What Is the Pelvic Floor, and Why Should You Care?
- Amanda Simmons
- Sep 30
- 3 min read
Hi friends, Dr. Amanda here! Let’s chat about something that doesn’t get nearly enough attention but affects so many of us: the pelvic floor.
Did you know that 1 in 4 adult women in the U.S. experiences a pelvic floor disorder? Yep—you’re not alone if you’ve ever dealt with things like:
Leaking when you sneeze, laugh, or exercise
A feeling of heaviness or pressure “down there”
Pelvic pain or pain with sex
Discomfort using tampons
These are all signs that your pelvic floor might need some love. And here’s the kicker: nearly half of women with pelvic floor issues avoid exercise because of their symptoms. But exercise is too important to give up—it helps prevent or manage at least 26 chronic conditions (think diabetes, anxiety, depression, and more!).
So, let’s break it down: what exactly is the pelvic floor?
Meet Your Pelvic Floor
Your pelvic floor is a group of muscles at the base of your pelvis. Think of it like a little hammock that supports your bladder, uterus, rectum, and all the contents above. It also plays a huge role in breathing, stability, continence, and sexual function.
There are two layers:
Superficial muscles – the triangle-shaped muscles closer to the surface
Deep muscles – the ones underneath that help with core stability and strength
And here’s the cool part: your pelvic floor doesn’t work alone. It’s part of your core canister—teaming up with your diaphragm (breathing muscle), your deep abdominal muscles (think “corset,” not six-pack), and the muscles along your spine.
When all these muscles work together, your body is strong, stable, and efficient. But when one part isn’t pulling its weight? That’s when problems show up.
High Tone vs. Low Tone: Two Sides of Dysfunction
Pelvic floor dysfunction isn’t one-size-fits-all. It can show up on a spectrum:
High Tone (too tight/guarded): Muscles are clenched all the time, often leading to pelvic pain. (Hint: more Kegels are not the answer here—these women need to learn how to relax.)
Low Tone (too weak/underactive): Muscles don’t have enough strength or endurance, which can cause leaking or prolapse. These women often need strengthening and coordination.
Most of us fall somewhere in between—and sometimes have a little bit of both! That’s why a personalized assessment is so important.
Think of Your Pelvic Floor Like an A-Frame House 🏠
One of my favorite ways to picture the pelvic floor is as an A-frame house.
At the top (the attic), we fully engage the pelvic floor. This happens when pressure increases in your abdomen—like sneezing, coughing, lifting, or sitting up.
At the bottom (the basement), we fully relax the pelvic floor. We need this ability when we urinate, have a bowel movement, or during labor.
In the middle (the first floor), we find our everyday living space—where we should spend most of our time.
A healthy pelvic floor isn’t stuck in the attic or collapsed in the basement. It’s comfortable on the first floor but can travel up or down as needed. That flexibility—moving between engagement and relaxation—is what keeps everything functioning smoothly.
Why It Matters
Your pelvic floor has three big jobs:
Control: Keeps you continent (urine, stool, and gas) and lets you “go” when you want to.
Support: Holds up your bladder, uterus, rectum, and even a growing baby during pregnancy.
Sexual Function: Contributes to arousal and orgasm.
When these muscles aren’t doing their jobs, it impacts everything—from exercise to confidence to intimacy.
The Bottom Line
Most of us didn’t learn about the pelvic floor in school—one study found that 87% of high school seniors couldn’t name the three openings in the female pelvic floor. Wild, right? It’s no wonder so many women are struggling in silence.
But here’s the good news: with the right education, support, and care, you can restore function, get back to exercise, and feel confident in your body again.
So next time you sneeze, cough, or crush that workout—remember, your pelvic floor is your A-frame house. Most of the time, you’ll be hanging out comfortably on the first floor, but it’s just as important to know when to head up to the attic or down to the basement.
👉 Stay tuned, because I’ll be diving deeper into topics like incontinence, prolapse, and pelvic pain in upcoming posts. And if you’re ready to get to the root of your symptoms, reach out—I’d love to help.
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