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The Impact Of Stress And Trauma On Pelvic Floor
Dysfunction In Women

You have probably heard about or experienced the fight or flight response.

It describes your body’s hormonal and physiological reactions to perceived or real imminent danger.

A stressful or threatening event or situation evokes a hormonal cascade, triggering physiological responses that prepare your body to fight or flee.

But what you may not know is that your pelvic muscles contract as a part of the stress response, and that can cause pelvic health issues that are embarrassing to talk about.


What Causes Tight Pelvic Floor Muscles?

Women who have suffered pelvic trauma during childbirth or from sexual assault and abuse, or who suffer from chronic stress, often experience hypertonicity of the pelvic floor muscles that causes pain and dysfunction throughout the pelvic region.

While stress and trauma are not the only causes of pelvic tension, they are the most prevalent.


Other factors that may contribute to hypertonic pelvic floor muscles include:

  • Pregnancy and childbirth

  • Overtraining the core muscles during exercise

  • Lifting heavy objects on a regular basis

  • Obesity and being out of shape

  • Chronic constipation

  • Chronic coughing from smoking and COPD

  • Post-surgery response the hysterectomy or corrective prolapse surgery

  • Genetically taut pelvic connective tissues (rare)

For women, pelvic tension may be multifactorial, with more than one cause contributing to hypertonicity.

But acknowledging and addressing past trauma and managing stress, can be key to relaxing the pelvic floor muscles and restoring normal pain-free function.


Hypertonic Pelvic Floor Symptoms


While pelvic pain is the main symptom of a hypertonic pelvic floor, tight pelvic floor muscles can cause additional symptoms:

  • Pain and discomfort during sexual intercourse

  • Chronic constipation

  • Pain in the hips, groin, low back or tailbone

  • Urinary problems

  • Vaginismus, a condition that makes vaginal penetration of any kind, including inserting a tampon or getting a pelvic exam, painful or impossible


Many women find it difficult and embarrassing to talk about these symptoms, even with a health care provider, partner or close friend.


But failure to address hypertonic pelvic floor symptoms can dramatically impact your relationships and quality of life.


The Role of Stress and Trauma in Pelvic Muscle Tension


There are a number of physiological fight or flight responses that occur when you feel stressed or threatened.

They may include shallow breathing, elevated heart rate, tension in the neck and upper back, a knot in your stomach, headaches, and feelings of anxiety.


But contraction of the pelvic floor muscles is a key response that is often overlooked.

Consequently, your doctor may fail to make the connection between your pelvic floor dysfunction and mental and emotional stress.


Important research conducted in 2001 studied women with and without symptoms of vaginismus, to measure their pelvic muscle response to emotional and psychological stress.


Muscle responses were measured using intravaginal electromyography as the women viewed video clips of sexually violent and threatening scenarios.


The data revealed that all women in the study experienced increased pelvic muscle contraction in response to the video clips.


If you have been a victim of vaginal trauma from sexual assault, childbirth, or other causes, it is reasonable to assume that a connection exists there between your trauma and your hypertonic pelvic floor muscles.


If so, the issue is not likely to resolve itself without deliberate intervention.


Treating Hypertonic Pelvic Floor Muscles


There are many things you can start doing right away to reduce and eliminate the underlying causes of hypertonic pelvic floor dysfunction.

  • Clean up your diet. Chronic constipation is directly related to what you eat and how hydrated you are. Drinking more water, eating more vegetables and eliminating sugars, grains and processed foods from your diet can completely eliminate constipation that causes pelvic tension.

  • Exercise regularly. Your pelvic floor muscles play a key role in movement of any kind. Regular exercise like walking increases oxygen flow to your pelvic muscles, increases their core temperature, and promotes optimal muscle tone and function. Over time, exercise can help you lose weight and completely eliminate pelvic floor dysfunction.

  • Learn to manage stress. Tight pelvic muscles are a symptom of chronic stress. Deep breathing, yoga, massage therapy, listening to relaxing music, taking a stroll in the park, or soaking in a hot bath are all enjoyable activities that can relieve stress, restore hormonal balance, and reduce pelvic tension.

  • Get more sleep. Sleep deprivation is a key contributor to chronic stress and the hormones it produces. Getting 7-9 hours of quality sleep per night reduces the impact of stress hormones on your pelvic muscle tension.

  • Face past trauma. If you have been a victim of rape, sexual abuse, or trauma during childbirth, you may have unresolved emotional issues and PTSD that cause your pelvic muscles to contract during intercourse. Seeking counseling to confront past trauma can be an important step toward overcoming your pelvic muscle stress response.

  • Communicate with your partner. Failure to talk with your partner about the pelvic tension you experience during intercourse can create serious friction in your relationship. An understanding partner can help you relax during sex, and they are more likely to support you in seeking pelvic floor treatment.

  • Find a pelvic floor physical therapist. Pelvic floor physical therapy can teach you to control your pelvic muscles. It can also help you stretch tight pelvic muscles and connective tissue, correct pelvic and low back alignment, and restore healthy pelvic function.

To learn more about your pelvic floor and how to restore healthy function, consult this Guide to alternative treatments for pelvic pain and pudendal neuropathy.

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