Why Your Pelvic Floor Matters Before You’re TTC (Trying to Conceive)

From the Desk of a Pelvic Floor Fertility Specialist...

When most people think about fertility, they immediately picture hormones, ovulation trackers, and nutrition—but one powerful piece of the puzzle often goes overlooked: your pelvic floor.

As a pelvic floor physical therapist with a focus on fertility, I work with individuals and couples who are preparing their bodies for conception. And one thing is clear—the health and function of your pelvic floor can either support or interfere with your ability to conceive. Let’s talk about why.

First, What Is the Pelvic Floor?

The pelvic floor is a group of muscles, ligaments, and connective tissue at the base of your pelvis. These muscles support your reproductive organs (uterus, ovaries), bladder, rectum, and also play a huge role in sexual function, circulation, lymphatic flow, and even hormone regulation.

Why Pelvic Floor Health Matters for Fertility

Here are some key ways your pelvic floor can impact your fertility:

1. Blood Flow to the Reproductive Organs

Healthy pelvic floor muscles allow for optimal circulation. When the muscles are too tight (hypertonic) or weak (hypotonic), blood flow to the uterus and ovaries can be compromised, which may affect the quality of the

endometrial lining and ovarian function—both key for conception.

2. Alignment and Mobility

The uterus doesn’t exist in isolation. It sits within a dynamic system of fascia, ligaments, and muscles. If there's tension or misalignment in the pelvis (from old injuries, poor posture, chronic constipation, or past trauma), it can reduce the mobility of the uterus and fallopian tubes. This can interfere with implantation or egg/sperm transport.

3. Nervous System Regulation

Chronic pelvic tension is often linked with a dysregulated nervous system. When your body is stuck in a stress response (fight-or-flight), it deprioritizes reproductive function. Pelvic floor therapy includes hands-on work and breath practices that support a parasympathetic (rest-and-digest) state—ideal for conception.

4. Addressing Scar Tissue or Adhesions

A history of abdominal or pelvic surgeries (like laparoscopy, C-sections, or appendectomies), infections, or endometriosis can lead to adhesions that restrict tissue movement and impair organ function. A pelvic PT can work manually to reduce adhesions and improve tissue mobility.

5. Sexual Function & Pain

Pain with sex, vaginal dryness, or inability to orgasm may be signs of pelvic floor dysfunction. These issues not only impact quality of life but can interfere directly with conception—especially if penetrative intercourse is painful or avoided.

What Does a Pelvic Floor Fertility Assessment Include?

When you come in for a preconception pelvic floor assessment, we look at the full picture:

• Internal and external pelvic floor muscle evaluation: Are muscles too tight, weak, or coordinated?

• Postural and breathing patterns: How is your core and diaphragm functioning?

• Abdominal and pelvic organ mobility: Can your uterus, bladder, and bowel move freely?

• Visceral and fascial restrictions: Are there areas of stuck tissue from prior injury or inflammation?

• Stress response and vagus nerve tone: Is your nervous system supporting or sabotaging fertility?

How Pelvic Floor Therapy Can Support Fertility

Here are some common interventions we use:

• Manual therapy to release tight pelvic floor muscles or abdominal adhesions

• Visceral mobilization to improve uterine and ovarian mobility

• Breathwork and core retraining to improve circulation and regulate the nervous system

• Neuromuscular re-education to improve coordination and strength

• Education and support around posture, toileting, sexual health, and lifestyle changes

• Partner involvement when needed, especially in addressing sexual pain or mechanical factors in conception

When Should You See a Pelvic Floor PT?

If you're planning to start trying in the next 3–12 months, now is the time to invest in your pelvic health.

You don’t have to have symptoms to benefit—many of my fertility clients come in simply to optimize their body for conception and improve their chances of a smooth pregnancy.

But if you have any of the following, pelvic floor therapy is especially important:

• Irregular or painful periods

• Pain with sex or tampons

• History of abdominal or pelvic surgery

• Endometriosis or PCOS

• Recurrent UTIs or yeast infections

• Digestive issues like constipation or bloating

• Fertility struggles without clear cause

You Deserve a Whole-Body Fertility Approach

Your journey to conception deserves more than just hormones and test results. You deserve care that looks at the full you—your tissues, your alignment, your stress patterns, your breath, your history.

If you're curious about how pelvic floor therapy can support your path to parenthood, I’d love to connect.