“Just Do More Core” Might Be Making It Worse

Have you ever noticed that the moment you're about to give a presentation, board a plane, sit an exam, or leave the house, you suddenly need to go to the toilet? You might go... and then five minutes later, you feel like you need to go again. If this sounds familiar, you're not imagining it. For many people, anxiety and urinary urgency go hand in hand. While anxiety doesn't cause every bladder problem, it can have a significant impact on how your bladder and pelvic floor function. The good news? Understanding this connection can be the first step towards regaining confidence and breaking the cycle. What is urinary urgency? Urinary urgency is a sudden, strong need to urinate that can be difficult to ignore. Some people describe it as: "I have to find a toilet immediately." "The urge comes out of nowhere." "I panic if I don't know where the nearest bathroom is." "I keep going 'just in case.'" Urgency may occur with or without bladder leakage and can affect people of all ages. Can anxiety really affect your bladder? Yes. Your brain and bladder are in constant communication. As your bladder fills, it sends messages to your brain. Your brain then decides whether it's the right time and place to empty your bladder or whether it should wait. When you're anxious or under stress, this communication can become more sensitive. You may notice bladder sensations earlier or more intensely, even when your bladder isn't actually full. This doesn't mean the symptoms are "all in your head." It means your nervous system is playing an important role in how you experience bladder signals. What happens in the body during anxiety? When you feel stressed or anxious, your body activates its "fight or flight" response. You might notice yourself: breathing more quickly clenching your jaw tightening your shoulders holding tension in your stomach gripping your pelvic floor without realising it. Over time, this persistent muscle tension can affect how your pelvic floor coordinates with your bladder. For some people, this contributes to urgency, frequency or difficulty fully relaxing when it's time to empty the bladder. The "just in case" toilet habit One of the most common behaviours we see is preventative toilet trips. Perhaps you: always wee before leaving home use the toilet every time you pass one go "just in case" before a meeting empty your bladder multiple times before bed. It feels reassuring in the moment. However, regularly emptying your bladder before it's truly full can sometimes train it to signal the need to urinate at lower volumes. Over time, this may contribute to more frequent urges. When urgency becomes a cycle Urinary urgency and anxiety can sometimes reinforce one another. It often looks something like this: You experience a sudden urge to urinate. You become worried you won't make it to a toilet. Your anxiety increases. Your muscles tense and your nervous system becomes more alert. The urge feels even stronger. Breaking this cycle isn't about ignoring your bladder—it's about helping your brain, bladder and pelvic floor communicate more effectively again. Is it only anxiety? No. Urinary urgency can have many different causes, including: overactive bladder urinary tract infections (UTIs) constipation pelvic floor dysfunction pregnancy perimenopause and menopause certain medications neurological conditions excessive caffeine or fluid intake. That's why it's important not to assume anxiety is the only explanation. A thorough assessment helps identify the factors contributing to your symptoms. How can a pelvic floor physiotherapist help? A pelvic floor physiotherapist looks at the whole picture—not just your bladder. Your assessment may include: pelvic floor muscle function muscle relaxation and coordination bladder habits fluid intake bowel health breathing patterns movement and posture lifestyle factors that may influence symptoms. Treatment may include: bladder retraining pelvic floor relaxation strategies breathing techniques urge suppression techniques education about healthy bladder habits strategies to reduce unnecessary muscle tension. If your symptoms suggest another underlying condition, your physiotherapist may recommend further assessment with your GP or another healthcare professional. Frequently Asked Questions Can anxiety cause urinary urgency? Anxiety can increase your awareness of bladder sensations and influence how your bladder and pelvic floor function. While it may contribute to urgency for some people, it's important to rule out other medical causes before assuming anxiety is the sole reason. Why do I always need to pee before leaving the house? This is often called "just in case" weeing. While it may seem helpful, regularly emptying your bladder before it's full can contribute to increased urgency over time. A pelvic floor physiotherapist can help you develop healthier bladder habits. Can pelvic floor physiotherapy help urinary urgency? Yes. Pelvic floor physiotherapy is an evidence-based treatment for many people with urinary urgency. Treatment is tailored to the individual and may include bladder retraining, pelvic floor muscle training or relaxation, breathing strategies and education about bladder habits. The Bottom Line If your bladder seems to have a mind of its own whenever you're stressed, you're not alone. The connection between anxiety, the nervous system and the pelvic floor is real—but that doesn't mean your symptoms are "just anxiety." With the right assessment, it's often possible to identify the factors contributing to your urgency and develop practical strategies to improve bladder control and confidence. You don't have to plan your life around the nearest toilet. If urinary urgency is affecting your work, travel, exercise or daily routine, our pelvic health physiotherapists can help you understand what's driving your symptoms and create a personalised plan to help you feel back in control.

