Your Pelvic Floor's Scariest Stories: 7 Symptoms That Shouldn't Haunt You Forever

It's spooky season. And while everyone else is talking about ghosts, haunted houses, and the horrifying amount of money we're apparently spending on Halloween candy this year, I'd like to talk about something really scary: the pelvic floor symptom you've been ignoring for three years.

I know, I should’ve put some kinda warning before dropping that spooky one on you. You know how you cross your legs every time you sneeze? How about how you’ve mapped out every bathroom between Greenville and wherever you're going? Notice how sex hurts and you've convinced yourself that's just how things are now? I see how you’ve also stopped doing certain exercises because something feels heavy or uncomfortable. At Fortis, we hear these things all the time and unlike the weird noise you heard upstairs after everyone went to bed, pelvic floor symptoms usually don't go away on their own. I’m aware I have a lot of confidence in the noises going away…

So in honor of Halloween, let's talk about seven pelvic floor symptoms that may be common but shouldn't haunt you forever.

1. The Sneezing Situation

You sneeze, and your pelvic floor says surprise! Urinary leakage with coughing, sneezing, laughing, jumping, running, or lifting is called stress urinary incontinence. It's common, especially during pregnancy, postpartum, and as we age, but you don't have to automatically accept it and it’s not a “normal” part of these phases of life.

No, for heaven’s sake, the answer isn't always more Kegels. Leakage can involve pelvic floor strength, but coordination, muscle tension, breathing, pressure management, and how your body responds to a particular activity all matter too. If you cross your legs every time you feel a sneeze coming, your body is giving you information. Let's actually listen to it and not put a sheet over our heads (ghosties are cute…but no).

2. The Bladder That Gives You No Warning

There's needing to pee, and then there's NEEDING TO PEE RIGHT NOW. If your bladder goes from completely fine to emergency mode in about six seconds, that's urinary urgency, and some people also notice urinary frequency, meaning they're heading to the bathroom much more often than they expect.

There can be several reasons for this, including medical conditions that should be evaluated by the appropriate provider, but pelvic floor tension, bladder habits, constipation, fluid intake, and other factors can contribute too.

Constantly going to the bathroom "just in case" isn't always helping. If you pee before you leave the house, again when you get to Target, and once more before you leave Target because who knows what could happen during the 12-minute drive home, we should probably talk about your bladder habits. I hear you, Woodruff Rd stinks and is getting worse by the day (especially this time of year). Butttt, there are quite literally 3950 stores with bathrooms on it, I promise, we can find one in an emergency!

3. The "Something Is Falling Out" Feeling

Few things send someone into a late-night Google spiral faster than feeling pressure or heaviness in the vagina. Sometimes these symptoms are associated with pelvic organ prolapse, which is when one or more pelvic organs descend toward or into the vaginal canal. And yes, that sounds scary. However, please don't read one article about prolapse and decide you're never allowed to run, lift weights, pick up your child, or carry groceries again.

Prolapse varies a lot from person to person, from mild heaviness or pressure to pretty significant discomfort. Pelvic floor physical therapy can address muscle function, breathing and pressure management, bowel habits, movement strategies, and how you safely participate in the activities you actually want to do. We want you to understand what's happening and what we can do about it.

4. Sex Hurts, So You Just...Stopped Talking About It

Pain with sex is one of those symptoms people live with for a surprisingly long time before mentioning it to anyone. Maybe penetration hurts, or certain positions are uncomfortable, or things changed after birth, surgery, an injury, or menopause. Or maybe sex has always been painful and you were told some version of "have wine and just relax." Super helpful…

Painful sex can have many possible causes, and some of them need evaluation or treatment from a gynecologist or another medical provider. Pelvic floor muscle tension, difficulty relaxing, scar tissue, mobility restrictions, and previous pain experiences can contribute too, and if there's a musculoskeletal piece, pelvic floor physical therapy may be part of the plan. And please don't worry about embarrassing us. We're pelvic floor physical therapists, and talking about sex on a Tuesday morning is pretty normal around here.

5. Constipation Has Basically Become Part of Your Personality

If going to the bathroom involves straining, holding your breath, spending half your lunch break on the toilet, or a small ritual involving coffee and perfect timing, we need to talk. Constipation has many causes, including some outside the scope of physical therapy. But your pelvic floor plays a big role in bowel movements. Why? Because those muscles need to relax and coordinate for stool to pass. Sometimes people are bearing down against muscles that aren't relaxing well, which is basically pressing the gas and the brake at the same time. Oh and just because you poop every day does not mean you’re not constipated.

We may look at bowel habits, positioning, breathing, pelvic floor coordination, movement, and other factors that could be contributing. If something suggests you need additional medical evaluation, we'll tell you that too.

6. Exercise Makes Something Feel...Wrong

Maybe you leak when you run, or jumping gives you pelvic pressure, or your lower abdomen or pelvis hurts after a workout. Or maybe you've stopped lifting because every time you pick up something heavy, something down there feels alarming. The exercise is NOT forbidden forever. Unlike clowns….they can go.

