fight or flight response to a threat, like a lion in ancient times. Your nervous system’s responses are to rest and digest, or to fight or flight. The stress response of fight or flight inhibits functions like digestion and urinary or bowel movements.3

Your skeletal muscles also respond to the stress clues from the nervous system— including the pelvic floor muscles. They can tense with stress, and in our modern times, the increase in stressors means your body may be in a prolonged state of fight or flight. If your pelvic muscles cannot relax fully, that may contribute to pelvic pain.3

Continued tense muscles in the pelvic floor can lead to a syndrome called hypertonic pelvic floor. People with a tense pelvic floor that cannot relax may experience constipation, painful sex, urgency and pelvic pain. A hypertonic pelvic floor may also be accompanied by tension in surrounding hip and pelvic muscles. High levels of stress, fear or anxiety can cause muscles to reflexively tighten and eventually lead to a hypertonic pelvic floor.4

It’s important to note that underlying medical conditions can also cause pelvic pain, such as interstitial cystitis or endometriosis in women. But if such syndromes are ruled out, there may not be a test or imaging that will show the cause for pelvic pain. It can take years for a diagnosis, and it can become a vicious cycle in which pelvic pain causes stress and anxiety—and anxiety and stress can cause pelvic pain.5

There are also activities that can make it worse, like clenching your butt when you do feel stress, poor posture, cycling on a bike without a proper seat, and more.

There are also treatment options available, like pelvic health physical therapy. You can get help to learn about your body, what may be driving your stress and pain, and what you can do to improve your wellbeing.5

Treatments like learning how to stretch the tight muscles; performing yoga; learning breathing and relaxation exercises; and even biofeedback may help reduce the stress and relieve the pelvic pain.5

It’s important that you don’t suffer in silence. Seek help for stress and pain. Sudden and severe pelvic pain could be an emergency and you should seek immediate medical care.6

See a Doctor 

If you’re worried about your stress levels, or concerned about your pelvic health—or both—see a doctor to discuss your symptoms. Use our Physician Finder to find a doctor near you with expertise in women’s health, who can provide diagnosis, advice and guidance on treatment for your condition. In particular, have your pelvic pain checked by your doctor if it’s new, it disrupts your daily life or it gets worse over time.6

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