Can pelvic floor therapy help balance your hormones? You might be surprised that the answer is YES! We’re going to dive into a Q&A with Dr. Angie Mueller to learn more about this. Dr. Angie holds a doctorate in physical therapy, specializing in pelvic health, spine, and core rehabilitation. Trust me, she's absolutely amazing!

I previously introduced you to Dr. Angie in this two part series on pelvic floor health:

Addressing Pelvic Floor Dysfunction: Do You Need a Pelvic Floor Therapist?

Is the Position of Your Uterus Affecting Your Period?

So definitely check those posts out as well if you are interested in learning more about pelvic floor health.

To give you a little background, I started working with Dr. Angie a while ago, before my second pregnancy. At the time, I had some issues going on that I didn't even realize were related to my pelvic floor. Here's the thing: I had started running (yes, me, running!), and about halfway into my run, I felt this odd pressure, like I needed to pee. But I didn't actually need to go. It was confusing and frustrating, so I reached out to Dr. Angie for guidance.

I learned more about my pelvic floor in just 20 minutes than I had in my entire life. And the best part? I noticed a remarkable difference! After only four appointments, my pelvic floor issues were gone. But that's not all — my posture improved, my digestion was better, and get this: I hadn't done a single ab workout, yet my abs were popping! It was mind-blowing, especially after having a baby. Needless to say, I continued working with Dr. Angie when I found out I was pregnant again because I wanted to have a much better pelvic floor experience this time around.

So, let’s dive into how pelvic floor therapy can truly empower you on your journey to hormonal balance!

What exactly is the pelvic floor?

We’ll start with the basics — what is the pelvic floor? Most of us think of pelvic floor therapy as a solution for pain during sex or postpartum leakage, right? But there's so much more to it.

Dr. Angie explained that the pelvic floor is a layer of muscles located at the bottom of our pelvic bowl, which is shaped like a gentle, supportive bowl cradling our internal organs. These muscles have a multitude of vital functions that often go unnoticed. Firstly, they're responsible for sphincter control, contracting and relaxing around the urethra and rectum to prevent leakage and allow efficient elimination. They also send signals of urgency to our brain through mechanical receptors, informing us when our bowel or bladder needs attention.

On top of that, the pelvic floor provides crucial support for our internal organs, including the uterus, bowel, and bladder, while also supporting the hips, spine, and abdomen. And get this, it even plays a role in circulation, immunity, and respiratory function! It's truly mind-blowing how interconnected and influential the pelvic floor is in our overall well-being.

When our pelvic floor goes awry.

When these mighty muscles are not functioning optimally, they can manifest in various ways that we might not immediately associate with a muscle issue. Sure, leaking and pain during intercourse are commonly known symptoms, but there's a whole array of other indicators that we need to be aware of.

Dr. Angie enlightened me on some of these lesser-known signs of pelvic floor dysfunction:

Difficulty emptying the bladder or bowel, often accompanied by the need to strain or push, can indicate an imbalance.
Constipation, which we often attribute solely to our diet, can be influenced by pelvic floor muscle tension.
Urinary urgency and frequency can arise, giving us intense and frequent urges to pee, even when our bladder isn't full.
Bloating, pelvic pressure, and heaviness can all be signs of pelvic floor dysfunction.
Hip pain, low back pain, and abdominal pain are indicators too.
Frequent urinary tract infections - that’s a surprising one! But yes, if our pelvic floor muscles aren't effectively pumping blood and lymph to keep our pelvic organs healthy, we can actually become more susceptible to infections.
Sexual dysfunction can also be tied to pelvic floor dysfunction. Pain during intercourse or difficulty reaching orgasm may stem from imbalances within these vital muscles.

It's astounding to realize the intricate role our pelvic floor plays in our overall well-being, from physical comfort to sexual function. So, ladies, the next time you experience any of these symptoms, remember that they could be connected to your pelvic floor health. It's not just about leaking or discomfort during intimacy; it goes far beyond that. Understanding the far-reaching impact of our pelvic floor empowers us to take proactive steps in caring for our bodies. And that's exactly what pelvic floor therapy aims to do — restore balance, alleviate symptoms, and help us achieve vibrant health.

Can’t I just do some Kegels?