Having trouble getting or keeping an erection? You’re not alone, and it’s not always just about blood flow or hormones. Your pelvic floor muscles play an important role in helping you achieve and maintain an erection. If these muscles are weak, too tight or not working together properly, they may be contributing to the problem. The good news? Pelvic health physiotherapy may help improve how these muscles work and support better erectile function. How does your pelvic floor affect erections? Your pelvic floor is a group of muscles at the base of your pelvis. They help support your bladder and bowel, but they also play a role in sexual function. During an erection, these muscles help maintain firmness by supporting the mechanisms that keep blood in the penis. If your pelvic floor muscles aren't working as they should, you may find it harder to get or maintain an erection. This can happen when the muscles are: Too weak: They may not contract effectively to help maintain an erection. Too tight: Constant tension can interfere with normal muscle function and relaxation. Poorly coordinated: The muscles may struggle to contract and relax at the right time. It's important to remember that not all pelvic floor problems are caused by weakness. Sometimes, the muscles need to learn to relax rather than become stronger. Could your pelvic floor be contributing to ED? You might benefit from a pelvic floor assessment if you experience: Erections that become soft or don't last as long as you'd like. Difficulty maintaining an erection despite feeling aroused. Pain or tension around your pelvis, perineum or testicles. Urinary symptoms, such as urgency, frequency or difficulty emptying your bladder. Symptoms that seem worse when you're stressed or physically tense. Changes in erectile function following prostate surgery. Erectile dysfunction can have several causes, including vascular, hormonal, medication-related and psychological factors. Your pelvic floor may be one piece of the puzzle. How can pelvic health physiotherapy help? A pelvic health physiotherapist can assess how your pelvic floor muscles are working and develop a treatment plan tailored to your needs. Depending on your assessment, treatment may include: Targeted exercises: To improve muscle strength, control and coordination when needed. Relaxation techniques: To help release tension if your pelvic floor muscles are overactive. Hands-on treatment: Where appropriate, to address muscle tension and discomfort. Breathing and movement strategies: To help your pelvic floor work more effectively with your breathing and core. Practical lifestyle advice: Including ways to manage activities or habits that may be contributing to your symptoms. Your physiotherapist can also work alongside your GP or urologist to address other factors contributing to erectile dysfunction. The aim isn't simply to strengthen your pelvic floor. It's to help your muscles work the way they should. Frequently Asked Questions Can pelvic floor physiotherapy help with erectile dysfunction? It can. Research suggests that pelvic floor muscle training may improve erectile function in some men, particularly when muscle weakness or poor coordination is contributing. Results vary, and physiotherapy isn't the right solution for every cause of ED. Can pelvic floor exercises make things worse? If your pelvic floor muscles are already too tight, doing lots of strengthening exercises may increase tension or discomfort. That's why an assessment is important before starting a program. How long does it take to see results? Some men notice improvements within 6–12 weeks of consistent, appropriate treatment. However, progress varies depending on the cause of your symptoms and your individual circumstances. Can I do pelvic floor exercises at home? Yes, but it's helpful to know which muscles need attention and how to use them correctly. A physiotherapist can show you the right technique and whether strengthening, relaxation or a combination of both is best for you. Should I still see my GP? Absolutely. Erectile dysfunction can sometimes be an early sign of an underlying health issue, including cardiovascular disease or diabetes. Your GP can help investigate possible causes, and pelvic health physiotherapy may complement any medical treatment you need. The Bottom Line Erectile dysfunction isn't always just a blood-flow problem. Your pelvic floor muscles may also play a role in how well you achieve and maintain an erection. Whether your muscles need strengthening, relaxing or better coordination, pelvic health physiotherapy may help. You don't have to figure it out on your own. Our pelvic health physiotherapists can help you understand what's happening, work out whether your pelvic floor is contributing, and develop a plan that suits your needs. If you're experiencing ongoing erectile difficulties, speak with your GP and consider whether a pelvic floor assessment could be part of your next step.

Still leaking when you sneeze, run, jump or laugh years after having children? You might have been told it's "just part of having kids." It may be common, but that doesn't mean you have to live with it. Why does leaking happen after childbirth? Pregnancy and childbirth place significant demands on your pelvic floor. Changes can affect the muscles, connective tissues and the way your pelvic floor works with your breathing and abdominal muscles. You may notice leaking when you: Cough or sneeze Run or jump Exercise Lift something heavy Laugh Suddenly need to empty your bladder But leaking doesn't automatically mean your pelvic floor is simply "weak." Sometimes the issue is strength. Other times it's coordination, timing, muscle tension, bladder habits or how your body manages pressure. "But my kids are years old..." It's never too late to address pelvic floor symptoms. You may have adapted by wearing pads, avoiding running or jumping, crossing your legs when you sneeze, or always finding a toilet before leaving the house. These things can become so normal that you forget they're symptoms. You shouldn't have to organise your life around your bladder. What can help? A pelvic health physiotherapist can assess what's contributing to your leakage and develop a treatment plan based on your symptoms and goals. This may include pelvic floor muscle training, breathing and pressure management, bladder strategies, strengthening and movement retraining. And no — it's not always as simple as "just do more Kegels." The bottom line Having children can explain why your symptoms started. It doesn't mean you have to accept them forever. Whether your youngest is six months old or 16 years old, pelvic floor symptoms are worth assessing. If you're leaking after having children, talk to a pelvic health physiotherapist. You don't have to put up with it.