“Is This Normal?”: 7 Common Pelvic Symptoms I See (And What They Might Mean)

If you’ve ever asked yourself, “Is this normal… or just something I have to live with?” — you're not alone.

Many people silently put up with symptoms involving their bladder, bowel, pelvis, or intimacy because they don’t know what’s “normal,” or worse — they’ve been told it’s just part of aging or childbirth.

The truth? You don’t have to live with pelvic discomfort, dysfunction, or disconnection.
Here are 7 symptoms I commonly see as a pelvic floor therapist — and what they might be trying to tell you.

1. Leaking When You Sneeze, Cough, or Laugh

Common… but not normal.
This is called stress urinary incontinence, and it means your pelvic floor muscles may not be coordinating properly under pressure.
It often shows up postpartum, during exercise, or with chronic coughing — but you can retrain your system to stay dry and supported.

2. Feeling Like You Have to Pee All. The. Time.

Urgency, frequency, or waking multiple times at night to pee may be a sign of bladder urgency or overactive bladder — which often ties into nervous system overdrive, tension patterns, or bladder training habits.
You’re not doomed to memorize every public restroom. There are gentle strategies that work (and no, they don’t involve just “holding it longer”).

3. Pain With Sex or Insertion (Even Tampons or Pelvic Exams)

Pain during penetration is a red flag, not a rite of passage.
This could stem from pelvic floor muscle tension, scar tissue, hormonal changes, or even nervous system hypersensitivity.
With the right support — including education, breathwork, and body awareness — this can absolutely improve.

4. Heaviness or a “Falling Out” Sensation in the Pelvis

This may be a sign of pelvic organ prolapse — when the bladder, uterus, or rectum shift downward due to pressure or tissue laxity.
The good news? With the right movement strategies, breath mechanics, and support tools, many people improve their symptoms without surgery.

5. Constipation or Needing to Push to Poop

If you have to strain, push on your perineum, or feel like you never fully empty, it might be more than a gut issue — your pelvic floor muscles might not be coordinating well with your core and diaphragm.
Learning proper toileting posture and practicing relaxation-based techniques can make a huge difference.

6. Lower Back, Hip, or Tailbone Pain That Doesn’t Go Away

Surprise: these areas are often connected to the pelvic floor.
Tight or weak pelvic muscles can contribute to recurring sacroiliac pain, deep hip discomfort, or tailbone pain — especially with prolonged sitting or after falls.
Targeted movement and myofascial release can provide long-term relief.

7. “Disconnected” from Your Core or Pelvic Floor

Many people tell me they feel like they can’t “find” their pelvic floor, don’t trust their core, or just feel disconnected from that part of their body.
This might show up postpartum, post-surgery, trauma or after years of ignoring discomfort.
Rebuilding this connection gently — through breath, movement, and body awareness — is often the most empowering part of the healing journey.

Final Thoughts: If You’re Wondering If It’s Normal, It’s Worth Asking

Pain, leakage, heaviness, and disconnection are common, but they’re not inevitable.
Your body is incredibly adaptable — and with the right support, you can feel strong, connected, and confident again.

You deserve answers — and a plan that works with your life, not against it.

What to Expect at Your First Pelvic Floor Session (And Why You’re Always In Control)

If you’re considering pelvic floor therapy, you might have some questions — especially about internal exams. First, I want you to know: your comfort, consent, and empowerment are always my top priority.

This blog is here to answer your common questions, explain what internal exams are (and aren't), and share alternative ways we can work together — including if you’re not comfortable with internal work or if we’re meeting virtually!

What is an Internal Pelvic Floor Exam?

An internal exam is a gentle, gloved, and lubricated examination — usually vaginal and/or rectal — where I assess the muscles, tissues, and function of your pelvic floor from the inside.

It helps me check:

• Muscle strength

• Coordination

• Areas of tension or tenderness

• Organ support and positioning

Important things to know:

• You are never required to have an internal exam to work with me.

• You can change your mind at any time — before or during the session.

• You stay fully clothed for all other assessments.

• We go at your pace — everything is explained step-by-step, and you have full control to pause or stop at any point.

Internal exams can provide helpful information, but they are only one tool — not the only way we can assess and support your pelvic health.

Common Questions You Might Have

What if I'm menstruating?
It’s absolutely okay!
You can still attend your session while on your period. It’s completely your choice whether you want to proceed with an internal exam or skip it.
Some clients prefer to postpone internal work during their cycle; others are comfortable continuing. Either way, we have plenty of valuable things we can work on externally, through movement, breathwork, and education.

Can I opt out of an internal exam and still get help?
Absolutely.
We have many effective, empowering strategies that don't involve internal assessment at all (see below!).

Alternatives to an Internal Exam (or If You're Working With Me Virtually!)

If you're not comfortable with an internal exam — or if we’re working together virtually — you still have so many powerful options!

Here’s how we can support your pelvic floor without internal work:

✨ External Muscle Testing:
We assess your hips, core, glutes, and low back strength and mobility through simple movements. These muscles are closely linked with your pelvic floor health.

✨ Breathwork Assessment:
We'll check how your breathing patterns affect your core and pelvic floor connection. Sometimes adjusting your breath alone can make a big difference.

✨ Movement and Functional Screening:
By watching how you move — squats, lunges, sitting, standing — we can spot patterns that hint at pelvic floor tension, weakness, or compensation strategies.

✨ Education and Self-Release Techniques:
You’ll learn external stretches, muscle releases, and strengthening exercises tailored to you, all guided virtually or in-person — no internal work needed.

✨ Lifestyle and Behavior Coaching:
We’ll explore daily habits like toileting, posture, stress management, and movement routines, offering small changes that add up to lasting pelvic health improvements.

A Final Note: You’re In Charge

Every session is a collaboration — not a one-way street.

You’ll never be pressured into anything you’re not comfortable with. I’m here to guide you, educate you, and empower you, whether that involves internal assessments, external strategies, virtual coaching, or a blend of all of the above.

You deserve pelvic care that feels safe, supportive, and tailored to YOU.

If you ever have questions (even tiny ones!), I’m always happy to answer them.