If you’re dealing with any discomfort down there, here’s what you need to know, whether it’s bladder leaks when you laugh, or an aching, tense feeling that just won’t go away, you might be dealing with pelvic floor dysfunction. Maybe you’ve heard about the pelvic floor before, or maybe this is your first time coming across the term. Either way, knowing whether your pelvic floor is overactive or weak can help you figure out how to take better care of this important muscle group and improve your overall well-being.
In this guide, we’ll explore how to tell if your pelvic floor is tense or weak, what causes pelvic floor dysfunction, and some simple steps you can take to start feeling better. By the end, you’ll have a better understanding of what’s going on with your pelvic floor and what to do about it. Let’s dive in.
What is the pelvic floor?
Before we jump into how to identify if your pelvic floor is overactive or weak, it’s important to understand what the pelvic floor is and what it does. Your pelvic floor is a group of muscles that sits at the base of your pelvis. These muscles provide support to the organs above. They also play a huge role in bladder and bowel control, sexual function, and even stability for your core.
When these muscles are working as they should, they keep everything in check, helping you avoid leaks, manage bowel movements, and support your posture. But when things go wrong, and your pelvic floor becomes too tight or too weak, it can cause a whole range of issues—from urinary incontinence to chronic pain.
How to tell if your pelvic floor is tense or weak
So, how do you know if your pelvic floor is overactive or too weak? The symptoms of each can overlap, but there are some key differences that can help you figure out what’s going on.
Signs of a Tense Pelvic Floor
A tight pelvic floor happens when the muscles become overactive and don’t fully relax. This can lead to pain and discomfort in the pelvic region, but it can also impact with bladder and bowel function.
Common signs that your pelvic floor might be too tight include:
- Pelvic pain: You might feel a dull ache or sharp pain in your lower abdomen, hips, or lower back. This can happen during certain activities or just throughout the day.
- Pain during sex: Tight pelvic floor muscles can cause discomfort or pain during intercourse. This often feels like a sharp, burning sensation.
- Difficulty emptying your bladder: If your pelvic floor is too tense, you might have trouble fully emptying your bladder, hesitancy with urination, or urinary urgency.
- Constipation: A tight pelvic floor can make bowel movements difficult or uncomfortable. Some people with a tight pelvic floor also experience rectal pain or a feeling of incomplete evacuation.
- Difficulty inserting tampons or undergoing gynecological exams: A tense pelvic floor can make routine tasks like using tampons or visiting the gynecologist painful.
If any of these sound familiar, there’s a good chance that your pelvic floor muscles are too tense.
Signs of a Weak Pelvic Floor
On the flip side, a weak pelvic floor doesn’t provide enough support for your pelvic organs, leading to issues like bladder leaks and even pelvic organ prolapse. A weak pelvic floor is more common after pregnancy or childbirth, but it can happen to anyone.
Signs that your pelvic floor might be weak include:
- Urinary incontinence: This is one of the most common signs of a weak pelvic floor. If you leak urine when you laugh, sneeze, or exercise, it could mean your pelvic floor muscles aren’t strong enough to keep your bladder in check.
- Bowel incontinence: In some cases, a weak pelvic floor can also lead to bowel leaks or difficulty controlling gas.
- Pelvic organ prolapse: A weak pelvic floor can cause pelvic organs, such as the bladder, to shift and lead to a sensation of heaviness or pressure in the pelvic region.
- Lower back pain: A weak pelvic floor can contribute to poor posture and lower back pain, as these muscles are a key part of your core strength.
- Decreased sexual sensation: A weak pelvic floor can lead to reduced sensation during sex or difficulty achieving orgasm.
If these symptoms sound more like what you’re dealing with, your pelvic floor may need some strengthening.
What Causes Pelvic Floor Dysfunction?
Whether your pelvic floor is tight, weak, or somewhere in between, there are a few common causes behind pelvic floor dysfunction. Let’s break them down.
1. Pregnancy and childbirth
Pregnancy and childbirth are among the leading causes of pelvic floor dysfunction. During pregnancy, the growing uterus, the baby and many physical and physiological changes in pregnancy place extra stress on the pelvic floor muscles, which can stretch and weaken them over time. Labor and delivery (both vaginal and c section) births can contribute to potential pelvic floor dysfunction.
