Pressure “Down There” and Not Pregnant
What to do if you are experiencing pressure “down there” and not pregnant?
Pelvic pressure or heaviness can be signs and symptoms of pelvic floor dysfunction. One of the main functions of the pelvic floor is to support the pelvic organs, but also act as the floor of the entire trunk stability system.
The symptom of pressure and heaviness “down there” can result from pelvic floor weakness or “underactivity”. The pelvic floor is essentially not able to support the pelvic organs and trunk appropriately.
This blog will explore the causes of pelvic heaviness and what to do if you are experiencing pressure “down there” and not pregnant.
What is Pelvic Heaviness?
Pelvic heaviness is often described as a sensation of weight or pressure in the pelvic region, sometimes coupled with a feeling of fullness or bulging.
It can occur at any time—while standing, sitting, or after prolonged periods of activity, especially during or after exercise, lifting, or even while coughing or sneezing. These symptoms can range from mild discomfort to a constant, disruptive feeling.
What are common causes of pelvic floor dysfunction?
Childbirth: Vaginal delivery can stretch and weaken pelvic floor muscles, especially after multiple pregnancies or traumatic births.
Aging: As people age, the pelvic floor muscles can weaken, and estrogen levels decrease, which may contribute to pelvic floor issues.
Obesity: Excess weight can put additional pressure on the pelvic floor, leading to muscle strain and dysfunction.
Chronic Straining: Activities like heavy lifting, constipation, or chronic coughing can put repeated stress on the pelvic floor muscles.
Hormonal Changes: Menopause, pregnancy, and other hormonal changes can affect the integrity of the pelvic floor.
What could happen if I don’t work on reducing my pelvic heaviness symptoms?
One of the most significant and concerning consequences of pelvic floor dysfunction is prolapse. Pelvic organ prolapse occurs when one or more of the pelvic organs (bladder, uterus, rectum) drop from their normal position and push against the vaginal walls. This can create a sensation of heaviness or pressure in the pelvic area and may also cause a bulging feeling.
Symptoms of a pelvic organ prolapse can include:
A sensation of a bulge or something "falling out" of the vagina
Incontinence or difficulty controlling urination
Pain during intercourse
Frequent urinary tract infections (UTIs)
Difficulty emptying the bladder or bowels
Lower back pain or pelvic pain
Diagnosis and Treatment Options for Pelvic Pressure and Heaviness
A healthcare provider specializing in pelvic health—such as a gynecologist, pelvic floor physical therapist, or urologist—can perform an evaluation to determine the cause of pelvic heaviness. This may include a physical exam, an internal pelvic exam, imaging tests, and possibly an ultrasound or MRI for a more detailed view.
Treatment options for pelvic floor dysfunction and prolapse vary based on the severity of the condition and may include:
Pelvic Floor Physical Therapy: A trained pelvic floor therapist can teach exercises to strengthen and relax the pelvic floor muscles, which can alleviate pressure and improve symptoms. They can assess the integrity of the tissues in order to screen for hormonal imbalances, infections, and muscular atrophy/changes.
Lifestyle Changes: Managing weight and preventing constipation can help reduce strain on the pelvic floor. A therapist will also teach proper lifting techniques as well as appropriate ways to not bear down and put additional pressure on the pelvic floor.
Devices: A pessary is a device inserted into the vagina to support the prolapsed organs, especially in cases of mild to moderate prolapse. There are other over the counter options for assisting the pelvic floor in supporting the pelvic organs which can be more readily available and more cost effective.
Surgery: In severe cases of prolapse, surgical intervention may be necessary to repair or reposition the prolapsed organs. It is still important to rehabilitate the pelvic floor muscles following a surgical repair as it is not a guarantee that the prolapse will not happen again. This is due to the mechanics continuing to put pressure onto the pelvic floor if the person is not taught appropriate techniques for future use.
Pelvic heaviness is NOT a symptom that should be ignored, especially if it is accompanied by other symptoms such as a bulging feeling, incontinence, or pelvic pain.
These could be indicative of pelvic floor dysfunction or, in some cases, a prolapse.
If you are experiencing pelvic heaviness, it is essential to seek medical advice to determine the cause and explore appropriate treatment options. With proper care, many individuals can manage symptoms and improve their quality of life without ever needing surgery.
Where to get help if you have pelvic heaviness
If you are local to the Jacksonville area and are experiencing pelvic discomfort, frequent urination, leaking with exercise/exertion, or are looking for pelvic floor support during your menopausal years, we’d love to help you here at Samson Strength and Performance Physical Therapy. We offer pelvic health physical therapy services inside our Jacksonville Beach clinic and you can request a call to get started. We’d love to help you.