The Pelvic Floor Symptoms You Shouldn't Ignore

If you’ve ever had a baby, you’re probably well aware of what it’s like to experience pelvic floor discomfort, but pelvic floor symptoms impact women (and men!) of all ages and stages of life—whether or not they’ve gone through childbirth.

In fact, a 2022 study published in Scientific Reports found that 32% of the more than 25,000 women included in the study had at least one pelvic floor disorder. While the research showed bowel dysfunction was the most common ailment reported, there are loads of other common, sometimes even subtle, signs that indicate something might be up with your pelvic floor.

For example, have you ever let out a sudden sneeze only to notice your underwear is a little wet? Had an intimate experience with your partner that felt more painful than pleasurable? Sat on the toilet for too long, straining through a bowel movement?

Each of these scenarios could mean your pelvic floor needs some attention. Luckily, pelvic floor therapy can help—and it’s never too late to get started.

You may have heard about the pelvic floor—fitness trainers preaching the importance of it, mom friends lamenting about their own—but do you know what the pelvic floor is exactly?

“Your pelvic floor is basically this bowl-shaped group of muscles at the bottom of your pelvis,” says Amy Hoover, D.P.T., chief physical therapist and PVOLVE clinical advisory board member. “It spans from the pubic bone to the tailbone and between your sit bones.”

The pelvic floor is also part of your core, which can be thought of as four distinct parts—your abdominal muscles, pelvic floor, deep back muscles, and diaphragm, Hoover says. Together, these muscles support your spine and pelvis.

Your pelvic floor is skeletal muscle—making it no different from the muscle in your biceps or hamstring, Hoover says. As such, “just like every other muscle in your body, you can contract it, you can stretch it, you can strengthen it, it can get tight, it can get weak,” she says.

“A healthy and optimally functioning pelvic floor isn’t just ‘strong’—it can properly contract, relax, and respond to pressure when needed,” echoes Brady Lynn Dougherty, a certified personal trainer, prenatal and postnatal exercise specialist, and doula.

The primary functions of the pelvic floor are to hold the weight of your pelvic organs—bladder, uterus, vagina, and rectum—and help them work properly. “Bowel, bladder, and sexual functions are all supported and interact intricately with your pelvic floor muscles,” Hoover says.

This helps explain why, when the pelvic floor is tight, weak, or both, problems in the bathroom or the bedroom are often the first sign that something is wrong.

If you experience bladder leakage while coughing, sneezing, running, or during other activities, this urinary stress incontinence could signal pelvic floor weakness, says Dougherty.

In some cases, women can experience pelvic organ prolapse, which essentially means there’s a sagging or loosening of the supportive sling of pelvic floor muscles. Symptoms can range from mild discomfort and pelvic heaviness to severe cases that may require surgery, explains Hoover.

Conversely, difficulty fully emptying the bladder or bowels and pain during sex are signs of pelvic floor tightness or imbalance, says Dougherty.

“A tight muscle is inherently weak, so you might have symptoms of both tightness and weakness,” adds Hoover.

The pelvic floor has to be able to both contract and stretch (clench and release; engage and relax—whatever helps illustrate the functions best for you) using its full range of motion in order to work properly, she says.

Pelvic floor symptoms can show up during workouts, too. “Pay attention to compensation patterns,” says Robin Arzón, vice president of fitness programming and head instructor at Peloton. “Are you holding your breath during lifts? Feeling unstable when you run or jump? Can’t generate force the way you used to? Those things matter.”

While pelvic floor dysfunction may be common, it doesn’t have to be something you just live with. In fact, don’t wait until there’s a significant impact on your everyday life to seek help.

“Every woman could benefit from seeing a pelvic floor physical therapist at some point in her life, whether she has had kids or not,” says Arzón. “We normalize annual checkups for so many parts of our health, but we rarely talk about this part of the body unless something feels really wrong.”

Beyond improving pelvic floor symptoms, “there’s value in understanding your body better and learning how to support it proactively,” she adds.

The exact treatment will vary from person to person, but the objective is always the same, says Hoover. “The goal is to connect you with the pelvic floor, getting you to understand how and when you're supposed to use it, and when you're supposed to relax it, and being able to do both of those things,” she says.

During a session with a pelvic floor therapist, you can expect to spend some time in a private exam room and out on the training floor with your therapist.

By nature, pelvic floor evaluations and treatment are intimate.

“Pelvic PTs are specially trained to assess and treat the pelvic floor, and that would include doing a vaginal and/or rectal exam because that's really the only and best way to assess the muscles directly and treat them,” says Hoover. “We're looking visually at how your pelvic floor is functioning from the outside, and then we're using our hands to internally assess strength, tone, range of motion, trigger points, and pain points.”

Once your therapist explains their findings, they’ll often guide you through a combination of stretches, mobility drills, and strength exercises on the gym floor. During each movement, they will cue proper breathing patterns and how to sync your breath to the engagement or release of your pelvic floor muscles.

Deep core work and functional fitness exercises can be especially helpful when training the pelvic floor, says Arzón. These movements—think squats, deadlifts, farmer carries, rows, chest presses—mimic the hinging, squatting, pushing, and pulling patterns you do in everyday life. “Your body is always adapting to the patterns you repeat,” she says. The goal is to bring the same mindfulness to your pelvic floor and breathing that you harness in the gym, everywhere else.

No matter what your goal is when it comes to managing your pelvic floor health—from gaining knowledge and awareness to alleviating symptoms to reversing longstanding issues—showing your pelvic floor some much-deserved attention can make a big difference in your daily functioning and physical fitness.

“Pelvic floor health is athletic health,” says Arzón. “This is not niche; this is foundational. If you care about power, endurance, longevity, or simply feeling connected to your body, [pelvic floor health] matters. Master the foundation, and you build real power from there.”