Understanding Your Cycle: How Hormones Impact Your Pelvic Floor Health
Your menstrual cycle is more than just a monthly visitor — it's a dynamic process that affects almost every part of your body, including your mood, energy levels, digestion, and yes, even the health and wellness of your pelvic floor!
The menstrual cycle, typically ranging from 21-35 days long, is divided into four key phases: menstrual, follicular, ovulatory, and luteal. Each phase brings its own hormonal shifts — namely estrogen and progesterone — that influence how your body feels and systems function. These ever-fluctuating hormones can have far-ranging impacts that are often overlooked but important to pay attention to including influencing variations in muscle tone, fluid balance, inflammation, and even pain sensitivity.
So what does that mean for your pelvic floor? Quite a bit, actually. The rise and fall of hormones can influence how strong, relaxed, or sensitive your pelvic floor muscles are at different times of the month. You might have noticed that your workouts feel harder during certain weeks or that you experience more bloating, cramping, or pelvic tension before your period—these are direct physiological results of the hormone shifts your body experiences throughout your cycle!
In this post, we’ll briefly explore each phase of the menstrual cycle and how it interacts with your pelvic floor.
1. Menstrual Phase (Days 1–5): Rest and Release
This is when your period begins and you experience bleeding. Hormone levels during this phase are at their lowest and your body is shedding the uterine lining.
Pelvic floor impact: Many people report feeling more cramping and pelvic heaviness during this time. The pelvic floor muscles may feel more tense or overactive as the uterus contracts to help shed the lining. This is a great time to focus on gentle movement, heat therapy, and relaxation techniques like deep breathing.
What can help:
Restorative yoga or stretching
Gentle walks
Avoiding intense core work
Hydration and warm compresses for cramps
2. Follicular Phase (Days 6–14): Energy on the Rise
After your period ends, estrogen begins to rise again. This sends the signal to your ovaries to start maturing an egg. During this time, you may feel a natural increase in energy, mental clarity, and motivation.
Pelvic floor impact: As estrogen rises, the pelvic floor muscles may feel more responsive and coordinated. This can be a great time to engage in strength training, including pelvic floor and core exercises. During the follicular phase, your body is more resilient, can build muscle more easily, and recover more quickly than at other times during your cycle.
What can help:
Pelvic floor strengthening exercises
Moderate-to-intense workouts
Core and glute work to support the pelvic floor
Trying new movements or fitness routines
3. Ovulatory Phase (Around Days 13–15): Peak Power
During ovulation, estrogen is at its peak and a mature egg is released. Many people report feeling increased energy levels and strength during this phase. Testosterone also spikes briefly, which can enhance muscle performance and libido.
Pelvic floor impact: This is often when your body feels its best. The pelvic floor muscles may be functioning optimally, both in strength and coordination. You may feel more connected to your core, posture, and breathwork, all of which have positive impacts on your pelvic floor health.
What can help:
Challenging workouts or strength training
High-impact cardio (if it feels good to you)
Awareness of pelvic floor coordination during movement
Noticing how pelvic floor activation supports performance
4. Luteal Phase (Days 16–28): Slow Down and Stabilize
After ovulation, progesterone peaks as estrogen levels begin to decrease. You may find that you have less energy and that you are beginning to experience premenstrual symptoms. Bloating, fatigue, and mood shifts are all common during the luteal phase, especially in the latter part as you begin moving back into the menstrual phase.
Pelvic floor impact: Progesterone can lead to fluid retention and a feeling of heaviness in the pelvis. Some may notice increased sensitivity, constipation, or tension in the pelvic floor. Others might feel looser or more fatigued.
What can help:
Gentle movement like stretching or walking
Supporting digestion with hydration and fiber
Mind-body work like breath-focused pelvic floor relaxation
Avoiding pushing through intense workouts if energy is low
Bringing It All Together: Cycle-Aware Pelvic Floor Care
Syncing workouts and other energy-expending activities with your cycle can be a game changer for your pelvic health and wellness. Instead of expecting the same performance or energy levels every day, learning to work with your hormones — not against them — can lead to better results, fewer injuries, and a deeper connection with your body.
A few cycle-friendly pelvic floor tips:
Practice pelvic floor relaxation exercises during the menstrual and late luteal phases
Focus on strength and coordination during the follicular and ovulatory phases
Be aware of your hydration and bowel habits throughout the four phases of your cycle
Seek professional support (like a pelvic floor physical therapist) if you’re dealing with symptoms like pain, leaking, or tension
Final Thoughts
Your menstrual cycle can be a tool to better understand your pelvic floor and your body as a whole. Tuning into your pelvic floor throughout your cycle allows you to make choices about how to workout, eat, and live in ways that will make you feel stronger and more adaptable throughout the ongoing hormonal shifts. If you're experiencing symptoms like pelvic pain, heaviness, leaking, or discomfort during your cycle, you're not alone — and you don’t have to push through it. As always, our pelvic floor physical therapists are here to help you understand what’s normal, what’s not, and how to work with your body through the phases of your cycle.