Pelvic floor dysfunction is a tricky issue, and let me tell you, Kegels are not the be-all and end-all solution they're made out to be. We need to understand the unique nature of our pelvic floor muscles to see why Kegels may fall short.

Here's the scoop: Our pelvic floor muscles are different from the ones in our arms or legs. While we can consciously control those muscles, like our biceps or triceps, the pelvic floor muscles are mostly involuntary. Can you believe it? We only have control over 20% of them! So when you're doing Kegels, you're only reaching a fraction of the whole muscle.

And that's why Kegels alone won't fix all the problems associated with pelvic floor dysfunction. They won't magically stop urinary incontinence, pain, UTIs, urgency, constipation, or other issues. They're not the superheroes they're made out to be. Plus, relying solely on Kegels won't save you from hip pain, back pain, or SI joint dysfunction because you're missing out on the other 80% of your pelvic floor muscles.

If you want to learn more, Dr. Angie has a fantastic post sharing more about why Kegels are not the answer to pelvic floor dysfunction.

To really get those muscles in shape, we need to activate the involuntary contractions through other methods. One approach is down-training, which helps release the tension in those tight pelvic floor muscles. Techniques like diaphragmatic breathing work wonders to reduce muscle tightness and promote relaxation.

And let's not forget the amazing work of pelvic floor physical therapists. They use special techniques like internal and external massage, myofascial release, and stretching exercises to ease the tension and tightness in your pelvic floor muscles. By getting those muscles mobile and relaxed, you'll be on your way to a happier pelvic floor.

Of course, exercise is still important. Retraining your pelvic floor muscles with customized exercises can do wonders. These exercises help with coordination and strength, tailored to your specific needs. By combining these different approaches, you'll be well on your way to rehabilitating your pelvic floor and finding relief from those pesky symptoms.

Keep in mind, though, that it's not just about weak muscles. In fact, 99% of people with pelvic floor muscle dysfunction have muscles that are too tight and tense. Imagine your pelvic floor as an elevator. It should rest on the ground floor, move up when needed, and come back down afterward. But when those muscles are in a spasm, it's like the elevator's stuck halfway between floors. This limited movement weakens the muscles and leads to issues like urgency, pain, and infections.

How your pelvic floor impacts your hormones.

Okay, we’re finally gonna dive into the main question I know you’re wondering about — how does the pelvic floor actually impact your hormones? Dr. Angie is a plethora of knowledge on this front. She explains that when it comes to your hormones, the placement of your uterus and the state of your pelvic floor play a significant role. It's fascinating how these factors intertwine. When I was filling out my intake forms with Dr. Angie it asked about my period blood color and last menstrual cycle. I mean, who else asks about that stuff? It’s so important but no one is paying attention to it!

And Dr. Angie explained why — your pelvic floor muscles have a crucial job in promoting circulation and lymphatic flow to all your pelvic organs. If your pelvic floor is in good shape — balanced tone, full range of motion, and not too tense — it allows your organs to sit pretty, improving hormonal regulation. And guess what? The position of your uterus is a big deal in all of this! Surprisingly, this isn't something they teach you in PT school, and most Western doctors don't see it as a concern. When you visit your gynecologist for your regular check-up, they may mention if your uterus is tilted forward (antiverted), backward (retroverted), or leaning to one side, but they won't consider it problematic.

However, when your uterus isn't in its optimal position within your pelvis, it doesn't receive sufficient blood flow, lymph flow, and nerve flow. This, in turn, affects its functions, leading to menstrual issues like irregular cycles, painful periods, and changes in your blood flow.

Let's say your uterus is tipped forward and leaning to the left. As a muscle, the uterus undergoes changes throughout your menstrual cycle. But if it's not in its optimal position, the uterine lining won't build symmetrically around it, hampering blood flow to different parts. This can result in clotting, brown discharge (old blood), and inefficient contractions during menstruation. And you know what that means? Painful periods and frustration! And that's not all—fertility can also be affected when your uterus doesn't receive adequate blood flow, because the impaired blood flow is disrupting hormonal regulation.

Now, here's the interesting part: There's definitely something you can do about an out-of-place uterus. By centering the uterus through various methods, you can bring back adequate blood flow to improve its conditions. While it may not transform a heart-shaped uterus into a typical shape, it can positively impact the associated symptoms and conditions.

