The pelvic floor, a group of 26 different muscles, supports the pelvic organs like the bladder, uterus, and bowels. The pelvic floor also maintains continence, the ability to control bladder and bowel movements, and plays a major role in sexual function. Sometimes, the pelvic floor muscles can become weakened, tight, or stretched out. As a result, pelvic floor disorders (PFDs) can develop, causing issues like urinary incontinence (leaking urine), chronic pelvic pain, pelvic organ prolapse (when organs sag or bulge out of place), dyspareunia (pain during intercourse), or difficulty having an orgasm.
Around 25-50% of women will develop a PFD sometime during their life. Living with a PFD can be very hard emotionally, and it can feel embarrassing to discuss private symptoms with others — including healthcare providers — to get the care you need. Understanding the ways PFDs can affect your mental health, relationships, and quality of life can be a helpful step toward getting the support you deserve.
Mental health impacts of PFDs
Studies have shown that PFDs can increase things like depression or anxiety. It can feel embarrassing or shameful to struggle with these conditions. You may experience pain, or worry about urine or bowel leakage, which could cause you to avoid public places, social events, or travel. This can be a blow to your independence or lifestyle, causing feelings of isolation or shame. Sexual symptoms like pain during intercourse (dyspareunia), reduced sexual sensation, trouble having orgasms, or fear of incontinence during sex may cause you to avoid intimacy altogether. These symptoms can all lower self-esteem, impact relationships, and decrease overall quality of life.
It’s important to remember that you’re not alone, and you don’t have to suffer or live in discomfort. Unfortunately, many women wait to seek help due to stigma and lack of awareness surrounding PFDs. It can be hard to reach out for help when it feels like no one understands what you’re going through, but this can extend the length of time you live with a PFD without care and prevent partners and loved ones from understanding what’s happening. Open and honest communication with healthcare providers and your support system is the best way to get the care you need, and treatment has been shown to improve mental health and overall wellbeing. If you notice something unusual, say something! Early intervention is one of the best ways to improve outcomes.
Treatment and seeking help
There are many therapies for PFDs. Pelvic floor physical therapy and biofeedback can significantly improve symptoms. These treatments help to retrain the pelvic floor muscles and can give you more control over processes like urination, and improve sexual function. Pelvic floor physical therapists can help figure out which specific muscles need to be retrained and the best ways to do that. Lifestyle changes such as supplemental fiber or cutting out certain foods or drinks can also make a huge impact. And, as symptoms improve, many women report enhanced confidence, better sexual function, and improved relationship satisfaction. If you’re peri- or post-menopausal, hormone therapies can sometimes also help with some pelvic floor challenges. You may also choose to see a board-certified urogynecologist, an expert in pelvic floor health, to find a treatment plan that works for you and your symptoms.
Mental health therapy, relationship counseling, or sex therapy, in addition to PFD treatment, can also be beneficial for self-esteem and navigating relationships. Sometimes, talking it out can be a weight off your shoulders. These kinds of therapies can help you to rebuild your self-esteem, reconnect with your partner, and develop coping skills that can help you to battle the emotional effects of PFDs.
Speaking honestly with the people around you is the best way to reduce stigma around PFDs and, ultimately, get the support you deserve. It can feel isolating to live with a PFD, but you’re far from alone. It’s okay to talk to the people around you and build up a support system you can count on. It may also help to find communities in your area or online of women who have also been diagnosed with a PFD.
Advocating for yourself is not always easy, but getting care that considers both the physical and emotional aspects of a PFD can help you live life to its fullest. It often helps to reach out to your primary care provider (PCP) or a women’s health provider like an Ob/Gyn first, and they can help connect you with physical therapists, urogynecologists, therapists or counselors who might be right for you. Reach out to your support system and ask for help when you need it.
Reviewed by the Ovia Health Clinical Team
Sources
- “The Psychological Component of Chronic Pelvic Pain.” Cleveland Clinic, Cleveland Clinic, 9 Sept. 2025, consultqd.clevelandclinic.org/the-psychological-component-of-chronic-pelvic-pain.
- Peinado-Molina, Rocio Adriana, et al. “Prevalence of Depression and Anxiety in Women with Pelvic Floor Dysfunctions: A Systematic Review and Meta-Analysis.” Wiley, Feb. 2024, obgyn.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ijgo.15719.
- “Symptoms & Causes of Bladder Control Problems (Urinary Incontinence) – Niddk.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, July 2021, www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/symptoms-causes.
- Snyder, Amber. “Pelvic Floor PSA.” National Institutes of Health, U.S. Department of Health and Human Services, 25 Apr. 2024, nihrecord.nih.gov/2024/04/26/pelvic-floor-psa.
