Your pelvic floor muscles are not like your other muscles…
The pelvic floor muscles are a group of muscles that span your pelvic bowl, attaching from the tailbone to the pubic bone. While their main role is to support your pelvic organs, they also contribute to stability and posture. Just like other muscles in the body, they contract and relax to varying degrees and can develop tension or trigger points that affect their function.
But here’s the thing: your pelvic floor muscles aren’t quite like your other muscles. They’re more nuanced and influenced by a range of factors that most skeletal muscles aren’t. So when we treat them the same way we would a biceps strain or hamstring, we often miss the mark. Let’s talk about some of the key ways your pelvic floor is different—and why those differences really matter!
“Image used with permission from Pelvic Guru®, LLC as a member of the Global Pelvic Health Alliance Membership (GPHAM)” wherever you use the image.
1. The Tissue Lining Is Different
Pelvic floor muscles are lined by mucosal epithelium, not the typical skin epithelium that covers most other muscles in your body. Mucosal tissue is thinner, more delicate, and more responsive to environmental changes like pH, moisture, and even friction. That means these muscles are not only more sensitive physically, but also more reactive to internal changes in your body like hormone shifts, microbiome imbalances, or irritation.
2. They're Deeply Influenced by Hormones
Where you are in your cycle (menstruation, follicular phase, ovulation, or luteal phase) can change how your pelvic floor feels and functions. Hormonal birth control, IUDs, and life phases like perimenopause or menopause also play a major role. I’ve worked with clients who only experienced symptoms the week before their period, or who noticed dramatic changes in their symptoms after starting or stopping hormonal birth control. I’ve also seen people with vulvar atrophy and pelvic pain that were clearly tied to hormone depletion. Estrogen, in particular, helps keep the tissues of the pelvic floor supple, hydrated, and resilient. When estrogen levels dip, things feel drier, tighter, and often more painful.
3. Your Microbiome Matters
Your vaginal and gut microbiomes have a direct line of communication with your pelvic floor. If the vaginal pH is off, or there’s recurring irritation, infection, or inflammation, your pelvic floor muscles often respond by tensing or guarding. Likewise, gut dysbiosis or constipation can influence how well your pelvic floor functions. If the tissue is irritated from the inside out, it’s going to change how your muscles behave.
4. Organ Health Has a Huge Impact
The pelvic floor’s main job is to provide structural support to your pelvic organs—like the bladder, uterus or prostate, and rectum. If you’re experiencing gut issues, bladder irritation (or UTIs!), prostate inflammation, or uterine discomfort, the pelvic floor will almost always respond. Muscles tend to contract and guard in response to pain or irritation, and your pelvic floor is no exception.
5. Diet and Digestion Affect the Pelvic Floor
What you eat can either support or strain your pelvic floor. Foods that you’re sensitive to, or meals that lead to bloating, can increase pressure on your pelvic floor and cause it to work harder. I’ve seen clients who experienced leaking or urgency only on days when they were extra bloated or had eaten trigger foods. There are some foods that are known bladder irritants such as coffee, chocolate (I know, the good stuff!) citrus foods, etc that can cause irritation to the bladder or gut lining, and cause the pelvic floor to react as well. Often times, figuring our what your triggers are and managing them is what is needed in these cases.
6. They Help Manage Intra-Abdominal Pressure
One of the pelvic floor’s critical roles is managing intra-abdominal pressure. Every time you move—whether that’s bending down, getting up from a chair, or going through a workout—pressure builds and shifts inside your abdomen. Normal things like coughing, sneezing and laughing cause a sharp increase of pressure in your abdomen. Your pelvic floor needs to coordinate with your core muscles to manage that pressure efficiently. If it doesn’t, or if you’re holding your breath or bearing down a lot, the pelvic floor takes on extra strain. Over time, that can lead to dysfunction that wouldn’t typically affect other skeletal muscles in the same way.
7. They’re Tied to the Nervous System and Emotional Health
Your pelvic floor responds to stress, trauma, and emotional overwhelm. When we’re afraid, anxious, or in survival mode, we reflexively clench our jaws, neck, and our pelvic floors. High cortisol levels and chronic stress can create a baseline of tension in these muscles. I’ve worked with many people who get emotional releases during pelvic floor work because it’s not just about the body—it’s about what the body has stored. Trauma, PTSD, and even everyday stress can all live in the pelvic floor.
In conclusion…
By now, I hope it’s clear why the pelvic floor is different from the rest of your muscles. This is also why healing pelvic floor dysfunction often takes longer than the six-week recovery timeline that works for other muscle injuries. These muscles are deeply intertwined with your hormonal health, organ systems, nervous system, and emotional state. Treating them requires a holistic approach.
So if you’re experiencing incontinence, pelvic pain, bowel or bladder issues, or sexual dysfunction—it’s essential to work with a pelvic floor specialist, not just a general physical therapist. The pelvic floor asks for a little more curiosity, nuance, and care.
Work With Me
If you're in the Denver area, I’d love to support you through in-person pelvic floor sessions. You can request an appointment here, and I’ll get back to you within 24–48 hours!
Not local? I also offer online pelvic health coaching for clients out of state. Fill out an inquiry form here to get started.
My rates are listed openly on my website—no surprises. You can view them here.
