How Sitting on Your Tailbone Could Be Worsening Your Pelvic Health, Period Pain, and Gut Symptoms

We’ve all heard that “sitting is the new smoking” - but what if I told you that long hours spent sitting, especially with poor posture or pressure directly on your tailbone, could be silently sabotaging your pelvic floor and worsening symptoms like bloating, painful periods, or even endometriosis-related flare-ups?

While we often associate sitting with stiff hips or back pain, many women don’t realise that it can also play a major role in pelvic floor dysfunction - and by extension, menstrual and digestive health. This blog explores how our daily sitting habits impact the pelvic floor, how this contributes to common women’s health concerns, and what you can do to protect and rehabilitate this crucial (but often ignored) part of your body.

 The Pelvic Floor: More Than Just a “Bladder Muscle”

Your pelvic floor is a dynamic sling of muscles, fascia, and ligaments at the base of your pelvis. It supports your internal organs - the bladder, uterus, and bowel - while also playing essential roles in posture, sexual function, continence, childbirth, and even breathing.

These muscles don’t work in isolation. They form a coordinated system with the diaphragm (your breathing muscle), the deep abdominal muscles (like the transverse abdominis), and the lower back muscles. Collectively, they stabilise your core and allow you to move through the world with strength and control.

But here’s where it gets interesting: the pelvic floor is also incredibly responsive to posture, movement patterns, and how you sit. Prolonged sitting - particularly on the coccyx (tailbone) or with a posteriorly tilted pelvis - puts the entire system under strain.

Over time, this can lead to muscle imbalances, reduced circulation, nerve compression, and loss of functional coordination.

Sitting on the Tailbone: Why It Matters

Many women unintentionally sit with a tucked pelvis - a slouched position that rolls the tailbone underneath the body and compresses the pelvic floor. This posterior pelvic tilt reduces the natural lumbar curve, (hello hunchback) limiting space in the pelvic bowl and decreasing activation of stabilising muscles.

A study published in Manual Therapy by O’Sullivan et al. (2012) demonstrated that poor sitting posture inhibits the activation of deep trunk muscles, including the pelvic floor. Over time, this leads to muscle weakening, poor tone, and an overreliance on compensatory patterns(1).

When we sit directly on the tailbone for extended periods:

• We compress the pudendal and sacral nerves, which innervate the pelvic floor and genital region.

• We restrict blood flow and lymphatic drainage, both of which are crucial for hormonal detoxification and inflammation resolution.

• We alter breath mechanics, reducing diaphragmatic movement and impairing the natural rise and fall of intra-abdominal pressure that stimulates pelvic floor mobility.

The result? A pelvic floor that is either underactive (lacking tone and strength) or overactive (tense, painful, and rigid) - both of which are considered forms of pelvic floor dysfunction (PFD).

Pelvic Floor Dysfunction: A Root Cause for Common Women's Health Issues

Pelvic floor dysfunction affects 1 in 3 women during their lifetime. But beyond the classic symptoms of bladder leaks or prolapse, PFD can contribute to:

• Chronic pelvic pain

• Painful periods (dysmenorrhea)

• Irritable bowel symptoms

• Pain with sex

• Tailbone pain (coccygodynia)

And yes - poor sitting posture can directly influence these symptoms.

The Clinical Signs You Might Be Experiencing PFD:

• A feeling of heaviness or dragging in the pelvis

• Trouble fully emptying your bladder or bowel

• Painful urination or constipation

• Lower back, hip, or SIJ tension that doesn’t resolve with stretching

• Sharp pain in the tailbone or deep inside the vagina or rectum when sitting

• Increased bloating or pressure when sitting for long hours

The Endometriosis & Pelvic Floor Link

Endometriosis is not just a hormonal condition - it’s a complex inflammatory and neuroimmune disease. One lesser-discussed consequence of endo is its profound effect on the pelvic floor.

Chronic pain, inflammation, and tissue scarring often cause the pelvic floor to enter a state of protective overactivity. Muscles may become tight, guarded, and hypertonic as a way to “brace” against pelvic pain - especially with deep infiltrating endometriosis or rectovaginal involvement.

A 2010 study in The Journal of Minimally Invasive Gynecology confirmed that pelvic floor hypertonicity is significantly more common in women with endometriosis, contributing to pain with sex, urination, and defecation (2).

This tight pelvic floor often goes undiagnosed, especially when the focus is only on hormonal suppression or surgical treatment. But sitting for long hours, particularly on an inflamed pelvic region, exacerbates muscle tension, pressure, and pain perception. It also worsens pelvic congestion - a key driver of heaviness and aching in the lower pelvis for women with endo.

