Overactive vs Underactive Pelvic Floor Muscles – What You Can Do

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Pelvic Floor Health is one of the most neglected aspects of women’s wellness. In fact, one study showed that there is, indeed, a lack of knowledge about pelvic floor dysfunction. This primarily impacts groups who’ve completed less education and those who have never sought medical help for such conditions.

It’s alarming that nearly 24% of women (in the US alone) are suffering from pelvic disorders, yet these conditions are treated as nothing but a sign of aging or a common occurrence. 

To continue shedding light on these health issues, let’s talk about overactive and underactive pelvic floor disorders. Plus, we’ll advise on what you can do about it. 

What Exactly are Overactive & Underactive
Pelvic Floor Muscles?

safe and effective alternative treatments for overactive and underactive pelvic floor muscles

Under ideal conditions, our pelvic floor muscles (PFMs) should be able to support our pelvic internal organs, bladder, bowel, and sexual activities. However, a number of factors can cause these vital muscles to weaken, resulting in pelvic floor dysfunctions —  overactive and underactive PFMs are two of them. 

A healthy pelvic floor is reflexive – it requires equal amounts of contraction and relaxation, just like any other muscle. When one or both of these elements are lacking, complications arise.

To set things straight, neither overactive nor underactive PFMs are better or worse than the other. That is to say that both PFMs need addressing, and each of them has distinct symptoms and specific interventions.

Let’s dive deeper into each one. 

Underactive Pelvic Floor Muscles

The problem with Underactive PFMs is that they can’t hold or fully contract when they have to. In other words, these muscles are loose and weak, which makes them incapable of performing proper urinary, bladder, and sexual functions.

These are mostly observed in women who have just given birth or are nearing menopause. Thankfully, it’s not hard to tell if you have an underactive pelvic floor, giving you time to address it and heal these muscles. 

How to Know if You Have an Under Active Pelvic Floor

Here are the most common symptoms of underactive PFMs:

  • Urinary and fecal incontinence
  • Frequent or urgent urination
  • Pelvic organ prolapse 
  • Painful sex (whether initial or deep penetration) 
  • Pelvic Girdle Pain (PGP)
  • Vaginal wideness

While these symptoms are common, it doesn’t mean they’re “normal”, even if you hear your doctor say this. 

frequent urination and pelvic girdle pain are common symptoms of overactive and underactive pelvic floor muscles

When women discover they have an underactive pelvic floor, or another disorder affecting their pelvic floor, they may feel shame, embarrassment, or helplessness. But there’s no need to feel this way.

All of us women at one point in our lives will experience some type of imbalance. But, there’s nothing in life that we can’t handle. And with the guidance from WomenCycles teachers, you’ll feel supported and held throughout your healing journey.

I think I might have Underactive PFMs,
what should I do about it?

If you suspect that you have an underactive pelvic floor, it’s best to work with someone in person or online who specializes in treating pelvic floor disorders.

You’ve probably heard of Kegels before. While it’s good to note that Kegels can be effective in strengthening a weak pelvic floor, it is crucial to know that Kegels are not always the answer, especially in treating incontinence and prolapse.  

In fact, doing this exercise can make your condition worse, depending on your symptoms, and if practiced incorrectly and inappropriately. 

We’ve been there before and have found safer and better alternatives to Kegels that you may want to explore.

Here are some of them:

Overactive Pelvic Floor Muscles &
How It Happens

Opposite to underactive PFMs, muscles of an overactive pelvic floor (also called Hypertonic or high-tone PFMs) constantly contract leading to pain, spasm, and increased tension in the pelvic floor area. 

In simple terms, these muscles have been (unnecessarily) working hard without rest. Over time, they become too exhausted and weak to function properly. When the muscles become overactive they’re too stiff and tight. However, this doesn’t imply that they’re strong. 

This condition is caused and worsened by various factors including:

  • Trauma or injuries during pregnancy and labor 
  • Frequent holding of urine and bowels
  • Existing infection or inflammation 
  • Chronic stress, anxiety, or fear
  • Rigorous exercises
  • Excessive Kegels
  • Unhealthy lifestyle 
  • Obesity
  • Pelvic-related surgery 
  • Sexual assault or abuse 
  • Other abdominal or pelvic issues 

an unhealthy lifestyle can greatly affect your pelvic floor and overall health negatively

How to Know if You Have an Overactive Pelvic Floor

Physical therapists, gynecologists, and gastroenterologists are the proper authorities to diagnose pelvic floor dysfunctions. 

They can assess your condition by asking about your medical history and conducting physical examinations to see how well you can control your pelvic floor muscles.

While it’s best to consult a doctor before making any conclusions, simply listening to your body will reveal that something isn’t quite right. 

Here are the most common indications that you have an overactive pelvic floor: 

  • Incontinence
  • Painful urination or defecation
  • Delayed start and slow urine flow
  • Inability or difficulty emptying the bladder and bowels 
  • Frequent urination
  • Constipation
  • Painful sex (whether initial or deep penetration)
  • Inability or difficulty to achieve orgasm
  • Chronic pelvic or lower back pain even when sitting still
  • Pelvic tilt
  • Instability in the hip area 
instability in the hip area is a common indication of having overactive pelvic floor muscles

I think I might have Overactive PFMs, what can I do about it?

In an overactive pelvic floor, there are two main issues— the inability to relax and muscle weakness. To address these issues, it’s critical to first relax the pelvic floor before strengthening it. 

Since pelvic floor dysfunction is a muscle problem, no surgery can effectively treat it. However, those with pelvic floor dysfunction often have other conditions present, so it’s best to talk to your doctor to rule in or rule out any other disorders.

For the non-surgical route, here are some options you can incorporate into your daily routine to relieve and in time, heal your condition:

As you can see, healing your pelvic floor muscles isn’t limited to physical exercises alone. In conclusion, the best way to heal is by practicing an overall holistic approach.

Watch this video where I answer your questions about hypopressives

Heal from Overactive or Underactive
Pelvic Floor Muscles with Women Cycles

Your healing journey will be different from others.

Perhaps, you’ll find some things work for others, but not for you.

This doesn’t mean healing isn’t possible. It just means, you may want to consider a holistic approach to getting the best results

And not only with lifestyle changes or exercises, but with a community that shares the same sentiments as you.

A community that has your back no matter what.

join us here in women cycles, we are a community that will help and guide you heal naturally

Join us at Women Cycles

where we’ve created a safe and welcoming environment so women like you can heal naturally, too.

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