Pelvic floor dysfunction in high achieving women.

Written By Liesbeth Peeters

Why High-Achieving Women Struggle With Pelvic Floor Dysfunction

After 20 years in pelvic health, I see all kinds of women. But there's one pattern I keep coming back to: high-achieving women, theses amazing women managing a career, a household, a training schedule, often all three, tend to show up with pelvic floor dysfunction at a disproportionate rate.

And when we dig into why, it almost always comes back to the same thing: a nervous system that has been running on high for far too long and is affecting the pelvic floor.

Chronic stress and the pelvic floor

When you live in a low-grade, always-on state of stress, the kind that high-achievers often just normalise, your sympathetic nervous system stays activated. Fight-or-flight becomes your baseline. And your pelvic floor, like every other muscle in your body, responds to that by bracing. (ready to take on the fight against “danger”)

A pelvic floor that's chronically tense can't coordinate properly. It can't release when it needs to. And over time, that shows up as symptoms that can feel completely unrelated to each other:

  • Bladder irritability: urgency, frequency, leaking before you make it to the bathroom

  • Bowel issues: constipation, irritable bowels

  • Pelvic pain

  • Pain during intercourse

These aren't separate problems. They're different expressions of the same underlying dysfunction, a pelvic floor stuck in a state it can't get out of.

Why kegels alone won't fix this

The standard advice assumes the pelvic floor is weak. But for a lot of the women I work with, weakness isn't the issue. The pelvic floor is too tense and too disorganised to function well. Doing more kegels into a chronically braced system is a bit like trying to relieve a cramp by squeezing harder, it doesn't help, and it can make things worse.

The nervous system is where the work starts

Your pelvic floor is in constant communication with your diaphragm, your breath, and your vagus nerve, the main pathway of your parasympathetic nervous system, the rest-and-digest state that's the antidote to chronic fight-or-flight.

Research confirms that the vagus nerve directly innervates the pelvic floor, and that the diaphragm and pelvic floor move in coordination with every breath you take. When your nervous system is dysregulated, that coordination breaks down, and no amount of targeted pelvic floor exercise will override it.

This is why a holistic approach to pelvic floor treatment matters. Nervous system regulation, breathing mechanics, bladder and bowel habits, lifestyle, these aren't optional extras, something that I will address straight up.

If you've been doing all the right things and still not seeing results, this could be why.

Questions? Send me a message, I'm happy to chat.

Liesbeth | @the_strongher_physio

Liesbeth Peeters
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