what the fuck is up with the pelvic floor

Written by: Tamar Simone Weir

I've been thinking a lot about the pelvic floor and the pelvis as it has been something that has all of a sudden come into my life and into my awareness in very blunt ways. The pelvic floor is an incredibly important part of the body to understand and to have a relationship with. I'm just now starting my relationship with my pelvic floor and figuring out what the fuck is going on in there! Years ago, during my sisters pregnancy and postpartum I had heard about the pelvic floor in terms of different conditions that arise after giving vaginal birth. I had witnessed and been part of my sisters birthing journey, in her room as her son was born, and with her during the many months of recuperation and integration into this new life. At the moment, I did not have much context for what this meant on a larger scale, this was 5 years ago, before my sexual education and somatic journey, although my sister had emphasized the importance of getting intimate with this space of the body.

Where am I going with this? We fast forward a few years and arrive at the fall of 2025. I had some really hard life events that occured last year, but nonetheless took a month long trip in September that fed my soul in more ways than one. This trip was a multi state, multi country extravaganza, where I felt myself be tender and open up. Essentially right after coming home from this trip, I had what seemed to be a UTI, the familiar extreme burning while peeing pain was ever present, and it made sense. I was out of my routine in so many ways, so this was not surprising. I had my regular protocol of herbs and medicines that normally helped to clear it right up, but this time it did not clear. I had this pain for weeks, slowly going away and right when I thought it was almost cleared, a slight lingering pain remained..... I went back to my doctor and all my tests were coming back negative for a UTI. My doctor instructed me to take antibiotics anyways, and after a week treatment, my pain remained. It did not create any significant changes. Now at this point I contacted my naturopathic doctor, one who has helped me with so many of my health questions and concerns. We worked together to assess my pain from various levels, the hormonal, the emotional, and the physical through diet etc. It was and IS a long journey of discovery, and something that has been at the core of my pain, is the deep sadness and frustration of not knowing the why to this pain. Chronic pain is often categorized when you experience persistent or reccuring pain for more than 6 months. It's been a little over 7 months now, and I am still struggling to figure out what my pain means, where this is taking me, and what my body needs that I am unfamiliar with. I've officially entered into the chronic pelvic pain category, and I hold sadness that I am here, and compassion for what this is teaching me as I move through this with care, love, and patience.

Pain is a unique experience in that it leaves us feeling lonely although most people in their lifetime will deal with chronic pain or be actively in community with folks who have chronic pain, and are disabled. The comprehensive study of pain mechanics and management is called, 'Dorology'. Through my pain journey, I listened to an amazing podcast where pain psychologist Dr. Rachel Zoffness enthusiastically explains the brain, pain and how to retrain it in a holistic grounded approach that validates peoples pain experiences.

Me, painted by an anonymous artist in a figure painting class

Fast forward 6 months, and I am still on my pelvic pain journey. What does this mean for me? This means that as of now everytime I go pee there is STILL a slight burning sensation present, and that up to this point, the remedies that have normally brought me relief are no longer "Working". I am coming again and again back to the question of what it means to relate to a body that is in some level of deep pain, while trusting and knowing that this is not permanent, and in order for me to heal I need to be in direct relationship with this pain.

Now in order to understand the body, there are many components to get familiar with. The ways the body is so smart, is something that I will never find unfascinating.... For instance, in the plant world there are plants that directly relate and help one another, create balance, and harmony when they are together. In the body there are are also directly links to different muscles, fascia, and bone structures. If one is off, then it correlates directly to another part in the body. In terms of the pelvis, there are studies that have found the connection with the jaw. This connection runs down the front side of the body, in addition to the posterior femur. Really interesting studies have begun to analyze different manual therapies that have connected pain from the jaw to the pelvis. One study conducted in 2024, examined impacts of a single session of temporomandibular joint soft tissue therapy on the pelvic floor muscles. The most notable finding of this study is the enhanced ability of the pelvic floor muscles in relaxation afterwards. The vast implications of this study is that there are plenty of therapies and modalities that can be explored to reduce pain in the jaw and in the pelvis.

