Stop Calling It Stress. Your Body Has a More Specific Diagnosis.

By Dr. LaSonya Lopez, MD | Physical & Pelvic Health | 5 min read

A woman previously sat in my exam room and told me she'd been "stressed" for about two years. That was the word she used. Stressed. She said it the way most women say it, like it's a weather pattern, something that just happens to you and eventually passes. I asked her one question. When did the bladder issues start?

She got quiet for a second. Then she said, right around the same time. Same two years.

That's not a coincidence. That's anatomy. And "stress" is the word we use when we don't want to look at what's actually happening in the body.

Here's the real talk, as a urogynecologist. Your pelvic floor is a muscle group, same as your shoulders or your jaw. And like any muscle group under chronic pressure, it doesn't just sit there and take it quietly. It braces. Chronic stress keeps your nervous system in a low-grade state of guarding, and the pelvic floor is one of the first places that guarding shows up, tightening instead of resting, holding instead of releasing, staying switched on when it should be able to switch off.

That bracing is not abstract. It has a specific list of symptoms, and I want you to actually hear them instead of filing them under "stress":

Urinary urgency or frequency that's crept up over time. A feeling that you're not fully emptying your bladder, even right after you go. Pelvic pain or pressure that doesn't have an obvious cause. Low back pain that shows up alongside the pelvic symptoms, not separately from them. Pain with intercourse that wasn't there before. Constipation that's become the norm instead of the exception.

If two or more of those have been true for you over the same stretch of time you've been calling "stressed," that's not a coincidence either. That's a pelvic floor that has been bracing for longer than it was built to.

I'm not telling you this to scare you. I'm telling you because "stress" as a catch-all lets you skip the specific question, which is: has my pelvic floor actually had a chance to rest in the last however-many months, or has it been quietly holding a position the whole time.

So here's your deliverable, and it's three parts, all quick.

Part one — notice, don't diagnose. The next time you use the bathroom, pay attention to three things: are you having to push or strain, does it feel like you've fully emptied, is there any pain or pressure. Don't judge it. Just notice it. That's data you didn't have yesterday.

Part two — one stretch. Kneel on the floor, then sit your hips back toward your heels. Reach your arms forward and let your forehead rest on the ground, or on a pillow if that's more comfortable. Let your knees fall open slightly wider than your hips. Stay there for sixty seconds and just breathe normally, no forcing anything. This is child's pose, and it does something specific: it gently lengthens the pelvic floor instead of asking it to actively do anything. A muscle that's been chronically braced doesn't always respond to being told to relax. Sometimes it responds better to being physically stretched into a longer position and given a minute to stay there. This is one of the first things you can actually do to show the muscle what "longer" feels like before you can teach it to get there on its own.

Part three — fix how you're sitting on the toilet. This one sounds small and it is not. If you've ever hovered over a public toilet instead of sitting, or you sit with your feet flat and knees lower than your hips, your pelvic floor cannot fully release, and you end up straining to empty or not emptying completely. Here's the fix a pelvic floor PT would actually give you: when you sit down, put your feet up on something, a small stool, a stack of books, anything that gets your knees higher than your hips. Lean your torso slightly forward. Let your belly relax completely. Do not hold your breath or push from your throat. That position straightens the angle your body needs for your pelvic floor to actually let go, instead of fighting itself the entire time. And stop hovering. Every time you hover instead of sit, you're asking a muscle group to stay contracted and empty your bladder at the same time, which is exactly the kind of conflicting instruction that trains a pelvic floor to stay braced long after you've left the bathroom.

If what you noticed in part one has been going on for months, or if it's affecting your daily life, that's not something to sit with indefinitely. That's a conversation with a urogynecologist or a pelvic floor physical therapist, and I'd rather you have it now than two more years from now, still calling it stress.

Your body has never once been vague. We're the ones who've been avoiding the specifics.