It comes as no surprise that stress is a major health problem in the United States. It is estimated that approximately 33% of Americans are living with extreme stress and the physical and psychological changes associated with stress can’t be overemphasized. Some physical manifestation of stress include headache, fatigue, changes in appetite, bowel troubles, and muscle pain. The pelvic floor is an important muscle group prone to the impact of stress which often causes pelvic pain.
The pelvic floor is made up of unit of muscles shaped like a bowl. These muscles stretch from the pubic bone in the front and attach near the tail bone. They are responsible for keeping abdominal and pelvic contents inside the body, especially urine and stool. They also make up the birth canal which facilitates the birth of a baby. There are few muscles in the body that are as dynamic and multifaceted as the pelvic floor. Unlike many of the muscle groups in the body, the pelvic floor muscles are always working which makes them prone to muscle fatigue and pain.
Muscles become active during stress
During increased periods of stress, neurotransmitters like Dopamine, Epinephrine, and Norepinephrine are released to activate your “fight-or -flight” system. This is the reflex that’s normally in place to allow you to run away from danger. The downside is that internal stress also activates the same pathways which leads to prolonged periods of muscle activation. Muscles like the pelvic floor which are always at work will eventually fatigue after prolonged periods of stress causing pelvic pain.
Strategies to reduce stress and pelvic pain
Prior to treatment for pelvic pain, it is important to rule out other common causes of pelvic pain with your OBGYN. If your pelvic pain results from stress, then it can be treated like pain in other muscle groups. The first step is pelvic floor muscle relaxation techniques and exercises which reduce muscle fatigue. These techniques are easily taught by a licensed pelvic floor physical therapist. A list of licensed therapists can be found on the American Physical Therapy Association website. Other strategies to reduce stress like meditation, stretching, exercise, and massage therapy is also helpful at reducing stress. As always learning to manage and cope with stress will reduce its impact on the pelvic floor and surrounding musculature reducing muscle fatigue and pain.

I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.