Can Pelvic Floor Dysfunction Cause Constipation? Understanding the Connection
Constipation is one of the most common digestive complaints, but in many cases, the problem isn’t only in the digestive system and it may be coming from the pelvic floor. If you struggle with straining to have a bowel movement, incomplete emptying, or difficulty relaxing during bowel movements, pelvic floor dysfunction could be part of the reason.
Here’s how the pelvic floor influences digestion and why pelvic floor therapy can make a significant difference for people dealing with chronic constipation.
What Is Pelvic Floor Dysfunction?
The pelvic floor is a group of muscles at the base of the pelvis responsible for supporting the bladder, bowel, and reproductive organs. These muscles need to be able to relax, contract, and coordinate properly for normal bowel movements.
Pelvic floor dysfunction occurs when the muscles:
Are too tight
Don’t relax fully
Are weak or uncoordinated
React with pain or guarding
When this happens, the bowel can’t empty effectively, even when the digestive system itself is working normally.
How the Pelvic Floor Affects Bowel Movements
For a bowel movement to happen comfortably:
The pelvic floor muscles need to relax
The abdominal muscles and diaphragm generate gentle pressure
The rectum and sphincters coordinate to allow stool to pass
If the pelvic floor cannot relax, or contracts instead, bowel movements become difficult, painful, and incomplete.
Signs Your Constipation May Be Pelvic-Floor Related
Constipation linked to pelvic floor dysfunction often includes:
1. Straining to Have a Bowel Movement
If you have to push or bear down excessively, your pelvic floor may not be relaxing as it should.
2. Feeling Like You Can’t Fully Empty
Many people describe:
Needing multiple trips to the bathroom
Stool that stops and starts
The feeling that something is “stuck”
This is a classic symptom of pelvic floor muscle tension.
3. Hard, Painful, or Infrequent Bowel Movements
If the pelvic floor stays tight, stool can remain in the rectum longer than normal, causing:
Hard stools
Increased discomfort
Longer time between bowel movements
4. Pain with Bowel Movements
This can include:
Pelvic pain
Rectal pain
Tailbone discomfort
Cramping
Pain often leads to guarding and more muscle tension, creating a cycle that makes constipation worse.
5. A Need to Change Position to Pass Stool
People may feel they need to:
Lean forward
Lift the hips
Press on the perineum
Use special stools or adjustments
These “workarounds” can be a sign that the pelvic floor isn’t coordinating properly.
Why Pelvic Floor Dysfunction Causes Constipation
Sometimes constipation is caused by diet, hydration, or medications.
Reasons the pelvic floor might not relax include:
Chronic stress
Postpartum changes
Surgery or scar tissue
Chronic straining
Injury
Poor toileting posture
Trauma
Long-term gut issues like IBS
Over time, the pelvic floor may become overactive and working too much, instead of relaxing when needed.
How Pelvic Floor Therapy Helps
Pelvic floor physical therapy can improve constipation by:
Teaching the muscles to relax properly
Improving coordination between the core and pelvic floor
Reducing tension and pain
Optimizing toileting posture and habits
Addressing contributing issues like hip or abdominal tightness
Therapy is individualized, but may include:
Breathing exercises
Manual therapy
Neuromuscular retraining
Postural or mobility work
Biofeedback
Education for healthy bowel mechanics
Relief can often be felt within just a few sessions.
When to Seek Professional Help
You may benefit from pelvic floor therapy if you experience:
Chronic constipation
Incomplete emptying
Painful bowel movements
Straining or pushing
IBS symptoms that don’t fully improve with diet changes
Tailbone or pelvic pain
Constipation that began after childbirth or surgery
Yes! Pelvic floor dysfunction can absolutely cause constipation, and it often goes undiagnosed. If you’ve tried diet changes, supplements, or medications without lasting relief, your pelvic floor may be playing a key role.
The good news? With proper diagnosis and targeted pelvic floor treatment, many people experience significant and lasting improvement.
Ready to explore whether your constipation may be pelvic floor related? Schedule a pelvic floor evaluation today.