2. Chronic straining
Straining during bowel movements, chronic coughing, or heavy lifting can all put a lot of pressure on the pelvic floor muscles. Without proper muscle recruitment, this pressure can lead to both tightness and weakness, depending on how your body responds.
If you struggle with constipation or spend a lot of time lifting heavy objects (whether at work or at the gym), this could be contributing to your pelvic floor dysfunction.
3. Hormonal changes
Hormonal changes, particularly those related to menopause, can affect the health of your pelvic floor. As estrogen levels decrease during menopause, the tissues in the pelvic region can become weaker, leading to a higher risk of pelvic floor dysfunction. Hormonal shifts during pregnancy and postpartum may also contribute to pelvic floor muscle dysfunction.
4. Trauma or injury
Pelvic injuries, which can result from falls, surgeries, or accidents, may affect the pelvic floor muscles or nerves, leading to potential dysfunction. It’s important to approach this topic with sensitivity, acknowledging that each person’s experience is unique. For some individuals, the trauma might cause the pelvic muscles to tighten as a protective response. In contrast, others might experience muscle weakening due to injury or prolonged inactivity during recovery. Understanding and addressing these variations is crucial for effective healing and support.
5. Chronic stress
Stress and anxiety don’t just affect your mental health—they can also impact your pelvic floor. When you’re stressed, you might unconsciously tense your muscles, including those in your pelvic floor. Over time, this can lead to tightness and discomfort.
6. Lifestyle factors
Certain lifestyle factors, like prolonged sitting, poor posture, or lack of physical activity, can all contribute to pelvic floor dysfunction.
How to Address a Tight or Weak Pelvic Floor
Now that we’ve covered how to identify whether your pelvic floor is tense or weak, let’s talk about what you can do to start addressing these issues. There are a few key strategies that can help, whether you need to relax or strengthen your pelvic floor.
1. For a tight pelvic floor: focus on relaxation
If you suspect your pelvic floor is too tight, the goal is to relax and release the tension in these muscles. Here are some helpful techniques:
- Breathing exercises: Diaphragmatic breathing (or belly breathing) can help relax the pelvic floor. As you inhale, focus on expanding your belly, and as you exhale, let your pelvic floor muscles soften and relax.
- Stretching and yoga: Gentle stretches, especially those that target the hips and pelvis, can help release tightness in the pelvic floor. Poses like child’s pose, deep squats, or happy baby are particularly effective.
- Pelvic floor physical therapy: If your pelvic floor is overly tight, working with a pelvic floor physical therapist can help. They can guide you through exercises and techniques to relax the muscles and improve function.
2. For a weak pelvic floor: focus on strengthening
If your pelvic floor is weak, you’ll want to focus on exercises that build strength and endurance in these muscles.
- Kegel exercises: Kegels are one of the best-known ways to strengthen the pelvic floor. To do them, contract the muscles you would use to stop the flow of urine, hold for a few seconds, then release. Repeat several times throughout the day.
- Pelvic tilts: Pelvic tilts are another great exercise for strengthening the supporting muscles, such as the abdominals and hip muscles. Lie on your back with your knees bent, then tilt your pelvis upwards, tightening your core as you do so.
- Low-impact exercises: Activities like walking, swimming, or yoga can help strengthen the supporting muscles, such as the abdominals and hip muscles, without putting too much strain on the pelvic floor. Strengthening your core and lower body provides additional support for the pelvic floor, promoting overall stability and reducing discomfort.
3. General tips for pelvic floor health
Whether your pelvic floor is tight, weak, or a combination of both, these general tips can help improve your overall pelvic health:
- Practice good posture: Sitting and standing with good posture can help take the pressure off your pelvic floor muscles and prevent tightness or weakness.
- Stay active: Regular exercise is important for maintaining overall muscle strength and flexibility, including in the pelvic floor.
- Avoid straining: Be mindful of your mechanics and breathing throughout heavy lifting; avoid straining or pushing too hard during bowel movements. If you struggle with constipation, consider making dietary changes or speaking to a healthcare provider about ways to improve digestion.
Final thoughts
Pelvic floor dysfunction is common, but it’s not something you have to live with. Whether your pelvic floor is overactive, too weak, or somewhere in between, recognizing the signs and taking steps to address it can make a big difference in your quality of life. With a little bit of knowledge and some targeted exercises, you can start feeling better and supporting your pelvic health for the long term.