How Poor Pelvic Function Makes Period Pain Worse

Even if you don’t have endometriosis, chronic sitting may still be contributing to period pain.

Menstrual cramps occur when the uterus contracts to shed its lining. But if the surrounding muscles - especially the pelvic floor - are tense, weak, or imbalanced, those contractions can feel more intense and less coordinated.

In a 2020 review published in Pain Reports, researchers found that women with primary dysmenorrhea often had altered lumbopelvic mechanics, including reduced spinal mobility and increased pelvic floor tension (3).

This isn’t just a muscular issue - it’s a circulatory one. Prolonged sitting restricts pelvic blood flow and lymphatic drainage. Since the uterus relies on oxygenated blood to regulate smooth muscle contractions, any disruption in flow can amplify cramping and fatigue.

A tight, compressed pelvic bowl also prevents the natural “descent” of the uterus during menstruation - a biomechanical detail that women often intuitively feel as “pressure” or “stuckness” in the lower belly.

IBS, Bloating, and the Pelvic Floor-Gut Connection

It’s well documented that pelvic floor dysfunction and digestive disorders frequently co-exist. In fact, many women with IBS-type symptoms (bloating, constipation, urgency, incomplete evacuation) are unknowingly dealing with pelvic floor coordination issues.

A 2019 study in Neurogastroenterology & Motility showed that nearly 50% of women with IBS also had impaired pelvic floor mechanics, particularly during defecation (4). For these women, the pelvic floor either failed to relax when trying to empty the bowel or engaged in paradoxical contraction, creating further pressure and retention.

Prolonged sitting worsens this by increasing intra-abdominal pressure, weakening core activation, and inhibiting the natural reflexes that promote gut motility - like diaphragmatic breathing, walking, or squatting.

Practical Tools to Support Your Pelvic Floor (Without Quitting Your Job)

Let’s face it - most of us aren’t about to quit our desk jobs or parenting roles to squat all day in the forest. But there arerealistic ways to support your pelvic floor and overall health, even if sitting is non-negotiable.

1. Improve Your Sitting Posture

Avoid slumping or tucking your pelvis. Sit with your sit bones grounded, feet flat, and spine upright. Your pelvis should be in a neutral tilt, not rolled under or flared forward.

Consider a coccyx cushion or wedge seat that takes pressure off your tailbone and allows your pelvic floor to “float” rather than compress.

2. Move Every 30–60 Minutes

Set a timer or use a standing desk. Even brief movement - a minute of walking, squats, or spinal rolls - can reinvigorate pelvic blood flow and relieve fascial tension. A study in Diabetes Care by Dunstan et al. (2012) showed that breaking up sitting significantly reduced inflammatory and circulatory stagnation (5).

3. Restore the Breath–Pelvic Floor Connection

Diaphragmatic breathing, where the belly expands and pelvic floor gently descends on the inhale, is a powerful tool to restore tone and relaxation.

Try 3–5 minutes daily of deep belly breathing or hypopressive breath work to reduce tension and improve pressure regulation through the core.

4. Tailored Pelvic Floor Exercises

Not all pelvic floors need Kegels - in fact, many women need to learn how to release rather than contract. A pelvic floor physiotherapist can assess your tone and teach you how to rehabilitate your specific dysfunction.

Especially if you have endo, IBS, or chronic bloating, your pelvic floor may need “down-training” to reset.

Your pelvic floor is a silent player in almost everything you do - from how you digest, bleed, move, and breathe, to how you feel in your body. And yet, for many women, it’s the first system to fall out of sync under chronic stress, pain, or poor posture.

If you’ve been struggling with period pain, endometriosis, IBS, or pelvic discomfort and no one has looked at how you're sitting - now is the time.

You don’t need to overhaul your whole life - but recognising the impact of your sitting habits, and supporting your pelvic floor with posture, breath, and movement, can be a game-changer in your long-term health.

References

1. O’Sullivan P, et al. (2012). Sitting posture affects deep trunk muscle activity. Manual Therapy.

2. Fenton BW, et al. (2010). Pelvic floor hypertonicity and endometriosis-related pain. J Minim Invasive Gynecol.

3. As-Sanie S, et al. (2020). Dysmenorrhea and musculoskeletal patterns. Pain Reports.

4. Chiarioni G, et al. (2019). Pelvic floor dysfunction in IBS. Neurogastroenterol Motil.

5. Dunstan DW, et al. (2012). Interrupting prolonged sitting reduces inflammation. Diabetes Care.