10 Pelvic Floor Symptoms You Shouldn’t Ignore

You probably don’t think about your pelvic floor much—and that’s totally normal. But these muscles do a lot of heavy lifting every day. When they start acting up, it can sneak into your daily life in ways you wouldn’t expect.

Here are 10 signs your pelvic floor might need a little extra attention.

1. Leaking When You Laugh, Sneeze, or Exercise (Urinary Incontinence)

If you’ve ever leaked a little when sneezing, laughing, jumping, running, or exercising, you’re not alone. Urinary incontinence is one of the most common pelvic floor symptoms, and it happens when your muscles aren’t providing the support and control they should.

There are different types of leaking: stress incontinence (with sneezing, coughing, or movement), urge incontinence (a sudden, strong “gotta go” feeling you can’t hold back), or a mix of both. While many people chalk it up to aging or postpartum changes, leakage is a sign your pelvic floor needs attention. The good news? Pelvic floor physical therapy can help you retrain and strengthen those muscles, allowing you to move through life confidently and without worrying about accidents.

2. Urgency and Frequency (Overactive Bladder)

On the flip side, maybe you don’t leak, but you constantly feel like you have to pee, even when your bladder isn’t full. Or you find yourself mapping out every bathroom when you leave the house “just in case.” This is called urinary urgency or frequency, and it’s often linked to an overactive bladder and pelvic floor dysfunction.

Some people go to the bathroom more than 8–10 times per day or wake up multiple times at night to urinate (nocturia). Others feel a sudden, intense urge that’s hard to control. While common, it’s not normal. But it is treatable! A pelvic floor PT can help you retrain your bladder (urge suppression) so you can live your life without constantly worrying about your next bathroom stop.

3. Painful Sex

Did you know that nearly 3 out of 4 women or people with female anatomy experience pain during intercourse at some point in their lives? It’s a startling statistic that highlights just how common this issue is. Pain during intercourse can be a sign of pelvic floor dysfunction, in which overactive or tight muscles make intimacy uncomfortable and downright painful. Addressing it can improve your physical comfort and give you more fulfilling sexual experiences.

4. Trouble with Bowel Movements

We have to talk poop sometimes! Your pelvic floor muscles help control bowel movements, so constipation, straining, incomplete emptying, or accidental leakage can all be signs that something is off. A healthy poop should be soft, smooth, and easy to pass. Changes in frequency, shape, color, or effort can indicate pelvic floor issues or other gastrointestinal problems. Pelvic floor physical therapy can retrain and strengthen these muscles, helping you get back to normal, comfortable bowel habits.

5. Chronic Pelvic Pain or Discomfort

Pelvic pain is surprisingly common and can affect anyone. It might be a dull ache, sharp twinges, or discomfort during walking, exercising, sitting, or intimacy. Pain often comes from the pelvic floor muscles but can also involve your lower abdomen, hips, or back. It also sometimes relates to conditions like endometriosis, IBS, or interstitial cystitis.

Pelvic pain usually doesn’t go away on its own. A pelvic floor physical therapist can help identify the cause and create a personalized plan to relieve pain and get you back to your normal activities.

6. A Bulging or Heaviness Sensation (Down There)

A sensation of heaviness, pressure, or even a visible bulge in the vaginal area could be a sign of pelvic organ prolapse (POP). This happens when the pelvic floor muscles aren’t fully supporting your organs. Symptoms can fluctuate throughout the day, get worse with standing or activity, and may fluctuate with your menstrual cycle, pregnancy, or postpartum recovery.

Prolapse is more common than many people realize, and there are effective ways to manage it. Pelvic floor physical therapy can help strengthen and coordinate your muscles, teach you pressure management techniques, and support your daily activities. For some, a pessary or surgery may also be options. Meeting with a PT is a great first step to explore non-surgical approaches and find what works for your body.

