Have you ever noticed that your pelvic pain, bladder urgency, or discomfort with intimacy seems worse at certain times of the month? You’re not imagining it. Hormones, stress, and nervous system changes can all influence how your pelvic floor feels and functions, especially for people with menstrual cycles.

Understanding these patterns can help you feel more in control of your body and get more out of pelvic floor physical therapy.

How Hormones Affect the Pelvic Floor

Estrogen and progesterone play a role in tissue elasticity, circulation, and muscle tone. As these hormone levels rise and fall throughout the month, the pelvic floor may respond in different ways.

Some people notice increased tightness, sensitivity, or pain when estrogen is lower. Others experience more bladder urgency or bowel changes during certain phases of their cycle. These shifts are common, but they should not completely disrupt your quality of life.

The Role of the Nervous System

Your pelvic floor is closely connected to your nervous system. During times of stress, poor sleep, or hormonal changes, your body may default into a more protective state. This can cause pelvic muscles to tighten or become less coordinated, leading to pain, pressure, or difficulty fully relaxing.

This is why symptoms often fluctuate rather than stay constant.

Common Symptoms That May Change Month to Month

Pelvic floor symptoms that may vary throughout the cycle include:

Pelvic or vaginal pain
Pain with sex
Urinary urgency or frequency
Constipation or straining
Hip, low back, or tailbone discomfort

Tracking these changes can help identify patterns and guide treatment.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy focuses on helping your body adapt and respond more efficiently to internal changes. Treatment may include:

Manual therapy to address muscle tension and sensitivity
Breathing and relaxation strategies to regulate the nervous system
Movement and strength work that supports hormonal fluctuations
Education on pacing, recovery, and symptom management

Rather than forcing your body into one approach, pelvic PT meets you where you are each phase of the month.

When to Seek Support

If pelvic symptoms are interfering with your work, exercise, relationships, or overall comfort, support can help. Even if symptoms come and go, they are worth addressing. Pelvic floor PT can help reduce flare ups and give you tools to feel more stable and confident over time, despite the normal monthly rhythms.

Let’s Work Together

At Rhode Island Pelvic Wellness, we take a whole body approach to pelvic health that considers hormones, stress, and lifestyle factors. Care is always one on one and tailored to your unique experience.

Want to learn more about who we are and how we work? Visit our About Us page to learn more about our philosophy and team.

Have questions about pelvic floor therapy or whether it is right for you? Our FAQ page provides clear answers and next steps.

Ready to feel more in control of your pelvic health? Explore our services to see how pelvic floor physical therapy can support you.

Why Your Pelvic Floor Symptoms Fluctuate Throughout the Month