autoimmune disease and pelvic health: the link we can’t ignore
If you’ve ever wanted to ask a question about pelvic symptoms, whether out loud or typed into a support group, but felt the need to start with:
“Sorry in advance for TMI…”
“This is really embarrassing, but…”
“I hope it’s okay to ask…”
“Please don’t be offended, but…”
You’re not alone.
I see this pattern all the time — with patients, in support groups, and on social media. When symptoms become unbearable, curiosity and frustration often spill over, and the question comes out:
“Does anyone else have [insert pelvic symptoms here]?”
That might mean bladder urgency, tailbone pain, vaginismus, pain with sex, incontinence, or even tears during a pelvic exam that brought on both pain and anxiety.
And almost always, especially in groups focused on chronic pain or autoimmune disease, the post or conversation ends with something like:
“Please tell me I’m not the only one. Does this have anything to do with my [insert autoimmune condition here]?”
This cycle of embarrassment and loneliness might not feel so heavy if we talked more openly about the connection between autoimmune disease and pelvic health.
You’re Not Imagining It: Pelvic Symptoms and Autoimmune Disease Are Connected
If you’ve wondered whether your pelvic symptoms might be tied to your autoimmune condition, the answer is yes. There’s a connection. One doesn’t always cause the other, but they can be linked.
Pelvic floor symptoms can feel like a mystery guest at a party you never invited. Why did they suddenly show up? The truth is, they are influenced by your immune system, inflammation, hormones, and stress responses. Once your pelvic floor gets involved, symptoms can ripple into nearly every part of daily life: how you go to the bathroom, intimacy, or even just sitting comfortably through the latest Netflix binge. Your pelvic floor really knows how to make its presence felt.
Why Your Pelvic Health Really Matters
Your pelvic floor is more than a set of muscles you can exercise. It’s a whole network of muscles, nerves, and connective tissue that supports your bladder, bowel, and reproductive organs. Everyone’s anatomy and experience can be different, but these structures play a key role in core strength, posture, and how your body handles stress. Autoimmune conditions can stir up inflammation, change connective tissue, shift hormones, and sometimes influence how medications affect your system. All of these factors create an environment where pelvic floor issues can appear, sometimes subtly and sometimes in ways that are uncomfortably obvious.
What feels like a random pelvic symptom—pain, urgency, heaviness, or tension—is often connected to the bigger picture of your health and signals that your body and mind need attention and care.
Inflammation, Hormones, and More: What’s Really Happening Down There
Autoimmune conditions don’t just target one part of the body. They can influence your whole system, which is why pelvic concerns often show up alongside other autoimmune challenges.
Here’s why that can happen:
Inflammation: During flares, inflammation through the body is often increased. That inflammation can irritate nerves, muscles, and tissues in the pelvic region, leading to pain, tension, or urgency.
Connective tissue changes: Autoimmune conditions often affect connective tissue, like ligaments and tendons, which provide support and elasticity. If these tissues become too tight, too loose, or inflamed, pelvic floor dysfunction can sneak in.
Hormonal shifts: Many autoimmune conditions are more common in women and are influenced by hormonal changes during menstruation, pregnancy, or menopause. Hormones affect both immune activity and pelvic tissue health, which means pelvic symptoms can fluctuate at different times in your cycle or life.
Medications: Steroids, immunosuppressants, and other treatments can impact fluid balance, tissue healing, or bowel and bladder habits, sometimes adding another layer to pelvic floor challenges.
Mental health and activity levels: Chronic pain, fatigue, and stress associated with autoimmune conditions can affect pelvic floor function. Anxiety or tension can increase muscle tightness, while reduced activity or movement due to pain can contribute to weakness or coordination challenges, making pelvic symptoms more noticeable.
The big picture: Autoimmune conditions shape the environment your pelvic floor lives in. They can change how tissues respond, heal, and communicate, which can show up in ways you might not expect.
Spotting the Signs: Pelvic Symptoms to Watch For
Pelvic floor symptoms, like autoimmune conditions, don’t all look the same. Some people notice one symptom, others a mix that shifts depending on flares, stress, or hormones.
Here are some of the more common ones I see:
Urinary urgency or leakage — feeling like you have to go right now or leaking when you cough, sneeze, or exercise. People often say, “I feel like my bladder has a mind of its own.”
Bowel changes — Trouble going, straining, swinging between constipation and diarrhea, or even losing control entirely.
Pelvic fullness or prolapse — A sense of heaviness, pressure, or a bulge in the pelvic region. Some describe it as a “falling out” feeling.
Pain with intimacy — sensations of discomfort, tightness, or pressure during sexual activity, closeness, or other intimate contact that involve the pelvic floor.
Pelvic pain — Aching, burning, or sharp discomfort in the pelvic region, which can come and go or be constant.
Take Action: Support Your Pelvic Health Today
Pelvic health is essential for your overall well-being. Symptoms might not show up on lab results, but they are real and deserve attention. Autoimmune disease affects the whole body, and that can include the pelvis—even if no one has asked you about it directly.
Here’s what you can do today:
Speak Up About Pelvic Symptoms
Tracking your symptoms and sharing them with your healthcare providers can make a real difference. If you have an autoimmune condition and pelvic symptoms, don’t ignore them. The sooner you bring them up, the sooner you can get the care you deserve.Find the Right Pelvic Health PT/OT
Look for someone experienced in autoimmune conditions and trauma-informed care. I offer free discovery calls to help figure out if pelvic floor therapy is right for you. Most treatments work best in person, though some can be addressed via telehealth. I can also help point you to trusted local providers if you need in-person care. There are many passionate, skilled PTs and OTs out there ready to help.Start Gentle and Listen to Your Body
You don’t need a perfect plan to begin. Body awareness, pelvic floor breathing, and guided self-check-ins are all great first steps. I’ll be adding trauma-informed, beginner-friendly videos to my YouTube channel to safely support pelvic health, even during flare-ups.
Join a Community That Gets It
Shame and isolation can make symptoms worse. Simply connecting with others who “get it” can reduce stigma and improve outcomes. That’s why I created my Circle community — a supportive space to talk openly about autoimmune disease, pelvic health, chronic pain, and more.Empower Yourself: Learn More and Take Control
Knowledge is power. Understanding how autoimmune conditions affect your pelvic floor, learning self-care strategies, and hearing others’ stories can help you feel more confident in navigating your health. There are plenty of free resources out there to explore!
Your Body Has a Story to Tell
Pay attention to it, honor it, and take small steps toward care and support. With awareness, gentle actions, and connection to others, you can feel better in ways that truly matter.
I know it’s not always simple, but simply beginning to acknowledge the link between autoimmune health and your pelvic floor is a powerful first step. Congratulations on taking it 🥳