What have you heard about your pelvic floor? Did you know your pelvic floor plays a role in your infertility journey? (If you are looking for the Printable PDF Version, find it HERE)

Have you’ve been told to “just do kegels” or that painful intercourse or urinary leakage are issues that you just have to deal with? Skip that advice and read this guide instead! Your pelvic floor does so many things for you. Learning more about it can be incredibly helpful as a part of your fertility journey.

One thing that still amazes me, is how many people do not even know that their pelvic floor exists. The goal of this article is to do a couple of things. Number one,  continue working on normalizing the discussion of pelvic health concerns. The symptoms discussed in this article are so common, particularly in women, but they are not normal and pelvic health physical therapy can help! The second goal, is to give you hope. If you’re experiencing any of the symptoms discussed in this article, the guidance of a pelvic floor physical therapist may be exactly what you need to feel your best and support you in your fertility journey.

So let’s start at the beginning – what is your pelvic floor, anyway?!

What is your Pelvic Floor and What does It Do?

Your pelvic floor is a group of muscles, structured like a hammock, on the bottom side of your pelvis. These muscles cross all three holes of female anatomy – the urethra (where urine exits), the vagina, and the anus (where stool exits). These muscles are a part of your entire core system. Yes, I said it, your core is a system – not just your abs! In “pelvic health physical therapy land”, we talk about your core as this system of muscles, shaped like cylinder, in the middle of your body.

Your pelvic floor is a part of this system.

Think of this system like a pop can –

Your diaphragm is at the top of this system, your pelvic floor is on the bottom side, your abdominal layers are on the front and wrap around the sides of your body into your back muscles. This system works together to support you and your abdominal and pelvic organs as you move. This system also manages pressure within your abdominal cavity. This means when you cough, laugh, sneeze or lift something heavy, your core system plays a role in how pressure is distributed throughout the system. Pooping, peeing, any form of penetration, and having babies are also functions that your pelvic floor plays an important role in supporting.

Your pelvic floor has several jobs and in order to do these jobs, these muscles have to be able to both relax or let go, as well as contract or be strong. Pelvic floor relaxation is essential for emptying fully when you urinate, emptying fully when you poop, for any form of penetration to occur comfortably, as well as for the delivery of a baby. On the other hand, your pelvic floor has to be able to contract and be strong to prevent leakage of urine or stool, to provide support for the pelvic organs, and also support hip and low back stability with daily tasks or during exercise. 

How do I know if something I’m experiencing could be related to my pelvic floor?

If your pelvic floor is holding too much tension, this may result in symptoms such as intercourse that is painful or impossible, hip pain, low back pain, tailbone pain, constipation, straining with urination, abdominal tension or pain, menstrual cramps, recurrent UTIs that don’t resolve or stay away with medical management, or vaginal or rectal pain to name a few. 

If your pelvic floor is weak, this can often result in feelings of pelvic heaviness or tension with daily activities, running or lifting, urinary leakage, stool leakage, as well as low back or hip pain. Sometimes there can be a combination of tension and weakness, which can present in a combination of symptoms mentioned above.

If you are experiencing any of these symptoms, the guidance of a pelvic floor physical therapist to help you overcome them could be exactly what you need. These symptoms are more common than any of us would like to admit, and there is no need to suffer in silence. There are solutions and you absolutely can feel better soon.

How does this relate to your fertility journey?

In addition to addressing the symptoms mentioned above, pelvic floor health is also an important aspect of your fertility journey. Here are a few ways the guidance of a pelvic health physical therapist can be helpful.

Your pelvic floor shares a strong relationship with your stress and emotions.

You may already be aware of holding tension in your neck and shoulders when you’re feeling stress, anxious, or frustrated. Did you know that your pelvic floor and abdominals also hold emotional tension? Even though your fertility journey and the way you experience it is completely your own, it is very likely stressful and emotional at times. This means your pelvic floor may respond with increased tension. Your mind-body connection is so powerful! Learning how your pelvic health is connected to this, and what you can do about it, can be such a game changer for any pelvic symptoms you may be experiencing.

