The 5 Functions of Your Pelvic Floor

I bet you didn’t know your pelvic floor was responsible for so much, but understanding these functions changes everything about how we think about pelvic floor dysfunction!

The Question That Started It All

"So... what exactly does the pelvic floor DO?"

I was asked this question by a private client during our first session together. She'd been dealing with pelvic pain for two years, had seen multiple doctors, and had been told she needed "pelvic floor therapy" – but nobody had ever actually explained what her pelvic floor was supposed to be doing in the first place, and she was feeling frustrated and like she just didn’t “get it”.

I realized in that moment how backwards our approach to pelvic floor health really is. We wait until something goes wrong, then try to fix it, without ever understanding what "right" actually looks (or feels) like.

Imagine trying to repair a car engine when you have no idea how it's supposed to function when it's working properly!

The Oversimplified Version That's Failing Everyone

When most people think about pelvic floor function (if they think about it at all), they usually picture one thing: not peeing yourself.

This reductive understanding has led to the "just do your Kegels" approach that's left millions of women frustrated with their lack of progress. Because when we don't understand the full scope of what our pelvic floor is supposed to do, how can we possibly address all the ways it might be malfunctioning..?

No wonder so many issues go undiagnosed, undertreated, or completely misunderstood.

Let’s dive in to the 5 big roles of the pelvic floor. Because knowledge is power!

Job #1: Structural Support 

What it does: Literally holds up your bladder, uterus, and rectum against gravity

Think of your pelvic floor as a baby hammock, holding up your pelvic organs. Every single day, gravity is pulling your pelvic organs downward, and your pelvic floor muscles, ligaments, and fascia work together to counteract this force.

When you stand up from sitting, run, laugh at a joke, lift something heavy, etc, your pelvic floor is what provides support to keep everything in place.

When this job goes wrong you might experience:

• Prolapse symptoms (feeling like organs are "falling out")
• Heaviness or pressure in the pelvic region
• Discomfort that worsens throughout the day or with activity
• That sensation of "everything dropping down"

What affects this function:

• Pregnancy and childbirth (obvious stressors to the support system)
• Chronic coughing, constipation, or heavy lifting
• Hormonal changes that affect tissue elasticity
• Poor posture that alters the positioning of your pelvis
• Previous surgeries or injuries

Job #2: Sphincter Control 

What it does: Opens and closes like a sophisticated valve system to control when you urinate and defecate

Your pelvic floor works in coordination with your urethral and anal sphincters to provide precise control over when and how you empty your bladder and bowels. This isn't just about "holding it in" – it's about the complex coordination required for complete emptying when appropriate and perfect continence when it's not.

This system has to make split-second decisions: "Is this the right time and place to empty? How much pressure is building? Should I hold tight or relax and release?"

When this job goes wrong you might experience:

• Stress incontinence (leaking with coughing, sneezing, exercise)
• Urge incontinence (sudden, intense urges followed by leaking)
• Incomplete emptying of bladder or bowels
• Frequent urination or difficulty initiating urination
• Fecal incontinence or difficulty controlling gas

What affects this function:

• Nerve damage from childbirth, surgery, or trauma
• Hormonal changes affecting tissue sensitivity
• Chronic constipation that stretches and weakens the system
• Medications that affect bladder or bowel function
• Neurological conditions that disrupt nerve signaling

Job #3: Sexual Function 

What it does: Contributes to arousal, sensation, and orgasm

This is the job that gets talked about the least, but it's crucial for sexual health and satisfaction. Your pelvic floor muscles are intimately involved in sexual response – they fill with blood during arousal, contract rhythmically during orgasm, and provide the muscle tone necessary for pleasurable sensation.

The female pelvic floor muscles surround the vaginal opening and contribute to the grip and release sensation during penetration. 

When this job goes wrong you might experience:

• Decreased sensation during sexual activity
• Pain during penetration (vaginismus or dyspareunia)
• Difficulty reaching orgasm or less intense orgasms
• General lack of sexual satisfaction

What affects this function:

• Trauma (physical or emotional) that creates protective tension
• Hormonal changes that affect tissue elasticity and blood flow
• Chronic pain conditions that create guarding patterns
• Medications that affect sexual response
• Psychological factors that create tension and disconnection

Job #4: Core Stability 

What it does: Works with your diaphragm and deep abdominal muscles to stabilize your spine and pelvis during movement

Your pelvic floor is a crucial part of your "deep core". Every time you move, lift, reach, or even just shift your weight, your pelvic floor has to coordinate with your diaphragm, transverse abdominis (corset abs), and multifidus (back muscles) to provide spinal stability.

This coordination happens automatically when the system is working well – you don't have to think about engaging your pelvic floor before picking up a grocery bag. But when this coordination breaks down, other muscles have to compensate, often leading to pain and dysfunction elsewhere.

