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The Brain - Pelvic Floor Connection

Oct 03, 2023

Did you know that your pelvic floor is directly connected to your brain? 

Well actually, everything in your body is directly connected to your brain via a network of nerves that run throughout your body. 

Nerves are like cables that carry electrical impulses around the body. They gather information and send it back to the brain and the brain sends instructions in response. Your nervous system is what causes you both to feel heat when you touch something hot and to pull your hand away quickly in response.

The nervous system includes the brain, the spinal cord and a vast network of nerves made up of neurons (specialised cells that transmit information). 

This system is divided into two parts: the Somatic Nervous System, which controls your movements, and the Autonomic Nervous System, which controls the activities you do without thinking about them like breathing or your heart beating.

The autonomic nervous system can be further divided into another three parts: the sympathetic, parasympathetic, and enteric nervous systems. The sympathetic nervous system helps your body go into fight/ flight/ freeze when you’re stressed or in danger and the parasympathetic system helps you rest and digest. Both of these systems help keep your body in balance. The enteric nervous system is the nervous system of the gastrointestinal tract (your intestines).

The nerves that run throughout your pelvic floor connect to your brain via the spinal cord. They form a feedback loop which means that your brain and pelvic floor are in constant two way communication. They contain nerves which are part of the somatic system (controlling movement) and the autonomic (sympathetic and parasympathetic) system.

The main nerve of the pelvic floor is called the pudendal nerve and it branches in two to serve both sides of your pelvis. Each branch divides further into three distinct nerves. The dorsal nerve serves the clitoris (some reports say there are more than 10,000 nerve fibres attached to the clitoris - more than twice the number in your hand which is much larger), the perineal nerve serves the vagina and the perineum and the rectal nerve serves the anus. 

These three branches further divide and serve all the muscles of your pelvic floor as well as the skin and organs in the area.

The way these branches divide forms a pattern that is unique to each individual - just like the branches of a tree. This is why people experience pleasure differently when they stimulate the clitoris, perineum, vagina, cervix or anus.

We all have different arrangements of nerve endings in these areas which means that no two people experience pleasure (or pain) from these areas in the same way. 

The whole thing is like a massive feedback loop which incorporates not only what sensations you’re experiencing in or on your physical body but also what you’re experiencing outside of your body and how you feel about it all. 

When we want to move our pelvic floor muscles, often the brain does this for us on automatic pilot (autonomic nervous system). When we’re accustomed to bad habits like incorrect posture or bad toilet technique, this can be a problem.

But we can take conscious control of these movements and teach our brain and our bodies how to do things in a way that causes less stress for our muscles and our brains, even when those habits are really ingrained.

The brain remains plastic throughout your lifetime. Changing the wiring just takes lots and lots of focus and repetition. 

When we are stressed, either emotionally or physically, our pelvic floor muscles tense up or contract involuntarily i.e. without our conscious control. This is known as the pelvic stress reflex response and it’s a problem because most of us are pretty stressed these days. 

If we’re stressed and our pelvic floor muscles are holding on to this stress for us most of the time, they’re going to get tired. Tired pelvic floor muscles can’t perform a pelvic floor squeeze effectively so you’re going to get stress incontinence symptoms (if you want to know more about stress incontinence see here).

Stress also causes our sympathetic nervous system to release the hormone cortisol which can make you feel anxious. Normal cortisol levels support healthy immune function among other things, but when we make too much, we experience a dip because we run out of the resources we need to make it. Then we experience exhaustion, lack of sleep, increased symptoms of pain and a decreased ability to handle emotional issues - all of which can increase symptoms of pelvic floor issues like incontinence and pain. 

In the long term, depleted cortisol levels due to chronic stress increases the risk of endometriosis, cystitis and vulvodynia. 

But on the flip side, your pelvic floor can also influence the production of DOSE or happy hormones via your nervous system.

So not only can you experience sensations of pleasure through your pudendal nerve, you can also stimulate Dopamine, Oxytocin, Serotonin and Endorphin release - which can help you feel happier, more connected and more alert. 

Increasing blood flow to the pelvic floor by exercising, improving your mind/body connection, and engaging in sexual activity, either solo or with a partner, can help boost production of these hormones. 

Understanding the brain's control over the pelvic floor muscles is crucial for maintaining pelvic floor health. The body is a remarkable web of interconnected systems. Our pelvic floor function is affected by the sensations we experience, the way we move, what is happening around us and how we feel about it. 

Taking conscious control of this feedback loop by exercising, using meditation, massage, sexual contact or even improving our sleep hygiene can allow us to prevent, manage and treat pelvic floor issues as and when they arise. 

If you need help managing your symptoms while you work on finding your appropriate solutions, check out our articles on pads, pants and compression garments or download our FREE guide to lifestyle changes to support lifelong pelvic floor health. 

For more accessible, practical content like this, follow us on Instagram ( and YouTube (@sheelawomen). 

Lastly, if there is a woman out there you think might need to hear any of this, please share. Pelvic floor issues are incredibly common but not normal and that means there are ways to prevent, manage and treat pelvic floor issues at any age. 

Sources: ​​,either%20side%2C%20like%20a%20wishbone.,in%20danger%20or%20physically%20active.,%22rest%20and%20digest%22%20state.

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