Modern womanhood involves an astonishing amount of clenching. We’re clenching through stressful meetings. Through traffic. Our jaws while we sleep. Our core. Clenching every muscle in our body while replying “no worries!” to an email that, in fact, is causing quite a lot of worries. But there is one place you probably haven't unclenched.
In a classic “of course there is” fashion, there’s a name for it - part of a growing, long-overlooked conversation around pelvic health and how we hold stress in the body. Enter “stress holding” - what pelvic health experts are calling the way chronic stress shows up as unconscious, sustained muscle tension.
For all our fluency in stress symptoms above the waist: the stiff neck, the familiar headache behind the eyes, a jaw set in permanent grit, the pelvic floor has largely been left out of the picture. And despite recent research suggesting pelvic floor dysfunction affects millions of women worldwide, with recent studies estimating symptoms affect around 40% of women, many of us still associate pelvic health entirely with pregnancy, childbirth or ageing.
The irony is that we’ve never had more information about our bodies. We know about cortisol spikes. We track our sleep. We buy supplements for our supplements. Yet mention pelvic floor and most of us are suddenly operating on GCSE Biology levels of knowledge.
Perhaps that’s why it's never occurred to me that stress might have something to do with it. Pelvic health was mentally filed away as “future me’s problem” - somewhere between pension planning and understanding how mortgages work, not something shaped by anxiety, exercise habits, or a nervous system permanently stuck on high alert.
Quick group-chat poll: when was the last time you thought about your pelvic floor? If the answer sits somewhere between “never” and “only after seeing this headline”, stick with me.
TLDR: The pelvic floor isn’t just a pregnancy concern - it reflects how we live today. Stress, constant “holding on,” and pelvic floor dysfunction are deeply connected, yet still under-recognised - particularly in younger women balancing desk work, pressure, and an always-on lifestyle.
If that resonates, consider yourself seen. Stress shows up in surprising ways, and at MC, we’re here to talk about it. Here are five signs to look out for.
Women are "stress holding" in their pelvic floors - your guide
First, What does it mean to be "stress holding" in your pelvic floor?
Have you ever been told that you’re “holding onto stress”? Well, it turns out your body may have taken that instruction rather literally.
“Stress holding” is the term pelvic health experts are using to describe the unconscious habit of carrying tension in the pelvic floor muscles in response to physical, emotional or psychological stress. According to Anna Wooley, pelvic health specialist at Core LDN, this can lead to what’s known as “hypertonic pelvic floor - where the muscles become overly tight and remain switched on for prolonged periods of time.
The reason it happens, she says, “comes down to the body’s stress response. When we’re stressed, the sympathetic nervous system - better known as fight-or-flight mode - kicks in, increasing muscle tension throughout the body as it prepares us to respond to a threat. While most of us notice this in our shoulders, jaw or neck, the pelvic floor is often recruited into the process, too.”
Which might be less of an issue in modern life if it wasn’t one long exercise in being mildly stressed. As Wooley explains, “Over time, that heightened muscle tension can become the body's default setting, meaning the pelvic floor remains tight even when the original stressor has long disappeared.”
The challenge here is that a hypertonic pelvic floor doesn't always make itself known in the way we’d expect. Instead, its effects can show up across multiple areas of health, contributing to everything from pelvic pain, bladder and bowel issues, painful sex, reduced sexual pleasure, constipation and persistent hip or lower back discomfort.
The body, it seems, is an excellent note-taker - only its reminders tend to surface in the least obvious corners. The real mystery is why so many of us know exactly what stress feels like in our shoulders, yet have never been taught what it might be doing lower down.
@drvivianzhang ♬ original sound - Dr. Zhang│Pelvic Floor PT
Why are so many women holding tension in their pelvic floor without realising it?
At the crux of it is a curious contradiction: women are expected to know an awful lot about their bodies, yet the pelvic floor remains one of the least understood parts of women's health. In fact, RCOG polling found that 69% of UK women have never spoken to an NHS healthcare professional about their pelvic floor at all. For a muscle group involved in everything from bladder function to sexual wellbeing, that's a remarkable silence.
According to women's health expert Dr Nighat Arif, that's a big part of the problem. "Awareness stays low because pelvic floor problems are still framed as birth damage or a niche rehab issue," she explains. "Even though women can experience symptoms well outside pregnancy and the postnatal period."
As a result, many women simply aren't looking for pelvic floor dysfunction in the first place. Symptoms such as urinary urgency, constipation, pelvic discomfort or painful sex are often dismissed as stress, a sensitive bladder, getting older, or simply the unavoidable side effects of a busy life.
There's also a wider cultural issue at play. In many communities, conversations around pelvic health remain limited or non-existent. As Dr Nighat points out, "some women have never been given the language to describe their pelvic floor at all, while others have grown up believing discomfort is simply part of being a woman and something to be endured rather than treated." For something so fundamental to some very important functions, it’s still one of women’s health’s best-kept non-secrets.