Your pelvic floor’s tension plays a role in how you may experience pain during intercourse, or pain associated with diagnoses such as PCOS and endometriosis.

Pain and tension associated with each of these can impact mechanical fertility. A pelvic floor physical therapist can teach you how to reduce pelvic floor and core tension, and improve relaxation. This can help intercourse become comfortable and enjoyable again. This can make periods less painful.
Additionally, If pain or pelvic symptoms arise secondary to IUI or IVF treatments, reduction of muscular tension can help improve this too!

Maintaining a positive relationship with exercise throughout your fertility journey is also something a pelvic floor physical therapist can provide.

This includes incorporating pelvic floor specific exercise, in addition to providing guidance with the amount and types of exercise that support your overall health and wellness goals. The National Institutes of Health recommends 150 minutes of moderate or 75 minutes of vigorous aerobic activity per week plus 2-3 strength training sessions per week. These guidelines are provided to encourage overall health and wellness, which supports a healthy environment for your body to function well as a whole.
We know that meeting the exercise guidelines supports overall health in a number of ways including – blood pressure regulation,  blood sugar regulation, bone health, reduced stress, improved sleep – the list goes on! We also know that skeletal muscle is an endocrine organ, and helps regulate hormones.
This means building more muscle through a regular strength training routine can actually improve your hormone health! Exercise does so many good things for your body!

I think I need some help with this – what should I do?

If you already have a pelvic floor physical therapist in mind who you know and trust, reach out to them!  There are lots of wonderful providers out there. The most important thing is to find someone who is a best fit for YOU. Someone who fully supports you in the goals you create and needs that you have! 

If you don’t have someone in mind and are wondering if pelvic health physical therapy or coaching could be helpful, I would love to connect with you! I work with clients in the Eastern Iowa Corridor via a combination of online and in-person support, or 100% virtually for anyone anywhere via pelvic health coaching. You can follow and DM me on Instagram @maryhagertydpt or email me at maryhagertydpt@gmail.com to set up a free consult call. Then we can talk more about where you’re at, where you want to be, and how to get you there!  

As we wrap up, there are a couple of things I hope every Hopeful Mama takes away from this article:

  • “Just do kegels” is not the end all be all for pelvic health concerns. And to be honest, for a lot of us, we actually need to learn to relax those muscles first!
  • Let’s keep talking openly and support each other in our pelvic health journeys. Just because pelvic floor symptoms are common does not mean they are normal, or that they will exist forever. We just need to know there are solutions, like working with a pelvic health physical therapist, to help us feel our best again!

My ultimate hope is that more women are empowered when it comes to their pelvic health. That they know that there are solutions to the symptoms they may be experiencing and that they get the support and guidance they need to feel like their best self — for all of life’s adventures. 


Want an intro on how to connect with your pelvic floor? Here are a couple of simple exercises I start most of my clients out with to help them learn how to both let go and connect with their pelvic floor. Developing some awareness is a great place to start! 

Connect with the pelvic floor via these videos: Introduction | Relaxation Breathing + Core Breathing

Written by Dr. Mary Hagerty DPT for the Hopeful Mama Foundation. We are incredibly grateful to all of our writers. If you would like to connect with one of our writers, please submit an email on our website’s contact page.

The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of the Hopeful Mama Foundation. Any content provided by our authors are of their opinion and are not intended to malign any religion, ethnic group, club, organization, company, or individual.

Learn more about Dr. Mary Hagerty DPT:
Inspire Movement LLC, was founded to support and empower women, like yourself, when it comes to your pelvic health and fitness journey. This includes supporting you prior to conception, during pregnancy, as you prepare for birth, postpartum, and beyond to keep you feeling strong, capable and confident for all of life’s adventures. I live in the Eastern Iowa Corridor with my husband and sweet sheepadoodle, Phoebe. When I’m not working with clients, you can find me lifting in my garage gym, in ballet class, trying a new restaurant or sipping coffee on a patio with friends. I love connecting with new people so please give me a follow @maryhagertdpt on Instagram so we can meet!