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When most people think of their pelvic floor, it’s usually during pregnancy, postpartum recovery, or menopause. But here’s the secret: your pelvic floor isn’t just something that pops into your life when you're expecting or dealing with hot flashes. It’s a core player in your overall health from childhood all the way through menopause and beyond. You're born with it.
This group of muscles, ligaments, and connective tissues does so much more than just keep your bladder and bowels in check. It plays a major role in your core stability, movement, sexual pleasure and even emotional well-being. Taking care of your pelvic floor can lead to better health throughout your entire life. And the best part? It’s never too late—or too early—to start!
So, let’s dive into five key seasons of life when women’s pelvic floor health really matters. Spoiler: It’s a lot more than you think!
1. Pre-Puberty: Setting the foundation early
You might not even know your pelvic floor is working yet, but it’s already doing its job long before you hit puberty. From the moment your little one starts learning potty training (actually way before this moment), their pelvic floor is already at work, helping with bladder and bowel control, stability, and even their developing core strength.
Here’s a surprising fact: constipation is the number one reason for nighttime bed-wetting in kids over seven years old. It’s often linked to a tight pelvic floor, dietary habits, or toileting routines. So, while pelvic health might seem like a grown-up issue, it’s something that should be on your radar even in childhood.
If your child is struggling with bathroom issues, don’t overlook the pelvic floor—it could be an early indicator that things aren’t functioning optimally. By teaching kids proper toilet habits, breathing techniques, and pelvic floor awareness early on, we set them up for a lifetime of better health. If you don't know how to teach them this stuff, find a pediatric pelvic PT in your area to help.
2. Puberty: Hormones, periods, and pelvic health
Puberty is a whirlwind, right? Your body is changing in more ways than you can count, and so are your hormones. When menstruation starts, it’s not just about learning to use period underwear, pads, tampons, discs or menstrual cups—it’s also the time when your pelvic floor starts to feel the effects of hormonal shifts.
Estrogen starts to flow, and this hormone works to increase blood flow, vaginal secretions, and elasticity in the pelvic tissues—keeping things healthy down there. And then there’s progesterone—the "happy hormone," which not only helps to regulate the menstrual cycle but also boosts mood and energy. It plays a key role in pelvic health by supporting smooth muscle function, including those that control bowel motility. Side note... progesterone can lead to issues like constipation, especially in the latter part of the menstrual cycle.
I know, I know—it seems like your hormones are constantly throwing curveballs at you. When I was a teen, I experienced the trifecta of menstrual cramps, constipation, and urinary frequency—talk about a hormonal cocktail! Back then, my doctor prescribed birth control to “regulate” my period and "manage" my pain, but I didn’t realize how that would suppress my natural hormones during some critical developmental years.
Puberty is a great time to learn that your hormones have a direct impact on pelvic health. By becoming aware of how your pelvic floor reacts to hormonal changes, you can take proactive steps to stay comfortable and in control, not just with period products, but with your overall pelvic health.
3. Pregnancy: More demands, more care
Ah, pregnancy. It's not just the baby that’s growing—you are too. And so is your pelvic floor! It’s a time when your pelvic muscles get stretched and increased demands as they support the weight of a growing baby, changes in your center of gravity, and the increased pressure on your pelvic organs. Research shows that up to 80% of pregnant women experience pelvic pain or urinary incontinence, thanks to this increased load.
Now, I know what you’re thinking—"Do I really need to think about my pelvic floor during pregnancy if I don't have any issues?" Trust me, you do. Think of it like foreplay for your body—preparing your muscles and tissues for the big day. Pelvic floor exercises like diaphragmatic breathing, pelvic mobility, and core strengthening can make a huge difference in labor outcomes and postpartum recovery.
So, let’s get one thing straight: neglecting your pelvic health during pregnancy is like trying to bake a cake without greasing the pan—don’t skip this step! The better you prepare, the smoother the ride.
4. Postpartum: The silent recovery your pelvic floor needs
After vaginal delivery, your pelvic floor has been through a lot. It has stretched (and possibly torn) to make room for your baby, and even if you didn’t experience a tear, it’s likely to feel weakened and fatigued. While the birth hormones help the tissues stretch, recovery takes intentional care. In fact, some women find that even if they don’t experience tearing, there is still a degree of pelvic floor weakness or dysfunction like leaking pee, pelvic pressure or painful sex.
And it’s not just vaginal births. Even cesarean section deliveries can affect your pelvic floor. Why? Because the disruption of the abdominal wall during surgery impacts the muscles that work in tandem with the pelvic floor. When your abdominal muscles are weakened or affected, it can place additional strain on the pelvic floor.
Research estimates that up to 50% of women experience some form of pelvic floor dysfunction postpartum—whether it’s urinary incontinence, pelvic pain, or prolapse. But here’s the good news: recovery is not just about waiting for time to pass. It’s about taking active steps to support your body.
Pelvic floor physical therapy is one of the most powerful ways to recover from childbirth. Whether you had a vaginal delivery or a cesarean, pelvic PT can help heal perineal tears, strengthen weakened muscles, and address any lingering discomfort or dysfunction. And don’t forget: learning how to breathe, move, and engage your core properly is key to a smooth recovery. It’s never too late to start!
5. Perimenopause, Menopause, and Postmenopause: Aging (But Not Like That)
Now, let’s talk about the big hormonal shift that comes with perimenopause, menopause, and postmenopause. These are the stages of life when your hormones go on a wild ride—think of it as “reverse puberty.”
Perimenopause is the transition phase when your cycles become irregular, and estrogen levels start to fluctuate. This can be a time when vaginal dryness, pelvic discomfort, or even urinary incontinence sneak in. And once you hit menopause (the day you’ve gone 12 months without a period), estrogen levels really drop, which can lead to a loss of elasticity in pelvic tissues and weakening of the pelvic floor muscles. And then there’s postmenopause—when estrogen is pretty much MIA.
But here’s the kicker: menopause doesn’t have to mean discomfort or dysfunction. With the right strategies, you can keep your pelvic floor strong and healthy. Regular pelvic floor exercises are a great place to start, and research shows that adding therapies like vaginal estrogen, red light therapy, or pelvic floor physical therapy can prevent or manage many of the issues that come with aging.
The key is understanding that while your pelvic floor is impacted by hormonal changes, you can take control and prevent a lot of the discomfort associated with aging. Aging doesn’t mean giving up—it means adapting, strengthening, and embracing self-care.
Educating the Next Generation: Knowledge is Power
For all the moms out there—remember, you are role models! Don’t shy away from talking about pelvic health. Seeking help when needed and showing that self-care is normal sends a powerful message. You’re not just improving your own health—you’re setting an example for the next generation.
Teach by doing and teach by talking to the next generation about pelvic health. Start with the basics—teach your kids how to breathe properly on the toilet (exhale when you poo), how to establish healthy bladder habits, and how to engage their core. These simple lessons lay the foundation for better pelvic health throughout their lives.
The Bottom Line
Your pelvic floor isn’t just a “mom thing” or a “menopause thing.” It’s a lifelong part of your health, and it deserves your attention at every stage of life. By understanding its needs, taking proactive steps, and seeking help when necessary, you’re investing in your long-term health—and teaching the next generation to do the same.
So, whether you’re navigating the ups and downs of puberty, preparing for pregnancy, recovering from childbirth, or embracing the changes of menopause, don’t forget to give your pelvic floor the care and attention it deserves. It’s the foundation for your physical, hormonal, and emotional well-being—and it’s worth every bit of effort you put into keeping it strong and healthy.
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