When this job goes wrong you might experience:

• Lower back pain, especially with lifting or movement
• Hip pain or dysfunction
• Core weakness despite doing "ab" exercises
• Feeling unstable or weak during physical activities
• Compensatory tension patterns throughout your body

What affects this function:

• Pregnancy and postpartum changes that alter core coordination
• Breathing pattern dysfunction that disrupts the pressure system
• Previous injuries that create compensatory patterns
• Poor posture that changes the optimal positioning of core muscles
• Chronic stress that creates overall tension patterns

Job #5: Respiratory Support 

What it does: Moves in coordination with your diaphragm during every breath you take

This is the job that surprises people the most. Your pelvic floor and diaphragm are intimately connected through fascia and function. With every inhale, your diaphragm moves down and your pelvic floor gently lengthens. With every exhale, your diaphragm moves up and your pelvic floor gently lifts.

This coordination creates an optimal pressure system within your core that supports all the other functions we've discussed. When this breathing-pelvic floor connection is disrupted, it affects everything from core stability to organ support to sexual function.

When this job goes wrong you might experience:

• Chest breathing patterns instead of diaphragmatic breathing
• Feeling of breathlessness or inability to take deep breaths
• Core dysfunction that doesn't respond to traditional exercises
• Neck and shoulder tension from compensatory breathing patterns
• Anxiety or stress symptoms related to disrupted breathing

What affects this function:

• Chronic stress that creates protective breathing patterns
• Previous respiratory illnesses that alter breathing mechanics
• Postural changes that restrict diaphragm movement
• Pregnancy that physically limits diaphragm excursion
• Trauma that creates holding patterns in the breathing system

How It's All Connected

Here's what makes pelvic floor dysfunction so complex and often confusing: these five jobs are completely interconnected. When one function starts to fail, it creates a domino effect that can impact all the others.

For example:

• Chronic constipation (sphincter control issue) can lead to prolapse (support problem) and back pain (core stability issue)
• Breathing pattern disorders (respiratory job) can worsen incontinence (sphincter job) and sexual dysfunction (sexual function job)
• Childbirth trauma affecting core stability can lead to compensatory patterns that create chronic pain and breathing dysfunction

This interconnection explains why isolated approaches to pelvic floor problems often fall short. You can't just address one function without considering how it relates to all the others.

The "Aha" Moment 

When my client finally understood the how and the why behind the pelvic floor, everything clicked. Her pelvic pain wasn't just a random problem that appeared out of nowhere – it was her pelvic floor's way of telling her that these multiple systems were struggling to do their jobs properly.

Her breathing had become shallow and restricted after a very stressful life experience. This disrupted her core coordination, which led to compensation patterns that eventually created the pelvic pain she'd been experiencing.

Instead of just treating the pain, we addressed the breathing patterns, restored core coordination, and in doing so, her nervous system learned how to feel safe again. The pain resolved, but more importantly, she gained an understanding of how to prevent it from returning.

A Simple Self Assessment

Here's a quick self-assessment to gauge how well your pelvic floor is managing its workload:

Support Function:

• Do you ever feel heaviness or pressure in your pelvic region?
• Does discomfort worsen throughout the day or with activity?

Sphincter Control:

• Do you leak urine with coughing, sneezing, or exercise?
• Do you have sudden, urgent needs to urinate?
• Do you feel like you can’t empty your bladder completely?

Sexual Function:

• Have you noticed changes in sexual sensation or satisfaction?
• Do you experience pain during sexual activity?

Core Stability:

• Do you have lower back pain, especially with lifting?
• Do you feel unstable or weak during physical activities?

Respiratory Support:

• Do you breathe primarily into your chest?
• Do you hold tension in your neck and shoulders
• Are you unable to feel your pelvic floor moving with your breath?

If you answered "yes" to multiple concerns across different categories, it's a sign that your pelvic floor might be struggling with its multifaceted job description.

The Path Forward

Understanding these five jobs fundamentally changes how you approach pelvic floor health:

Instead of just doing Kegels, you address breathing patterns, posture, and coordination

Instead of just treating symptoms, you support the underlying functions

Instead of working in isolation, you consider how each job affects the others

Instead of accepting dysfunction, you recognize that all five jobs can be optimized

Whether you're dealing with postpartum changes, hormonal fluctuations, or age-related shifts, your pelvic floor's five jobs remain the same. The approach just needs to be tailored to support these functions through your specific life circumstances.

The Revelation That Everything Is Connected

Once you understand that your pelvic floor is simultaneously your foundation, valve operator, pleasure coordinator, movement stabilizer, and breathing partner, so many things start to make sense:

• Why stress affects your bladder function
• Why back pain and pelvic problems often go together
• Why breathing exercises can improve sexual function
• Why core strength work needs to include pelvic floor release and coordination
• Why "just doing Kegels" often isn't enough

Your pelvic floor isn't just about not peeing yourself. It's about the complex, beautiful coordination of multiple systems that allow you to move through your life with strength, confidence, and optimal function.

The Bottom Line

Yes, your pelvic floor has been working five jobs simultaneously since the day you were born. But if you’re still reading, I’m going to take a stab in the dark and guess that at some point, things went awry. 

Understanding these functions isn't just academic knowledge – it's the foundation for optimizing your health, strength, and quality of life at every stage.

When we honor the complexity of what this system does every day, we can finally address problems at their root rather than just managing symptoms. And that's when real, lasting change becomes possible.

 Your pelvic floor deserves respect, understanding, and proper support because reclaiming this foundational strength isn't just about fixing symptoms, it's about rediscovering what your body is truly capable of!