Your Pelvic Floor Speaks —Are You Listening?

Welcome to the Pelvic Floor diaries volume 3: Your body is always talking to you. A little leak when you laugh. A sudden urgency to run to the bathroom. A heaviness at the end of the day. Discomfort during sex that you push through and say nothing about. These are not random inconveniences. These are messages.

Nearly one in three women will experience some form of pelvic floor dysfunction in her lifetime. And most of them will wait years before talking to anyone about it. Years of managing, hiding, adjusting, and quietly assuming this is just how life is now.

It doesn’t have to be.

What Does Pelvic Floor Dysfunction Actually Mean?

Dysfunction simply means the pelvic floor is not working the way it should. And this can go in two very different directions.

Some women have a pelvic floor that is too weak — muscles that cannot hold, support, or control the way they need to. Other women have a pelvic floor that is too tight — muscles that are chronically tense, unable to relax fully, creating pain and restriction. And many women have a combination of both at the same time, which is why ‘just do your Kegels’ is not always the right advice. A tight pelvic floor does not need more squeezing. It needs release.

Signs Your Pelvic Floor Is Talking to You

Some of these will feel familiar. Some you may have never connected to the pelvic floor at all.

• Leaking urine — when you cough, sneeze, laugh, jump, or exercise. This is called stress urinary incontinence and it is very common, especially after childbirth and during menopause.

• Urgency — a sudden, intense urge to urinate that is difficult to hold. You find yourself rushing to the bathroom, sometimes not making it in time.

• Frequent urination — going to the bathroom more often than feels right, including waking at night.

• Prolapse — a feeling of heaviness, pressure, or bulging in the vagina. The sensation that something is falling out. This happens when the pelvic organs — bladder, uterus, or rectum — begin to descend from their normal position.

• Bowel issues — leaking stool or gas unexpectedly, straining, or not feeling fully empty after a bowel movement.

• Pelvic pain — persistent discomfort in the pelvis, tailbone, hips, or lower back.

• Painful periods — tension in the pelvic floor muscles can contribute to menstrual cramps and discomfort.

• Sexual difficulties — pain during or after sex, reduced sensation in the vagina, lack of lubrication, difficulty reaching orgasm. We will explore this more in Part Four.

  
  

Why Does This Happen?

The pelvic floor faces enormous demands across a woman’s life. The most common contributors are:

• Pregnancy and childbirth: Nine months of growing weight pressing down, followed by labour and delivery. Vaginal birth, especially with forceps or vacuum assistance, can stretch and strain the pelvic floor tissues significantly.

• Hormonal changes: Estrogen keeps the tissues of the pelvic floor and the vagina strong, elastic, and well-hydrated. When estrogen declines during perimenopause and menopause, those tissues change — they thin, dry, and weaken. We talk about this in depth in Part Five.

• Ageing: Natural loss of muscle strength and tissue elasticity over time.

• Chronic pressure: Years of constipation, persistent coughing, heavy lifting, or high-impact exercise without proper pelvic floor engagement all add up.

• Stress and emotional tension: The pelvic floor is deeply connected to the nervous system. Chronic stress, anxiety, and unresolved emotional holding can manifest as physical tightness in these muscles.

  
  

The Part Nobody Talks About

Beyond the physical, pelvic floor dysfunction quietly takes things away from women. They stop exercising. They avoid going out for long periods. They stop enjoying intimacy or avoid it altogether. They carry a private shame that this is their fault somehow, that their body has failed them.

This silence is one of the biggest barriers to getting help. Because the moment a woman realizes that her symptoms are real, recognized, and experienced by millions of other women — something shifts. She is not broken. She is not alone. She is dealing with a health condition that has solutions.

You do not have to live with this. Help exists. And it works.