What is a Hypertonic Pelvic Floor?
Lauren Coin
| 3 min read
Lauren Coin is a summer 2025 Corporate Communication...
Pelvic floor dysfunction refers to a range of conditions where the muscles and ligaments of the pelvic floor do not work, according to the Cleveland Clinic.
While many of these conditions are typically associated with muscle weakness, a hypertonic pelvic floor involves muscles that are overly tight or tense, which can cause pain or discomfort during everyday activities. Learn more about a hypertonic pelvic floor, the causes, symptoms and ways to treat it.
What is a hypertonic pelvic floor?
The pelvic floor consists of muscles and connective tissues that support pelvic organs including the bladder, large intestine and internal reproductive organs in both women and men, per the Cleveland Clinic. These muscles span between the pubic bone, lower spine and sit bones on each side of your body.
A hypertonic pelvic floor occurs when the muscles in your lower pelvis are in a spasm or constantly contracting, according to the Cleveland Clinic. When the pelvic floor muscles are in this state, they can’t control certain bodily functions, such as urination and bowel movements. It can also cause pelvic pain, painful intercourse and lower back pain.
Potential causes
The exact cause of a hypertonic pelvic floor is complex and unclear. However, there are a series of factors that can increase your risk of this condition. Per the Cleveland Clinic, these risk factors may include:
- Habitually holding in your urine or stool
- Injury or trauma to the pelvic floor muscles, including those incurred during childbirth
- Muscular dysfunction from prolonged sitting or abnormal posture
- Other conditions such as irritable bowel syndrome or endometriosis
- Stress and depression
According to the FDA Office of Women’s Health, women may experience more risk factors for a hypertonic pelvic floor and other pelvic floor disorders. Such factors can include childbirth, a history of hysterectomy or menopause.
Symptoms of a hypertonic pelvic floor
One of the most common symptoms of a hypertonic pelvic floor is pain or pressure to your pelvic area, low back or hips, per the Cleveland Clinic. This discomfort may be localized to a part of the body or flare up during certain activities.
Other urinary, bowel or sexual symptoms may include:
- Frequent urination
- Pain while urinating
- Pain during or after defecation
- Pain with passing gas
- Constipation
- Pain during or after sex
Symptoms of a hypertonic pelvic floor develop slowly and get worse over time. Be sure to consult your primary care provider (PCP) for proper diagnosis and treatment options.
Treatment
The primary treatment for a hypertonic pelvic floor is physical therapy. Pelvic floor therapy utilizes a combination of exercises and nonsurgical treatments to help improve core stability and muscle control, according to Johns Hopkins Medicine.
If your discomfort is caused by stress, a mental health therapist can help you identify and manage stress through various techniques.
There are also different ways to reduce your risk of a hypertonic pelvic floor yourself. The Cleveland Clinic advises:
- Strengthening the pelvic floor through yoga or Kegel exercises
- Mindfulness and relaxation techniques
- Maintaining good bowel habits, avoiding constipation and straining, staying hydrated and consuming a fiber-rich diet
- Avoiding prolonged periods of holding urine and stool
- Engaging in regular physical activity for muscle tone and flexibility, including walking, swimming or cycling
Photo credit: Getty Images
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