How Does Stress Influence Pelvic Pain?

June 11, 2025

Trauma and chronic stress—whether emotional, physical, or psychological—have long been recognized as key contributors to a variety of health conditions. One area often overlooked, however, is the pelvic floor.

Many people are surprised to learn that stress can significantly impact pelvic health, especially when left unresolved over time. Whether you’re dealing with digestive irregularities, urinary urgency, pain with sitting, or unexplained pelvic discomfort, understanding how the nervous system, diaphragm, and pelvic floor work together is essential. When we have this awareness, we’re better equipped to take control of our bodies and improve our well-being.

Is the Autonomic Nervous System the Hidden Driver of Pelvic Health?

The autonomic nervous system (ANS) is the part of the nervous system that regulates involuntary body functions—things like digestion, heart rate, breathing, and even how tight or relaxed your pelvic floor muscles are. The ANS functions in two main states:

1) Sympathetic Nervous System ("Fight or Flight")
This is the system that kicks in when we’re under stress or facing danger. It’s designed to help us survive. If you were suddenly approached by a vicious dog, your sympathetic nervous system would jump into action. Your heart would race, breathing would quicken, and blood flow would shift to your limbs to help you run or defend yourself. In the process, systems not critical in that moment—like digestion and urination—are put on hold.

2) Parasympathetic Nervous System ("Rest and Digest")
Once the perceived threat is gone, your body ideally returns to a calm, balanced state where it can digest food, sleep deeply, and perform restorative functions. The vagus nerve, the longest cranial nerve in the body, plays a central role in this process. It originates in the brainstem and extends all the way down to the pelvic organs, helping to regulate digestive, cardiac, and pelvic functions.

What is the Link Between Stress and Pelvic Floor Dysfunction?

When your body is chronically under stress—whether due to emotional trauma, chronic pain, poor sleep, or unprocessed life experiences—it can become "stuck" in the sympathetic state. Over time, this leads to a constant state of tension throughout the body, including in the pelvic floor muscles.

The pelvic floor, which supports organs such as the bladder, uterus (or prostate), and rectum, is a group of muscles that need to contract and relax properly to function well. When the nervous system is dysregulated, the pelvic floor often becomes overactive or hypertonic. This can contribute to a range of symptoms including:

  • Pelvic pain
  • Pain with sitting or sexual activity
  • Constipation or diarrhea
  • Urinary urgency or incontinence
  • Lower back, hip, or abdominal tension
  • Difficulty fully emptying the bladder or bowels

People experiencing these symptoms often have difficulty relaxing their pelvic floor muscles, not because they’re weak or broken—but because the body doesn’t feel safe enough to let go.

That’s why addressing nervous system regulation is a foundational component of pelvic floor therapy.

What is the Role of the Diaphragm?

Now let’s talk about the diaphragm, your body’s primary breathing muscle. It sits beneath the rib cage and works in close coordination with the pelvic floor, the deep core, and the abdominal wall to regulate intra-abdominal pressure.

From a neurological standpoint, the diaphragm is influenced by both the phrenic nerve (which controls the muscle's movement) and the vagus nerve (which helps calm the nervous system). It’s also closely connected to the motor neurons in the floor of the mouth, showing just how interconnected the systems of the body are—from top to bottom.

When the diaphragm is restricted—often due to shallow breathing, chronic stress, poor posture, or trauma—it affects the entire pressure system of the body, including the pelvic floor. This is why breathing exercises and diaphragmatic mobility are often the first step in treating pelvic floor dysfunction.

Switching States: How do I Activate the Parasympathetic Nervous System?

Fortunately, there are simple yet powerful ways to bring the body into a parasympathetic (rest and digest) state. These include:

Stretching/Strengthening the Diaphragm. Stretching the diaphragm through slow, intentional breathing is one of the quickest ways to downshift the nervous system. Inhale through your nose, letting the belly and ribcage expand. Exhale slowly through pursed lips.

Humming, singing, or chanting. These activities stimulate the vagus nerve by activating the vocal cords and floor of the mouth, sending signals of safety and calm.

Gentle vibration or electrical stimulation. Certain therapeutic tools can enhance vagus nerve activity and promote relaxation.

Meditation and mindfulness. These help calm the brain and body, making space for healing and recovery.

What Is Low Pressure Fitness (LPF) and How Can It Help?

LPF is a postural and breathing-based training system that targets the diaphragm, core, and pelvic floor. The goal of LPF is to reduce pressure in the thoracic, abdominal, and pelvic cavities, allowing the body to realign, decompress, and activate muscles in a coordinated way.

The word hypopressive literally means “low pressure” by applying specific breathing techniques combined with postural work to:

  • Stretch the diaphragm
  • Improve core stability
  • Reduce tension in the pelvic floor
  • Enhance circulation and lymphatic flow
  • Stimulate the vagus nerve
  • Improve posture, especially in the thoracic spine and rib cage

Benefits reported from consistent LPF practice include:

  • Decreased pelvic and perineal pain
  • Improved bowel and bladder function
  • Reduction in neck, shoulder, and lower back tension
  • Decreased symptoms of stress, anxiety, and depression
  • Better breathing mechanics and rib cage mobility

What are Some Additional Tools to Help?

Here are some additional lifestyle and self-care practices you can incorporate into your daily routine:

Meditation & Guided Mindfulness

  • Find a quiet space and tune into a guided meditation app.
  • Recommended apps: Headspace, Calm, Healthy Minds Program
  • Just 5–10 minutes daily can begin to rewire stress patterns in the brain.

Epsom Salt Baths

  • Add 1–2 cups of Epsom salt to a warm bath to relax tight muscles.
  • A few drops of lavender essential oil can enhance the calming effect.
  • Combine with breathwork or a guided meditation for a full sensory reset.

Carve Out Time for Joy

  • Whether it’s dancing, journaling, painting, or walking outside—make time each week to do something purely for yourself. These practices help remind your nervous system that you are safe.

Let’s Work Together

If you’re experiencing pelvic floor dysfunction and suspect that chronic stress may be part of the picture, you’re not alone—and there is help available. At Activcore, we specialize in personalized, one-on-one care that addresses the whole person—body and mind.

We take an integrative approach that includes pelvic floor physical therapy, nervous system regulation, Low Pressure Fitness, and individualized breath and movement retraining.

Join Me for a Transformative 90-Minute Workshop!

Ready to experience this in a guided, supportive setting? Discover how Low Pressure Fitness and nervous system regulation techniques can help reduce pelvic pain, calm your system, and support whole-body healing.

Workshop: Breathe It Like You Mean It
Date:
Saturday, June 21, 2025
Time: 10:00am – 11:30am
Location: Activcore Bernardsville

👉 Reserve your spot here

 

Disclaimer:  The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Shawna Poltricitsky

Physical Therapist
Shawna Poltricitsky is a Doctor of Physical Therapy (DPT) and Board Certified Orthopedic Clinical Specialist (OCS) who specializes in pelvic health, women's health, and general orthopedics and manual therapy. She works at Activcore in Bernardsville, New Jersey.
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