In hypertonic pelvic floor, your pelvic muscles are continuously contracting. Symptoms include pain and difficulty with urination, bowel movements and sexual function. Physical therapy is a highly effective treatment. Tell your provider if you're experiencing symptoms. The sooner you seek treatment, the quicker you’ll feel relief.
Hypertonic pelvic floor is a condition where the muscles in your lower pelvis are in a spasm or state of constant contraction. This can be temporary or constant. When your pelvic floor muscles are in this state, they can’t relax and coordinate the control of certain bodily functions. This causes pain (either constant or with certain activities), problems with urination (peeing) and bowel movements (pooping) as well as sexual dysfunction and painful intercourse.
These symptoms can greatly impact your quality of life.
Your pelvic floor is a group of muscles that supports your pelvic organs. These organs include the following:
The muscles of your pelvic floor connect to your pelvic bones to form a strong, yet flexible foundation. They span between the:
Nerves and muscles in your pelvic floor help control urination, bowel movements and sexual function.
This condition occurs in people of all genders and ages.
In general, pelvic floor dysfunction is very common. Hypertonic pelvic floor is a type of pelvic floor dysfunction. It’s often undiagnosed and data suggests that it occurs as often as in 1 in 10 people.
A common symptom is pain. You may feel this as general pain or pressure in your pelvic area, low back or hips. Pain can also be specific to a location (like your bladder) or during certain activities (like bowel movements or sex).
Other symptoms include:
Symptoms of hypertonic pelvic floor usually develop slowly and get worse over time. It’s important to talk to your healthcare provider even if you have mild symptoms.
The causes of this condition can be complex. Factors that may increase your risk for hypertonic pelvic floor include:
Your healthcare provider will ask about your symptoms and medical history. This may include questions about your bowel movements, urination and sexual activity. You may find these topics difficult to talk about, but it’s important to be open about any problems you're having. This will help your provider make an accurate diagnosis.
Your provider will also likely do a physical exam. This may involve:
Other tests your provider may perform include:
The primary treatment is physical therapy to retrain your muscles. Your provider will recommend a therapist with training in pelvic floor dysfunction. Strategies physical therapists use include:
Other treatments your provider may recommend include:
Your provider may also seek help from other specialists such as:
You can reduce your risk by understanding the contraction and relaxation of your pelvic muscles. You can also:
Hypertonic pelvic floor is treatable. It may take time and patience, but most people have either partial or complete relief of symptoms with treatment. If your symptoms persist, your provider may refer you to a specialist based on your individual needs.
Talk to your healthcare provider if you experience pelvic pain, trouble peeing, and pain when pooping or with sexual activity. These symptoms typically don’t get better on their own, so it’s important to get care.
A note from Cleveland Clinic
Hypertonic pelvic floor causes pain and problems with peeing, pooping and sex that can be uncomfortable and embarrassing. Fortunately, physical therapy and other treatments can be very effective. By talking to your provider about your symptoms early, you can get the treatment you need and improve your quality of life.
Last reviewed by a Cleveland Clinic medical professional on 04/26/2022.
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