Which perhaps explains why so many women are carrying tension there without ever realising it.
@manumitevova Your pelvic floor doesn't lie. It's one of the first places your body stores tension, and one of the last places you think to check. Chronic stress, a busy day, even holding your breath at your desk. Over time, braced becomes normal. This sequence is 5 minutes only, and helps you release the deep clench you may not even know is happening in your own body. → Diaphragmatic breath - 1 min → Deep squat - 1 min → Bridge weight shifts - 1 min → Lifted happy baby - 1 min → Half frog - 1 min Save this for tonight. For more somatic practices → @join_kaya 🎁 Free 2-week trial in my bio
♬ original sound - Manu | somatic movement
The Missing Link Between Pelvic Health and Pleasure
Hands up if you know more about your libido than the muscles that help make pleasure possible in the first place? Chances are, most of us probably just sat still for a second then - and that small moment of awareness says a lot. According to psychosexual therapist and author of The Science of Sex, Kate Moyle, “stress holding” in the pelvic area can affect sexual wellbeing in multiple ways.
"When there is chronic pelvic floor tension, often driven or exacerbated by stress, it can affect sex in multiple ways. Physically, penetration may become painful, uncomfortable or difficult, which interrupts pleasure and can gradually dampen desire."
Moyle notes that this is often where stress and sexual function begin to overlap. When the pelvic floor is already in a heightened state of tension, the body can start to associate sex with guarding and anticipating discomfort, rather than relaxation and pleasure.
“What this means is that symptoms can feel harder to work with in the moment, and people may find themselves being more in their heads, distracted, and less able to stay present,” she says. “That can then affect how someone feels about themselves sexually, as well as their confidence in relationships.”
Stress holding also matters when it comes to orgasm. The pelvic floor plays a key role in the rhythmic contractions involved in climax - but, Moyle explains, it isn’t just about strength. “A strong pelvic floor is important, but it’s equally important to be able to relax, release and respond flexibly,” she adds.
In the field, this is something that’s increasingly reflected in pelvic health research, including a 2024 review in The Journal of Sexual Medicine linking pelvic floor muscle function with sexual response and dysfunction, with wider evidence also connecting pelvic floor overactivity with sexual pain.
5 Signs You May Be Stress Holding In Your Pelvic Floor
If you're now very aware of your pelvic floor (my job is done), let us dive into what "stress holding" looks like in practice. Anna Wolley breaks down five of the most common signs so you're equipped with the right tools to take back control.
1. You’re going to the loo more often than your usual
If you feel like you’re constantly planning your day around bathroom access, your pelvic floor could be involved. Wooley explains that an overactive pelvic floor can irritate bladder signalling pathways, creating that persistent sense of urgency when the bladder isn’t full. If it’s persistent, affecting daily life, or involves pain, leakage or recurrent UTIs, it’s worth getting assessed.
2. Sex or tampon use feels uncomfortable or painful
This one is the most commonly missed sign of pelvic floor tension.
Wooley explains that tight pelvic floor muscles can struggle to relax, which may create resistance, discomfort, or pain with penetration.
Important: this is not something to normalise or push through, and it definitely warrants assessment by a healthcare professional.
3. You struggle with constipation
The pelvic floor has a direct role in bowel function, and it needs to relax and lengthen for things to work properly.
When it’s too tight, this process becomes harder, often leading to straining or ongoing difficulty. Wooley warns that persistent straining can increase the risk of pelvic floor dysfunction and should not be ignored. “If things don’t improve with diet and lifestyle changes, don’t ignore it - get assessed.”
4. You’re dealing with persistent pelvic, hip or lower back discomfort
Because the pelvic floor works closely with surrounding muscles and joints, tension doesn’t always stay local.
Wooley explains that it can contribute to pain in the pelvis, hips, lower back, and, in some cases, even discomfort further down the body. If pain is lasting more than a few weeks, worsening or affecting movement, it should be assessed.
5. You feel like you can’t fully switch off - even when resting
This is one of the most overlooked signs.
Wooley notes that many women with pelvic floor tension also report jaw clenching, shallow breathing, abdominal gripping or a general sense of being “switched on”.
She also points out that the pelvic floor often reflects what’s happening elsewhere in the nervous system, so if the pattern feels familiar, your body may be signalling that stress is being physically held, not just mentally experienced.
@pelvicfloorliz ♬ original sound - Dr. Liz | Pelvic Floor PT 🩷
Final Thoughts
If there’s one quiet shift in all of this, it’s that the real story here isn’t that women are holding stress - it’s that we’re only just learning where to look for it.
Stress, as experts are now showing, doesn’t just disappear when the day ends. It shows up in the body in ways we’re only just beginning to name. And perhaps that’s the most useful part of “stress holding”: not that it tells us something is wrong, but that it finally helps us understand what’s been happening all along.
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