7. Tailbone Pain (Coccydynia)

If you’ve ever experienced tailbone pain, you know how much it can interfere with daily life. Sitting at your desk, driving, using the bathroom, or even being intimate can suddenly become painful. The tailbone (or coccyx) is small, but it anchors muscles and ligaments that help stabilize your pelvis. When it’s irritated, the discomfort is hard to ignore. Causes of tailbone pain (coccydynia) include falls, prolonged sitting, pregnancy and childbirth, as well as certain posture habits. For some, being underweight or overweight can also add extra strain. Symptoms often show up as pain when sitting (especially on hard surfaces), standing up, pooping, or during sex.

Pelvic floor physical therapy can significantly improve symptoms associated with tailbone pain. A PT can teach you posture and movement strategies, provide hands-on treatment, and guide you through stretches and exercises to ease tension in the muscles pulling on the coccyx. With the right care, you don’t have to keep wincing every time you sit down.

8. Constipation or Straining

Constipation is one of the most common gut issues that affects pelvic floor function. When constipated, your stool is hard and dry, which puts strain on the muscles of the pelvic floor, especially during bowel movements. This can lead to hemorrhoids, anal fissures, painful bowel movements, a cycle of avoidance (skipping bowel movements out of fear of pain), and an increased risk for pelvic organ prolapse (chronic straining pushes the bladder, uterus, or rectum downward against the vaginal wall).

Pelvic floor therapy can help by retraining bowel habits, improving muscle coordination, and alleviating tension that perpetuates the cycle.

Do you have a child who is constipated? You are not alone. Constipation affects up to 30% of children—most often in the preschool years. Kids who struggle with constipation may “withhold” stool to avoid pain, which overstretches the rectum, dulls the body’s natural signals, and makes the problem worse. This can spill over into issues with potty training, bedwetting, or daytime accidents.

9. Diastasis Recti (Abdominal Separation)

Diastasis recti occurs when the connective tissue down the middle of your “6-pack” muscles stretches, causing the abs to separate. While it’s most common during pregnancy and postpartum, it can affect men, women, and even children. Research shows up to 60% of women experience it at 6 weeks postpartum—and around 28% of the general population may have it too.

Signs of diastasis recti include a bulge or “doming” in your abdomen (especially when sitting up or exercising), bloating, constipation, back pain, or a feeling of core weakness. Left untreated, it can affect your posture, stability, and even your pelvic floor. The good news? With guided core exercises, breathing techniques, and pelvic floor physical therapy, diastasis recti can improve—often without surgery. A PT can teach you how to reconnect with your core, reduce pressure, and safely return to the activities you love.

10. Menstrual Changes and Painful Periods

Your menstrual period is actually a vital indicator that can reveal a great deal about your overall health. While everyone’s cycle looks a little different, there are some red flags you shouldn’t ignore. Heavy bleeding (soaking through a pad or tampon every hour), periods lasting longer than 7 days, or debilitating cramps that keep you home from work or school are not normal. Skipping periods altogether or sudden changes in your usual rhythm are also signs that something might be off.

Understanding your cycle, tracking its patterns, and seeking help when something feels off can help you better understand and support your overall health. If you experience period-related discomfort or pain during menstruation that interferes with your ability to enjoy life, pelvic floor physical therapy may be able to help.

When to Seek Help

If you recognize any of these symptoms in your own life, you don’t have to push through or accept them as “normal.” A pelvic floor physical therapist can help you get to the root of the problem and guide you toward relief. With the right support, you can feel stronger, more comfortable, and more in control of your body.

About Pelvic Health & Wellness

Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our physical therapists specialize in treating pelvic health concerns such as pelvic floor dysfunction, bowel and gut health, pelvic pain, pelvic organ prolapse, constipation, incontinence, fertility, and various pregnancy and postpartum-related conditions.

We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. We are here to support and encourage you on your journey back to health so you can return to doing what you love! If you are ready to take the first step in reclaiming your pelvic health and wellness, don't hesitate to get in touch with us today.