Did You Know That Chronic Health Conditions May Affect Your Pelvic Health?

Pelvic floor dysfunction is rarely just about the pelvis. For many patients, it’s part of a much bigger picture involving complex, chronic health conditions such as Ehlers-Danlos Syndrome (EDS), Postural Orthostatic Tachycardia Syndrome (POTS), Mast Cell Activation Syndrome (MCAS), Lyme disease and Thyroid Disorders. Chronic conditions often co-occur, and while each affects the body in a different way, they share a common thread - they place unique and significant stress on the pelvic floor.

EDS is a connective tissue disorder that affects collagen—the protein that gives strength and structure to skin, joints and organs. Pelvic floor symptoms include:

●      Joint hypermobility: pelvic joints may be overly mobile, affecting core and pelvic floor stability.

●      Prolapse risk: ligament laxity increases the risk of pelvic organ prolapse.

●      Muscle compensation: weak or unstable structures often lead to muscle overuse or guarding, contributing to pelvic pain and dysfunction.

Patients with EDS often present with urinary urgency, incontinence, pelvic pressure, and/or pain with sitting, sex or bowel movements. Treatment requires a gentle, stability-focused approach that respects tissue fragility.

POTS is a form of dysautonomia. The nervous system doesn’t regulate blood flow or heart rate properly. Common symptoms include dizziness, fatigue, and GI distress—many of which intersect with pelvic floor dysfunction:

●      Deconditioning and poor core activation can weaken the pelvic floor.

●      Breathing pattern dysfunction, common in POTS, can disrupt coordination between the diaphragm and pelvic floor.

●      Constipation and pelvic pain often result from autonomic dysregulation.

Therapy includes breath retraining, graded activity, and gentle mobilization to improve circulation and autonomic stability.

MCAS is a condition in which mast cells release inflammatory mediators too easily, often in response to triggers like stress, exercise, foods or chemicals. In the pelvic floor, this can manifest as:

●      Interstitial cystitis/bladder pain syndrome (IC/BPS)

●      Vulvar and vaginal burning or itching without infection

●      Pain with urination or intercourse

MCAS-related inflammation can make pelvic tissue hypersensitive and reactive. At Solstice we are trained to use hands-on treatment carefully, incorporate lymphatic drainage, and recommend supportive self-care strategies to calm mast cell flares.

Chronic Lyme Disease can inflame nerves and muscles, leading to pain syndromes, fatigue and pelvic floor dysfunction. Symptoms may include

●      pelvic myofascial pain,

●      neuralgia (nerve pain) affecting the vulva, rectum or perineum,

●      sexual dysfunction and bladder irritation.

Inflammatory processes in Lyme disease can mimic or trigger pelvic pain syndromes like Interstitial Cystitis or Vulvodynia. A trauma-informed, nervous-system-awareness approach helps manage pain in these patients.

Thyroid Disorders, such as hypothyroidism or hyperthyroidism, affect every organ system—including the pelvic floor:

●      Sluggish digestion and constipation (especially in hypothyroidism) place pressure on the pelvic floor.

●      Fatigue and low muscle tone reduce the ability to support core structures.

●      Hormonal imbalance affects tissue elasticity and healing.

Patients with thyroid dysfunction often benefit from a multidisciplinary approach—we work closely with endocrinologists, nutritionists and functional medicine providers when needed. A complete thyroid blood test panel is key in determining how your thyroid is affected and how to manage symptoms.

TSH alone does not tell the full story - request a comprehensive thyroid panel, which includes TSH (thyroid-stimulating hormone), Free T4, Free T3, Reverse T3, and thyroid antibodies. This may require a bit of advocacy, so be clear and explain your symptoms to your doctor. Some labs allow you to order tests directly — just be sure to work with a provider to interpret results safely. 

Why Pelvic Floor Physical Therapy Matters

Pelvic floor dysfunction in these conditions is systemic - not just mechanical. At Solstice Physiotherapy, we:

✅ understand the complex relationship between chronic illness and pelvic health,
✅ offer trauma-informed, nervous-system-regulating care,
✅ build individualized plans that prioritize pacing, safety, and autonomy,
✅ collaborate with your broader medical team.

We take an individualized, trauma-informed, and system-aware approach to pelvic health. Your therapy plan is customized based on medical history, current symptoms, and how you respond to treatment.

You can expect:

●      Comprehensive evaluation

●      Breathwork and nervous system regulation

●      Manual therapy if appropriate

●      Movement and strengthening program

●      Bladder and bowel retraining

●      Flare management

●      Multidisciplinary approach

You Are Not Alone

Have you been told that your pain is “just in your head”? Know this - We believe you. Your symptoms are real. Your experience is valid. And your pelvic health matters. Let us help you find a path forward—one that’s informed, respectful, and attuned to the complexity of your body.

At Solstice Physiotherapy, we specialize in pelvic health and support individuals in maintaining a strong and healthy pelvic floor. Stay informed. Be proactive.

Contact Solstice Physiotherapy at (929)269-2505 or at info@solsticept.com to schedule a free 15-minute consultation to discuss your personal concerns and questions.

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Georgina Genovese