🚩 Red Flags That Mean It’s Time to See a Pelvic Floor Physical Therapist

Many people assume pelvic floor symptoms are normal, something they just have to live with — especially after pregnancy, during stressful seasons, or as they get older. The truth? A lot of these symptoms are signals, not something to push through.

Here are some common red flags that indicate it may be time to see a pelvic floor physical therapist.

1. Leaking Urine — Even “Just a Little”

If you leak when you:

• cough, sneeze, laugh, or jump

• run or work out

• feel a sudden urge and don’t make it in time

…it’s a sign your pelvic floor isn’t coordinating properly. This can happen with weak muscles, overly tight muscles, or poor pressure management — not just weakness.

➡️ Leaking is common, but it is not normal.

2. Pain With Intercourse, Exams, or Tampon Use

Pain during:

• penetration

• pelvic exams

• tampon insertion or removal

often points to pelvic floor muscle tension, guarding, or nervous system sensitivity. Many people are told it’s “in their head” or that they should just relax — but this pain has a physical cause and can be treated.

3. Chronic Pelvic, Abdominal, or Low Back Pain

Ongoing pain in the:

• lower abdomen

• pelvis

• tailbone

• hips or low back

can be strongly connected to the pelvic floor. This is especially true if pain worsens around your menstrual cycle, during stress, or with prolonged sitting.

➡️ A “normal” scan does not rule out pelvic floor dysfunction.

4. Difficulty Emptying Your Bladder or Bowels

Red flags include:

• feeling like you still need to go after using the bathroom

• straining to pee or poop

• starting and stopping urine flow

• chronic constipation

These symptoms often indicate poor pelvic floor relaxation or coordination, not just a gut or bladder issue.

5. Frequent Urination or Urgency

If you:

• pee “just in case”

• feel urgency even with small bladder volumes

• wake up multiple times at night to urinate

your pelvic floor and nervous system may be stuck in a high-alert state. Pelvic floor PT addresses both muscle function and bladder habits.

6. Pelvic Pressure, Heaviness, or a “Falling Out” Sensation

A feeling of:

• heaviness

• pressure

• bulging

can be associated with pelvic organ prolapse — but also with muscle tension, poor breath mechanics, or pressure management issues. Early intervention matters.

7. Symptoms That Started After Pregnancy, Birth, Surgery, or a UTI

Pelvic floor issues often begin after:

• pregnancy or postpartum

• C-section or abdominal surgery

• a traumatic or prolonged birth

• recurrent UTIs

Even if symptoms showed up months later, the connection is still important.

8. You’ve Tried Kegels… and Things Got Worse

This is a big one 🚩
If strengthening exercises increased pain, pressure, or urgency, your pelvic floor may need downtraining, coordination, and relaxation — not more squeezing.

When in Doubt, Get It Checked

Pelvic floor physical therapy is not just for postpartum or leaking. It’s for:

• pain

• dysfunction

• prevention

• understanding how your body actually works

Early care often means faster, easier recovery — and fewer symptoms becoming chronic.

If your body has been sending you signals, it’s worth listening.