Learn more about centering the uterus from Dr. Angie.

If you ask me, pelvic floor therapists need to be included in prenatal care. Seriously, it's a missed opportunity. We go to our OBGYNs, they check the heartbeat, ask about symptoms, and dismiss many of our discomforts as normal pregnancy woes. It leaves us thinking we have to suffer through it all. But a better prenatal and postpartum journey is possible with the help of pelvic floor therapists. It's frustrating that their expertise isn't routinely integrated into care!

Western medicine has fallen into a pattern of treating only when symptoms arise, and even worse, normalizing dysfunctional symptoms. But here's a reality check: peeing your pants after having a baby or during pregnancy is not normal — it's a red flag for pelvic floor dysfunction. The good news is that postural and breathing exercises can work wonders in addressing pelvic floor issues. Now, don’t get me wrong, Western medicine has its place, but there is this whole other aspect of health care that is often overlooked.

Pelvic floor therapy and endometriosis.

Dr. Angie explained that endometriosis is an auto-immune condition where the immune system affects hormones and causes scar tissue and adhesions in the pelvis and abdomen. Pelvic floor therapy techniques like self-massage and breathing exercises can sometimes help release these adhesions and promote better blood flow and organ function. It's important to improve blood flow to the pelvis, uterus, and pelvic muscles because a lack of oxygen can lead to chronic inflammation and more adhesions. Additionally, people with endometriosis often have gut issues and by improving muscle function, we can address these problems too!

Oftentimes, people with endometriosis are only offered surgery or medication, which may not fully resolve their symptoms. Dr. Angie often works with people with endo and shared a helpful resource that anyone with endometriosis should check out — healendo.com — created by Katie Edmonds, who had endometriosis but managed to heal herself and have two beautiful babies! Katie became a certified nutritionist and health coach, and her website has lots of helpful information and blogs to support women with endometriosis.

It can be so frustrating when surgery and medication are presented as the only options. There are alternatives and resources available! Katie joined me on the podcast to share her story, so that’s a fantastic place to start and learn more about managing and improving endometriosis symptoms.

Pelvic floor therapy can work wonders.

We’ve talked a lot today about how beneficial pelvic floor therapy can be but I need you all to know that even within this hidden gem of a healthcare field, Dr. Angie stands out.

Her method — The Core Recovery Method® — differs from traditional pelvic floor therapy in several key ways. Instead of focusing solely on the pelvic floor muscles, her approach utilizes posture and breathing techniques to trigger involuntary activation of the pelvic floor, abdominal, spinal, and diaphragm muscles. This holistic approach promotes coordination and synchronization among all core muscles, ensuring optimal support for organs, spinal decompression, and pelvic organ health. Unlike standard pelvic floor therapy, which often involves internal examinations and biofeedback machines, Dr. Angie's method takes a comprehensive approach, incorporating exercises in various positions to engage the entire body.

A unique aspect of Dr. Angie's method is its emphasis on centering the pelvic organs. Through self-abdominal massage, blood flow to the gut is improved, aiding digestion and organ alignment. Breathing and postural techniques actively promote organ centering. Dr. Angie's virtual sessions offer convenience and accessibility, allowing individuals to participate from home. By incorporating posture, breathing techniques, and engaging the entire body, her method aims to provide superior outcomes for pelvic floor health and overall well-being.

Can breathing really make that big of a difference?

It's easy to underestimate the power of breathing exercises in managing conditions like endometriosis or pelvic pain. But as we learned from Dr. Angie earlier in this post, we’re targeting the 80% of our core muscles that are involuntary. After my second or third session, I remember thinking that all of my insides hurt. It was a testament to the effectiveness of these exercises, reaching muscles that aren't easily touched but play a crucial role in our overall health.

Dr. Angie explains that these breathing exercises strengthen and align the internal fascia, the white connective tissue supporting our organs. By engaging in hypopressive breathing, we actively lift and center our organs, promoting better alignment and function.

So, if you're skeptical about the simplicity of breathing exercises, I encourage you to give them a try. They may appear deceptively easy on the surface, but once you feel their impact and witness the positive changes within your body, you'll understand their true power. Trust the process and explore the possibilities of managing conditions like endometriosis through holistic approaches. Remember, every step towards healing matters, no matter how simple it may seem at first.

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