Hypertonic pelvic floor is a musculoskeletal condition wherein the pelvic floor muscles are overly active or contracting when they should be resting. Another commonly used term is Overactive Pelvic Floor Muscle Dysfunction.

When the pelvic floor muscles are hypertonic, over time they become tight and restricted which can result in pain and issues with bowel, bladder, and sexual function.

The pelvic floor muscles themselves are comprised of several muscles in 3 layers that form a sling of support for the pelvic organs (bladder, bowel, and uterus).

These muscles provide support and closure around the urethra and rectum to maintain continence and relax and elongate when toileting in people of all genders. For people with a vagina, the muscles also support the uterus surround the vaginal opening.

These muscles must be both strong and flexible, and well-coordinated. When the pelvic floor muscles are overactive or too tight, they commonly lack coordination to relax when needed such a during a bowel movement, and contract strongly when needed, such as during a big sneeze to prevent urinary incontinence.

Common Signs and Symptoms of Hypertonic Pelvic Floor Muscle Dysfunction Include:

  • Pelvic pain
  • Chronic constipation
  • Pain or difficulty using a tampon
  • Pain or difficulty having a pap smear in people with a vagina
  • Pain or difficulty with penetrative sex
  • Difficulty emptying the bladder
  • Frequent urination
  • Pain with sitting
  • Tailbone pain
  • Low back pain
  • Abdominal pain

Causes of Hypertonic Pelvic Floor Muscle Dysfunction

Hyperactive pelvic floor muscle dysfunction can have many root causes. Most people are unaware that they are clenching the pelvic floor muscles. Often the muscles respond reflexively by clenching or being overly active as a protective or guarding response to stress or perceived threat.

This phenomenon is similar to how some people clench their jaw or elevate their shoulders during times of stress resulting in headaches and neck pain. The pelvic floor muscles respond as an innate guarding response to protect the genitalia during a perceive threat as well.

When a person lives with chronic stress or in a threatening environment, these muscles can become hyperactive. Additionally, this condition can arise under more acute conditions such as after a surgery, illness, birth of a baby, lifestyle change, or a traumatic event.

Some people develop hypertonic pelvic floor muscle dysfunction after traumatic sexual events, or as a result of a believe system where sex is taught to be taboo or bad.

Overtime, the clenching behavior can cause the muscles to develop trigger points or tender points which can be painful and result in changes in how the muscle functions. These changes can alter the coordination during bowel movements or urination as well.

The good news is that hypertonic pelvic floor muscles can be treated. Pelvic physical therapy is a primary method of treatment. This specialized form of physical therapy addresses various issues with the pelvic floor and abdominal muscles.

People with hyperactive pelvic floor muscle dysfunction will receive a combination of specialized exercises for the pelvic floor, biofeedback, real time ultrasound, and manual therapy to help restore normal muscle function.

Additionally, tools may be used at home to help expedite the results and empower people to manage their symptoms independently. This may include tools such as Intimate Rose’s patented pelvic wand to treat trigger points, and dilators if penetration is difficult or painful.


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