The Connection Between Stress, Anxiety, and the Pelvic Floor

Bathroom Breaks as an Act of Self-Care

I have often talked with clients about the importance of going to the bathroom when it is time to go to the bathroom as an act of rebellious self-care. It sounds silly, but most women I know are so busy in their day that they hold their bathroom break until the last possible minute. The ability to take a bathroom break when it is needed seems like a luxury, and sadly there are bigger impacts to this mentality than just being uncomfortable a few times a day. Our pelvic floor holds much of the stress that says “I don’t have time for this yet”, and over time our pelvic floor learns to clench, brace, tighten, and hold tight as a response to many stressors. The body and nervous system are deeply intertwined and the pelvic floor is one place where emotional stress often shows up physically. As highlighted in Floored by Dr. Sara Reardon, pelvic floor health is not just about muscles that hold in our pee and poop, it is about how the body responds to safety, threat, and chronic stress. 

What Is the Pelvic Floor?

The pelvic floor is a group of muscles at the base of the pelvis that support the bladder, bowel, and reproductive organs. These muscles also play a role in core stability, bowel and bladder control, and sexual function. Like other muscles in the body, the pelvic floor responds to stress. It tightens when the nervous system perceives danger and relaxes when the body feels safe. The challenge is that in modern life, stress and anxiety are often ongoing rather than temporary. When the body stays in a heightened state of alert, muscles (including the pelvic floor) can remain tense long after the original stressor has passed.

How Stress and Anxiety Affect the Body

When we experience stress or anxiety, the nervous system shifts into a fight-or-flight response. This response is designed to protect us, but when it becomes chronic, it can lead to muscle tension, shallow breathing, and difficulty relaxing. For many people, the pelvic floor becomes part of this stress response. Clenching, guarding, or holding tension in the pelvis often happens unconsciously. Over time, this tension can contribute to discomfort or dysfunction, even when there is no obvious injury or medical explanation.

Pelvic Floor Symptoms Commonly Linked to Stress

Stress-related pelvic floor tension can show up in many ways, including:

• Urinary urgency or frequent trips to the bathroom

• Pelvic pain or pressure

• Pain or difficulty with sexual activity

• Low back, hip, or tailbone discomfort

• A feeling of tightness or difficulty “letting go” in the body

  
  

These symptoms are real, common, and often misunderstood. They are not a sign of weakness or something a person is doing wrong, rather, they are signals from the nervous system that the body may be under strain.

Why “Just Relax” Isn’t Helpful

People experiencing pelvic floor symptoms are often told to “just relax” or to do strengthening exercises without considering whether the muscles are already overworking. Relaxation is not something the body can force when it doesn’t feel safe.

True relaxation happens when the nervous system is supported, not pressured. For many people, pelvic floor tension is tied to long-standing stress patterns, anxiety, trauma, or chronic overwhelm. Addressing these symptoms often requires a compassionate, whole-person approach rather than quick fixes.

Support for stress-related pelvic floor symptoms often includes both physical and emotional care. Helpful approaches may include:

• Learning nervous system regulation and stress-management skills

• Working with a trauma-informed pelvic floor physical therapist

• Therapy that integrates body awareness and emotional processing

• Gentle breathing, mindfulness, and grounding practices

  
  

The goal is to help our bodies feel safe enough to soften and rebalance over time naturally.

When to Seek Support

If pelvic symptoms are persistent, worsening, or interfering with daily life or intimacy, it may be time to seek professional support. Collaboration between mental health providers and pelvic floor specialists can be especially effective, as stress and physical symptoms often reinforce one another. I have a couple of amazing pelvic floor therapists I often refer to, and our hope is that we will get to say goodbye to the days of women being told this is normal or just something else to endure. 

Lastly, no matter what age you are, please go out and buy Floored. I plan to re-read it yearly, it is THAT important. I learned so much and there is a chapter with important information for every season of life! 

Purchase Floored by Dr. Sara Reardon:

Amazon, or shop locally at Books Are Awesome