Floored summary

Though pelvic floor issues are common, they’re not normal. If you’re experiencing issues, seek treatment. The good news is that not everyone needs formal therapy. Many symptoms can improve with simple at-home changes.

It starts with the fundamentals, particularly posture. The way you sleep, sit, and stand directly affects your pelvic floor muscles. When sleeping on your side, stack your hips and place a pillow between your knees to keep your pelvic floor relaxed. While sitting, keep your feet flat on the floor and avoid crossing your legs at the knees, which tightens these muscles.

Sandra, a teacher nearing retirement, cherished her Saturday morning with her best friend –⁠ until frequent urges to pee started ruining everything. She gave up coffee and started avoiding water. But eventually, she couldn’t complete even one lap around the block without leaking. Mortified, she considered giving up the walks she loved so much.

Nothing fixed the problem because the root cause wasn’t being addressed –⁠ her pelvic floor. These muscles control both urination and bowel movements by tightening to hold things in and relaxing to let them out. When they’re too weak, too tight, or uncoordinated, problems like Sandra’s emerge. Occasional leaks can escalate to complete loss of bladder control.

When Candace tried to have sex for the first time at sixteen, her partner kept hitting what felt like a “wall.” Sadly, when she told her doctor about the pain, she was advised to simply “relax more.” Like many women, she was left feeling broken, when in fact the issue was with her pelvic floor.

Painful sex and pelvic floor dysfunction can affect women at any age. The pelvic floor must relax to allow penetration while staying engaged enough to create pleasurable sensation. When these muscles are overly tight or in spasm, sex becomes painful or even impossible. Causes can include chronic tension from holding urine too long, poor posture, or past trauma –⁠ physical, emotional, or sexual. In each case, the pelvic floor responds to perceived danger by clenching protectively.

Recovery after childbirth and the transition through menopause are two of the most under-supported phases of a woman’s life –⁠ especially when it comes to pelvic health.

Postpartum, the body undergoes massive hormonal shifts. Estrogen and progesterone drop sharply, while oxytocin and prolactin surge. Tissues are healing from stretching, tearing, or incisions. Yet women are often cleared for full activity at six weeks –⁠ far too early for most. 

Imagine feeling like you’re sitting on a golf ball. Or that your underwear is made of sandpaper. Or that your clitoris has turned into a live wire. Strange as they may sound, these sensations are surprisingly common. About one in four women will experience unexplained pelvic pain in her lifetime. 

Pain is the body’s alarm system, but with chronic pelvic pain, the signal often gets stuck. The original cause may be long gone, but the pain lingers, becoming more intense over time and often bringing anxiety, muscle tension, and fatigue along with it.