overactive pelvic floor

The Link Between Stress and an Overactive Pelvic Floor

According to the American Psychological Association’s Stress in America 2023 study, 24% of US adults would rate their stress levels an 8 out of 10 or higher.

Stress is a natural part of human life, and a little of it is never a bad thing. But when stress becomes chronic or long-term, it may start to impact other aspects of mental and physical health.

One physical health consequence of chronic stress is an overactive pelvic floor. The pelvic floor is made up of muscles responsible for regulating the bladder, bowel, and uterus in women.

How is stress linked to this painful condition, and what can you do about it? We explore the answers to these questions in this post, so read on to find out.

What Is an Overactive Pelvic Floor?

An overactive pelvic floor is a temporary or chronic condition featuring constant contractions of the lower pelvis muscles. Also known as hypertonic pelvic floor, this condition is painful and can cause complications like difficulty urinating or having bowel movements and sexual dysfunction.

Over time, overactive pelvic floor muscles can lead to other disorders like pelvic organ prolapse or urinary incontinence. These conditions occur when constantly contracted muscles fatigue, causing weakness.

Symptoms of Hypertonic Pelvic Floor

The most common symptoms of hypertonic pelvic floor are pressure or pain in the pelvis, abdomen, lower back, or hips. Pain may worsen during certain activities, such as the following:

  • Urinary symptoms like pain while urinating or frequent urination
  • Bowel symptoms like constipation and incomplete evacuation
  • Sexual symptoms like pain during sex, after sex, when erect, or while ejaculating

Some people also experience pain or discomfort while sitting. The pelvic floor muscle compressed nearby nerves, causing the pain to radiate to the thighs, buttocks, and other areas.

Causes of Hypertonic Pelvic Floor

Hypertonic pelvic floor often happens as a result of many different things. Some of the most commonly recognized risk factors for overactive pelvic floor muscles are:

  • Not using the bathroom when you get the urge
  • Pelvic muscle injuries
  • Muscular dysfunction due to a sedentary lifestyle, pelvic bone abnormalities, poor posture, and irregular gait
  • Pre-existing conditions, such as IBS and endometriosis
  • Sexual abuse
  • Mental health conditions, including depression and anxiety

Importantly, stress can also lead to an overactive pelvic floor. Understanding why that is the case requires you to know how chronic stress works, which is what we’re discussing next.

Understanding How Chronic Stress Works

When you are stressed, your body undergoes a whole host of changes. These changes begin in the brain. During stressful conditions, a brain region called the HPA axis releases hormones that trigger the release of certain chemicals.

These chemicals are epinephrine (also known as adrenaline), norepinephrine, and cortisol. Learn how cortisol, in particular, impacts pelvic health below.

Cortisol and Hypertonic Pelvic Floor

Cortisol is the primary culprit of overactive pelvic floor muscles, as this chemical leads to the following effects, among others:

  • Raised blood pressure
  • Elevated heart rate
  • Increased muscle tension

Cortisol’s ultimate goal is to ready the body for a fight or flight response. Once the stressful situation is over, cortisol levels decline progressively and allow the body to return to a state of rest.

Yet, people who experience chronic stress may never get to that point. Cortisol levels remain high, the pelvic floor muscles continue to contract, and the result is the hypertonic pelvic floor symptoms we mentioned above.

As cortisol builds up in the body, muscles can become less sensitive to its effects. Ultimately, levels of cortisol bottom out, and low levels of bodily cortisol are known to cause pain, among other symptoms.

Treatment for Stress-Related Hypertonic Pelvic Floor

The good news about hypertonic pelvic floor is the symptoms are typically treatable at home. The following activities are excellent for strengthening and relaxing pelvic floor muscles for pain relief and other benefits.

Stress-Relieving Techniques

The first step is to target chronic stress levels. If you don’t treat the underlying cause of your pain, other treatments may offer temporary relief, but your symptoms will return.

Evidence-backed methods for reducing your stress levels include but are not limited to:

  • Getting more exercise
  • Eating a nutritious diet
  • Practicing meditation or mindfulness
  • Deep breathing exercises
  • Using stress-relieving supplements
  • Seeking social support
  • Partaking in creative activities

When these lifestyle changes are not enough to help with stress, it may be time to talk to a doctor. Chronic inability to relax could indicate an underlying physical or mental health condition requiring more intensive treatments.

Relaxing Pelvic Muscles

People with incontinence and other issues resulting from over-relaxed pelvic floor muscles may try Kegels and other muscle-strengthening exercises. But if these conditions result from hypertonic pelvic floor, kegels may do more harm than good.

Instead, consider trying relaxing pelvic exercises, such as the constructive rest position. The constructive rest position encourages blood flow to the pelvic muscles, helping them to relax and heal.

To get started, lie on the floor with a chair or couch in front of you. Elevate your calves on the couch or chair and breathe deeply. Stay in this position for up to 15 minutes for best results, and repeat the exercise daily.

Tension-Releasing Stretches

Practicing yoga is an excellent solution for overactive pelvic muscles. Many poses target the muscles of the pelvic region, allowing them to unwind. When paired with deep breathing, the effects are even more pronounced.

Here are some of the best yoga stretches for encouraging your pelvic muscles to expand and relax:

  • Happy Baby Pose
  • Garland Pose (static squat)
  • Chair Pose
  • Bridge Pose
  • Child’s Pose

As you practice these stretches, incorporate diaphragmatic breathing. Also known as belly breathing, this technique allows the pelvic floor to relax and release, ideal for alleviating hypertonic pelvic floor symptoms.

See a UroGYN for Women’s Pelvic Health

An overactive pelvic floor can cause the pelvic floor muscles to contract painfully. Chronic stress is one cause of this condition, as it puts the body in a constant state of tension.

Are you wondering what kind of doctor you need to see for hypertonic pelvic floor? A urogynecologist like Peter M. Lotz, MD, specializes in pelvic floor disorders in women.

Schedule an appointment at our Houston or The Woodlands, Texas location to learn more about a uroGYN’s specialist approach to women’s pelvic health.

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