Dr. Robin Ellis from SET Physical Therapy, in our second guest post, explains why the pelvic floor matters for bowel movements—and even hemorrhoids.
Pregnancy changes a lot about your body—but one area that doesn’t get enough attention is the pelvic floor.
If you’ve ever dealt with constipation, straining, or hemorrhoids during or after pregnancy, your pelvic floor may be part of the reason. This group of muscles plays a bigger role in bowel health than most people realize.
The pelvic floor is a group of muscles at the bottom of your pelvis that act like a supportive hammock. They help hold up your bladder, uterus, and rectum.
Just as importantly, they help control your bowel movements.
These muscles need to do two opposite things well:
Hold stool in when you’re not ready to go
Relax and let go when you are
When that coordination is off, symptoms can start.
During pregnancy, the pelvic floor is under constant pressure from the growing baby. Hormones also make tissues more flexible, which can reduce support.
Then during delivery, these muscles stretch a lot—and sometimes don’t fully recover their strength or coordination.
This can happen after both vaginal and C-section deliveries.
When the pelvic floor isn’t working well, bowel movements can become more difficult.
You might notice:
Constipation
Straining
A feeling of incomplete emptying
A sense that something is “blocking” the stool
In some cases, the muscles don’t relax properly when you try to go, which makes even soft stool hard to pass.
This is where hemorrhoids come in.
Hemorrhoids are very common during and after pregnancy—but they’re often treated as a standalone issue. In reality, they’re frequently linked to what’s happening with the pelvic floor.
When you strain repeatedly or sit on the toilet for long periods trying to empty, you increase pressure in the rectal area. Over time, this can lead to or worsen hemorrhoids.
So while creams and procedures can help treat hemorrhoids, it’s just as important to address why the straining is happening in the first place.
Often, the pelvic floor is a big part of that picture.
If you’re dealing with constipation, straining, or recurring hemorrhoids, it’s worth looking a little deeper:
These symptoms are common—but not something you have to live with
It’s not always about “pushing harder” or even “getting stronger”
Sometimes the muscles actually need to learn how to relax and coordinate better
Pelvic floor physical therapy can help retrain these muscles so bowel movements are easier and require less strain
Pregnancy can have lasting effects on the pelvic floor, and those changes often show up as bowel symptoms—including hemorrhoids.
If you’re stuck in a cycle of straining and flare-ups, it may not just be about the hemorrhoids themselves. Addressing pelvic floor function can make a big difference in long-term relief.
Learn more about the pelvic floor.
Robin Ellis is a physical therapist specializing in the treatment of pelvic floor dysfunction. She works with patients of all genders in the Atlanta area, helping individuals overcome issues like constipation, pelvic pain, and bowel or bladder dysfunction through personalized, evidence-based care.
References
Bordoni B, Sugumar K, Leslie SW. Anatomy, Abdomen and Pelvis, Pelvic Floor. StatPearls. Updated 2023.
Grimes WR, Stratton M. Pelvic Floor Dysfunction. StatPearls. Updated 2023.
Mayo Clinic. Advancing care for childbirth-related pelvic floor disorders. Published 2024.
Corton MM. Anatomy of pelvic floor dysfunction. Obstet Gynecol Clin North Am. 2009;36(3):401-419.
Bo K, Frawley HC, Haylen BT, et al. IUGA/ICS terminology for pelvic floor muscle function. Neurourol Urodyn. 2017;36(2):304-310.