Why every woman should be paying attention to her pelvic floor

Just after my 24th birthday, I started experiencing an unpleasant combo of symptoms that pretty soon took over my life. I had chronic constipation and felt a frequent need to pee. But those were nothing compared to the muscle spasms and tightness I was also having in my pelvic region—feelings that made inserting tampons or having intercourse unbearable.

When tests ruled out a UTI or bladder infection, I was referred to a vaginitis specialist. After a pelvic floor muscle examination (which was pretty, er, intimate), I was diagnosed with pelvic floor dysfunction. Basically, the layer of muscles along the base of my lower abs weren’t contracting and relaxing the way they’re supposed to.

Until that moment, I’d never thought about my pelvic floor, like, ever. And I’d certainly never heard any friends talk about it. But according to a study published in the Journal of the American Medical Association, pelvic floor disorders affect a whopping 1 in 4 women—so many of whom go undiagnosed. And yes, that’s women of all ages, even young ones like me.

Childbirth injuries are a big contributor, but not the only one. Other causes include things like high-impact exercise gone awry and traumatic injuries to the area, which means childfree women can certainly be affected.

To get a better sense of what was happening down there, my doctor told me to imagine my pelvic floor muscles as a bowl. All of the major pelvic organs—including the bladder, vagina, uterus, and bowels—are held inside. My muscles were basically constantly contracting, hence the spasms and constant need to pee. My poor bladder was being squished. 

Pelvic floor disorders affect a whopping 1 in 4 women—so many of whom go undiagnosed.

“The pelvic floor can be involved in several common conditions that affect a woman’s quality of life,” explains Megan Schimpf, MD, a Michigan-based obstetrician-gynecologist and female pelvic specialist.

The good news is there are treatment options. “See a gynecologist or urogynecologist for an exam,” says Dr. Schimpf, “and then ask about pelvic floor physical therapy.”

I finally found relief after putting in several weeks of strengthening exercises and rehab. But even women without full-blown pelvic floor disorders can benefit from stretches to keep their pelvic floor relaxed and, well, happy. Julie Brewer, DPT, a Texas-based pelvic health specialist, recommends practicing diaphragmatic breathing, or belly breathing, for five to 10 minutes at least once or twice daily.

“Lie or recline and place your hand on your lower belly. Breathe in through the nose and notice how the belly expands, or lengthens, with the inhale,” she says. “Feel the pelvic floor also ‘let go’ and lengthen. Then, slowly exhale through the nose.”

Different yoga positions can also help your pelvic floor muscles relax and stretch. Brewer says child’s pose, butterfly, happy baby, and frog are all wonderful stretches for the pelvic floor. She also endorses a simple, deep-squat position, which can be held for a minute or two, to help your pelvic floor relax.

Now that I’ve experienced just how painful and life-upending pelvic floor pain can be, I’ve made stretching the area a regular part of my weekly wellness routine. And I make a point to talk to the women in my life about it, too. For such a common issue, it’s still pretty taboo—and that has to change.

Another women’s health topic that needs way more discussion: Endometriosis, which has a surprising link to cancer. And how to know if you’re suffering from Raynaud’s.