đ Key Themes:
* Bladder issues in midlife arenât just about Kegels, surgery, or medication.
* The root cause is often dysregulation in the autonomic nervous systemâespecially chronic fight-or-flight activation.
* Pelvic floor muscles are deeply connected to nervous system function, not just mechanical strength.
đ§ The Nervous System Connection:
* The pelvic floor is innervated by the autonomic nervous system, which has two branches:
* Sympathetic (fight or flight): sends resources to the heart, lungs, and big muscles.
* Parasympathetic (rest and digest): nourishes the pelvic and abdominal organs.
* When women live in chronic stress mode, the sympathetic system dominates, which disrupts bladder function even if the bladder itself is healthy.
đ©ș Common Causes of Pelvic Floor Dysfunction:
* Childbirth (pregnancy, labor, delivery)
* Chronic constipation
* Chronic coughing
* Chronic stress and nervous system overdrive
đ§ââïž Bladder Urgency Isnât About a Full Bladder:
* Many women feel a strong urge to pee (like rushing from the car to the bathroom) even when the bladder isnât full.
* This urgency is nervous system-driven, not about bladder capacity.
* The feeling of âIâm not going to make itâ is a behavioral and neurological response, not a small bladder.
đ Nighttime Urination (Nocturia):
* Getting up to pee multiple times at night is often a sign of nervous system arousal, not fluid intake.
* Simply telling women to âstop drinking before bedâ misses the root cause.
đ§ đȘ What Helps:
* Retraining the nervous system to feel safeâthrough movement, breath, body awareness.
* Exercises and practices that target the nervous system-pelvic floor connection.
* Recognizing and addressing chronic sympathetic dominance even after life âshouldâ be calmer (like after the kids grow up).