The Connection Between Pelvic Floor and Mental Health
What Is the Pelvic Floor?
The pelvic floor is a group of muscles that forms the base of your pelvic in both females and males. These muscles support the bladder, bowel and uterus, as well as playing a role in continence, sexual function, posture, and core stability.
Like any muscle the pelvic floor can become weak, overactive or dysfunctional which lead to symptoms such as:
Urinary or faecal incontinence
Pelvic pain
Pain during sex
Constipation
How Mental Health Affects the Pelvic Floor
Chronic Stress and Muscle Tension - Chronic stress or anxiety can cause your body enters a prolonged state of “fight or flight.” This stress response increases tension in various muscle groups including the pelvic floor. You may notice when you are stressed you clench your jaw or shoulders and just like this, we can subconsciously tense the pelvic floor muscles. Overtime this may lead to tightness, pain, and even dysfunction.
Depression and Pelvic Floor Weakness - While anxiety tends to create tension, depression may contribute to muscle underuse and weakness. People with depression might be less physically active, which can reduce overall muscle tone including in the pelvic floor.
Trauma and the Pelvic Floor - Emotional trauma, especially related to sexual abuse or violence can significantly impact the pelvic floor. The body often holds trauma physically, and the pelvic region is a common area for this. Trauma survivors may experience chronic pelvic pain, sexual dysfunction, or pelvic floor hypertonicity.
How Pelvic Floor Dysfunction can affect mental health
Pelvic floor dysfunction can significantly affect mental health. Physical symptoms can deeply impact a person's emotional and psychological well-being. Here’s how:
Anxiety and Depression - Embarrassment and shame around symptoms like incontinence can lead to social withdrawal, increasing loneliness and depression. Persistent, unexplained pelvic pain often causes anxiety, especially when the cause isn’t quickly diagnosed or effectively treated.
Body Image and Self-Esteem Issues - Pelvic floor dysfunction may affect how people perceive their bodies, especially when it causes changes in sexual function or physical sensations. Women and men may feel "broken" or "abnormal", especially if the condition follows childbirth, surgery, or trauma.
Sexual Dysfunction and Intimacy Issues - Pain during intercourse (dyspareunia), difficulty achieving orgasm, or erectile dysfunction due to PFD can reduce sexual desire and satisfaction. This can strain relationships, reduce self-confidence, and contribute to emotional distress.
Sleep Disruption - Nocturia (frequent nighttime urination) or chronic pain can disrupt sleep, which is directly linked to mood disorders like depression and irritability.
Impact on Daily Life and Functioning - People with PFD may avoid work, travel, exercise, or social activities due to fear of accidents or pain, leading to reduced quality of life and potential mental health deterioration.
Pelvic Health requires a Holistic Approach
Treating pelvic floor dysfunction requires a multifactorial approach that addresses both the physical and mental/emotional aspects.
Here’s what that might include:
Pelvic Floor Physical Therapy
A specialist can assess your pelvic floor muscles for tension, weakness, or imbalance, and guide you through exercises or relaxation techniques.
Mental Health Support
To help address underlying anxiety, depression, trauma, or stress contributing to pelvic symptoms.Breathwork and Mindfulness
Diaphragmatic breathing and mindfulness techniques can calm the nervous system and promote pelvic floor relaxation.Exercise and Movement
Gentle movement, pilates, yoga, or targeted exercises can improve circulation, reduce tension, and restore pelvic balance.
By Ashleigh King
Physiotherapist
To see our Physiotherapists or book in for a Pilates consult, book an appointment with us online today or call our team on 07 55 04 7000.