WE ALL NEED TO KNOW ABOUT THE PELVIC FLOOR

I really appreciate the conversations that analyze the body in a way that invites people in rather than creates binaries with gender. The pelvic floor is typically and in a majority of spaces is discussed as a women's health issue and information, instead of a part of the body that is relevant, significant, and impactful for ALL. No matter what type of genital configuration you may have, or however you identify with your body parts and your gender expression, everyone with a pelvis has a pelvic floor. As I was doing research on the pelvic floor, I came across an article, where Stephanie A. Prendergast, DPT, MPT, Cofounder, PHRC Los Angeles discusses how awareness and education around the pelvic floor should be taught to everyone not just young girls. She goes to analyze another article in the BBC that stated the importance of teaching young girls about the pelvic floor function in education today. While Stephanie was thrilled that more people were supporting more education around this increasingly important topic, she goes on to discuss how this should be included in sex ed for all young teens, not just girls. People with pelvic floors are susceptible to different conditions, dysfunctions, and moments of pain that without the proper education, can be harmful, isolating, and negatively impact the way people relate to their bodies. "While it is exciting to see pelvic floor education in the news, the exclusion of all people with pelvic floor muscles and the general instruction that all teenage girls should strengthen their pelvic floor muscles is disappointing and frankly potentially harmful."

Pelvic Floor Posted from: Raise the Pelvic Floor

THE DETAILS

The pelvic floor has lots of functions and potential capabilities. Recently, as I've begun to dive into pelvic floor therapy and undergo another process of figuring out really what needs to shift in my body to reduce pain and ultimately eradicate the pain for good, I am nerding out on all things pelvic floor health and care. The pelvic floor is a group of muscles that starts in the pubic bone in the front side, and connects to the tailbone along the back body. "The pelvic floor is the group of muscles, nerves, and connective tissues that create a hammock at the base of the pelvis, playing a vital role in various bodily functions. The muscles are always active performing essential functions we take advantage of as we move throughout our day. The pelvic floor works with the body as a part of the system, rarely acting alone."

What can the pelvic floor do?

-can contract

-can squeeze

-can lift

-can relax

A healthy functioning pelvic floor should be able to go from fully relaxed to contracting the muscles to hold in urine for example. But often many people struggle in with at least one of the functioning ranges of motions listen above.

I know now that I struggle with the relaxing fully aspect of motion, and can squeeze and lift very easily, but fully relaxing takes a lot of intention and thought, and often my body is subconsciously clenching while doing tasks around the house or while I am out at work.

Watercolor painted by: Rosie Ferne

The more I read about the pelvic floor the more I am in awe and utter amazement at how much the pelvic floor is holding. It stabilizes our our back, hips, and pelvic bones. It is at the core of our bodies! The pelvic floor is a central part of many of our day to day essential moments, bowel and bladder emptying, sexual arousal, orgasm, and moving fluids from our body. And many of us have suffered from certain types of pain that can be linked to the pelvis. Feeling pain in our pelvis is not normal, in the sense that nobody should have to experience pain in their genitals and rectum. A generalized term that has been used to describe a wide variety of conditions is, "Pelvic Floor Dysfunction". Bloom Pelvic Therapy Group, describe this phenomenon as something very prevalent, "Pelvic floor dysfunction in some form is really common, so much so that about 50% of us will deal with pelvic floor dysfunction at some point in our lives. The onset can be after a fall on the tailbone, during pregnancy or birth, times of increased stress and tension, changes in hormones, changes in routine or activity levels, or following abdominal or pelvic surgeries."

On their site they have a whole list of different issues you may have that can be helped with pelvic floor therapies. Some of them being, Urinary Incontinence, Strong & Urgent Bowel or Bladder Urge, Pelvic Heaviness or Pelvic Organ Prolapse, Pelvic or Genital Pain, Pain with Sex, Constipation, Urinating Too Frequently.

Other folks who are doing amazing work utilizing their own experiences with pain and turning that into a catalyst for healing other bodies are, The Vagina Whisperer, and Jemila Medley with the Lim Method. Another great book by one of the teachers and founders of my somatic sex educators program is Pelvic Pain Clinic.

Hydrangeas

WHAT NOW?

I think everyone, everyone should learn about their pelvic health. As I delve into this deeper, I will provide more resources, and updates about my experiences as more information comes... Pelvic Pain is really intimate and intense, and like all pain, what does this pain want to tell us? How can we talk to our pelvis and talk to the pain? My mom always says, what does your body want to tell you, and are you listening? "Prolonged pain is already an emotional burden, she says, compounded by the intimacy of the physical location of the pelvic floor and the functions it controls."

All in all, SAY IT WITH ME, UNCLENCH....

As I wrote this, I had to remind myself to unclench only 100 times....