How Anxiety Impacts the Pelvic Floor & Pelvic Health
Anxiety and the pelvic floor are in an intimate relationship. In fact, anxiety has relationships with a lot of parts of your body. Remember last time you felt anxious or stressed and you noticed your neck was tense as your shoulders were hiked up? Or maybe your jaw cracked open after it was just in a tense battle with your thoughts? Anxiety and the neck, shoulders, jaw… they’re in a very intimate relationship too, just like the pelvic floor. This is because the body is one. Our nervous system is our control center and the whole body functions together.
New to knowing what the pelvic floor is? In short, it’s a bowl of muscles sitting between your hips, including the genitals, that helps you pee, poop, have sex, have babies, all that good stuff! And guess what? The pelvic floor AND the pelvic organs are deeply connected to your nervous system, meaning stress and anxiety can directly impact their function.
How Anxiety Affects the Pelvic Floor Muscles
Like with many components of our body and its beautiful functioning, if you really dive deep it can get complex… but right now let’s just keep it simple.
Anxiety can lead to tension or muscle guarding, and this can include tension in the pelvic floor. If the anxiety is chronic, this muscle guarding can become chronic. Chronic hyper-tension in the pelvic floor can contribute to pain and dysfunction. In short - guarding is a protective response that contributes to brain’s perception of fear with sensation, impacting our pain response. Additionally, if muscles are tight when we don’t need them to be, they can’t function for us in the way we need them to. The pelvic floor is like a door. If that door is more closed, it can impact the ease of things coming in or out.
To deepen this connection further, anxiety impacts the brain signals involved in the functioning of organs that are a part of your pelvic health (such as your bladder or bowels).
When the nervous system perceives stress or danger (whether real or imagined), it activates the body’s fight-or-flight response. Stress and anxiety are not “bad” emotions, neither is our fight or flight response. However, are you getting stuck chronically in this response or not experiencing balance in your nervous system? If so, that’s where we might see symptoms. Nervous system dysregulation can interfere with how we perceive sensations (pain vs neutral vs pleasure), how the gut functions, how our brain signals an urge to pee, how our muscles function, what happens to our blood flow, and more.
TL/DR: Chronic stress and anxiety can impact muscle guarding and chronic pelvic tension, as well as pelvic floor & organ functioning.
Chronic muscle guarding that can result from frequent stress and anxiety can contribute to:
Pelvic pain – This can be with sitting, exercise, intercourse, arousal, non-sex related insertion (tampons, gyno exams), bowel movements, peeing, or seemingly unprovoked.
Urinary (pee) urgency or hesitancy – It may be harder to start your pee stream and/or it can cause a sense of urgency and frequency.
Pooping difficulties – If the “door” so to speak for poop to come out is tight, then it can be difficult to release stool. You could have constipation, increased straining, incomplete emptying, or discomfort with bowel movements. (And this is more of the muscular component, not even including the impact of the stress on gut and digestion overall).
Sexual dysfunction – This can be pain with insertion, difficulty with arousal, difficulty with erections, or decreased even sensation.
The Nervous System-Pelvic Floor Connection
Your pelvic floor and nervous system are in constant communication.
So we’ve established that when your body is in a chronic state of stress, the pelvic floor may remain in frequent engagement. When muscles are engaged all day when we don’t need them to, they can get tired and weaker. This can make it difficult to properly engage or release these muscles when needed. (This is why leaking urine can happen with pelvic tension!)
More about this mind-body communication... the pelvic floor & its organs communicate A LOT with your nervous system.
Let’s go to that classic example we all know and love… you’re being chased by a bear. If you’re being chased by a bear… odds are your flight or flight will kick in! Although it is NOT recommended to actually run from a bear, for the sake of ease of explanation, let’s say you run. To do that, your body is going to allocate all your resources to survival. This means taking your body’s focus away from things like digestion, and refocusing them to activate your arms and legs to run away.
Whether or not the body should engage in digestion, signals on if it should tell you to pee, interpretation of sensations as pain or not, and more are directly impacted by our nervous system’s states.
Supporting a balanced nervous system can help the pelvic floor and it’s organs function more optimally.
Why Addressing Both The Nervous System and Muscles Matters
Focusing only on one aspect, whether it's just stress reduction or just pelvic floor exercises, often isn’t enough to make long lasting impacts. A holistic approach that considers both the nervous system and pelvic floor functioning can help break the cycle of tension, discomfort, and dsyfunction. And that’s not all we consider. It’s also important to look at medical influences, chronic conditions, history, habits, routines, beliefs, nerve functioning, and so much more. Pelvic health is whole body, but the nervous system is that control center sitting at the center. Pelvic floor therapy can play a crucial role in restoring balance to the whole system.
If you’re dealing with pelvic floor dysfunction and anxiety, know that you’re not alone and there are ways to support your body in finding relief.
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Anxious Pelvis offers trauma-informed pelvic floor occupational therapy, virtual coaching, & education for pelvic pain, vaginismus, painful sex, bladder and bowel dysfunction, pregnancy, postpartum, perimenopause, and gender-affirming care.
Denver Clinic: 3801 E Florida Ave, Suite 915, Denver, CO 80210
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By Anxious Pelvis | Pelvic Floor Occupational Therapy in Denver, CO & Virtual Coaching Worldwide
Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. 