Symptoms during exercise tell us the demand you're putting on your body and your current capacity may not be matching well. We may need to look at strength, pelvic floor coordination, breathing, pressure management, mobility, technique, or how quickly you progressed the activity. Sometimes we temporarily modify something while we build your capacity, and the goal is to get you back to it. At Fortis, we'd much rather help you figure out how to return to an activity than hand you a list of everything your body supposedly can't do.

7. You've Had a Symptom So Long You've Decided It's "Normal"

This might be the scariest one. You leaked after your first baby, and that baby is now seven. Your hip has hurt since pregnancy, you've had pelvic pressure for years, sex has been uncomfortable for so long you can't remember when it wasn't, and you can't remember the last time you had a bowel movement without pushing with all your might. At some point the symptom stopped feeling like a symptom and became part of your routine.

One of the most common things I hear is, "I thought that was just part of having kids." Plenty of women have been told exactly that by a provider (excuse me while I internally scream). Common does not equal normal, and there is often something we can do about it.

Not every symptom can be completely resolved with physical therapy, and some pelvic health symptoms have nothing to do with the pelvic floor, so sometimes we bring another provider in. Either way, you should get to understand what's happening before you decide you have to live with it.

Okay, So When Should You Actually See a Pelvic Floor Physical Therapist?

You don't need to wait until a symptom becomes unbearable. If leaking, urgency, pelvic pressure, constipation, pain with sex, pelvic pain, or symptoms during exercise are affecting what you do, how you move, or how you feel about your body, that's reason enough to ask questions.

At Fortis in Greenville, SC, we look at more than the symptom itself. Depending on what you're experiencing, assessment may include pelvic floor strength and tension, coordination, breathing, pressure management, hips, core, mobility, bladder or bowel habits, exercise, and other factors that could be contributing. Your evaluation includes both a lying down and a standing assessment, and any pelvic exam is done to whatever level of comfort you want. And we're not automatically handing you a sheet of Kegels.

The Scariest Thing Might Be How Long We Wait to Talk About This Stuff

We joke about leaking, whisper about painful sex, avoid jumping, memorize where every bathroom is, change our workouts, and strain through bowel movements, and sometimes we do all of this for years without ever asking whether something could actually help. That's the part I want to change.

Your pelvic floor doesn't need to be mysterious, embarrassing, or something you only think about when it stops cooperating. If something doesn't feel right, let's talk about it. Worst case, we have a conversation about your pelvic floor. I promise we've had scarier conversations.

Looking for Pelvic Floor Physical Therapy in Greenville, SC?

If pelvic floor symptoms have been haunting you a little longer than you'd like, Fortis Physical Therapy & Pelvic Health provides individualized pelvic floor physical therapy in Greenville, South Carolina.

Whether you're dealing with urinary leakage, urgency, pelvic pressure, painful intimacy, constipation, pelvic pain, or symptoms during exercise, we'll start by figuring out what's actually happening. No judgment, no assuming you just need more Kegels, and absolutely no exorcism required.

Come see us! Book your evaluation and let's talk about it.

Frequently Asked Questions

What are common symptoms of pelvic floor dysfunction?

Pelvic floor dysfunction can show up differently from person to person. Symptoms may include urinary leakage, urinary urgency or frequency, constipation or difficulty with bowel movements, pelvic pain, painful sex, pelvic pressure or heaviness, and symptoms during exercise.

Is urinary leakage when I sneeze normal?

Leaking with coughing, sneezing, laughing, running, jumping, or lifting is commonly associated with stress urinary incontinence. While it is common, especially after pregnancy and birth, it shouldn't automatically be dismissed as “normal.”

Does pelvic pressure mean I have pelvic organ prolapse?

Pelvic pressure or heaviness can occur with pelvic organ prolapse, but those symptoms alone cannot diagnose it. If you're experiencing new or persistent pelvic pressure, an appropriate medical or pelvic health evaluation can help determine what's contributing.

Can a tight pelvic floor cause symptoms?

Yes. Pelvic floor muscles that are overactive or have difficulty relaxing may contribute to symptoms such as pelvic pain, painful sex, difficulty with bowel movements, and some urinary symptoms. This is one reason Kegels aren't appropriate for many pelvic floor problems.

Can pelvic floor problems cause constipation?

Pelvic floor dysfunction can contribute to some types of constipation when the pelvic floor muscles don't relax or coordinate appropriately during a bowel movement. Constipation can also have many other causes, so persistent or concerning symptoms may require medical evaluation.

Should I stop exercising if I leak or feel pelvic pressure?

Not necessarily! Pelvic floor symptoms during exercise don't automatically mean you need to stop that activity permanently. A pelvic health physical therapist can evaluate what's contributing and help determine whether modifications, strengthening, coordination, pressure management, or another approach may help.

Where can I find pelvic floor physical therapy in Greenville, SC?

Fortis Physical Therapy & Pelvic Health provides individualized pelvic floor and orthopedic physical therapy in Greenville, South Carolina. Treatment is based on your symptoms, pelvic floor function, movement, lifestyle, and goals.