If things feel a little more sluggish and less regular now the cold has arrived, you’re not imagining it. Constipation genuinely does creep up in winter – and the link between constipation and your pelvic floor is important. The good news is that a few simple changes can make a real difference.
Let’s look at why winter slows your bowels, why it matters more than you might think, and what actually helps.
Why winter slows your bowels
A few ordinary seasonal changes gang up on your digestion at this time of year.
- You drink less water. In the cold you simply don’t feel as thirsty, so you drink less – but your body needs fluid. Lower fluid intake may mean harder, drier stools that are more difficult to pass.
- You eat less fibre. Winter food leans towards warming comfort meals and away from fresh fruit and salads. That can mean less fibre, which is what’s needed to keep things moving.
- You move less. Cold, dark days make it tempting to stay put – and moving less slows the gut down. Physical activity really helps your bowel function.
- You put off going. On a freezing morning it’s tempting to ignore the urge and stay warm. But delaying lets stool sit longer in the bowel, drawing out more water and becoming harder – and the urge itself fades if it’s repeatedly ignored.
How constipation and your pelvic floor are connected
Here’s the reason a pelvic health physio takes constipation so seriously:
When you’re constipated, it’s tempting to strain: to hold your breath and bear down hard to get things moving. Repeated straining pushes down on your pelvic floor and its supporting structures. Such straining is a well-recognised risk factor for pelvic organ prolapse – where the bladder, bowel or uterus lose some of their support and press into the vaginal wall. In other words, repeated straining on the toilet really matters for your long-term pelvic health. If you think you may have a prolapse, check our post on how physiotherapy can help with prolapse.
A loaded, backed-up bowel can also contribute to bladder urgency – that sudden “got-to-go-now” feeling. The rectum sits right behind the bladder, and when the rectum hasn’t been emptied, it can cause an irritable, urgent bladder. So keeping things regular isn’t only about comfort; it takes pressure off the whole system. See our blog to find out more about urgency and urge incontinence.
Pelvic floor tightness and constipation
Sometimes the cause of constipation can be tightness of the pelvic floor muscles, or a failure of the right muscles to relax at the right time. So you may get the urge to go, and then not be able to. Pelvic floor physios are able to assess and see if this is the issue. The treatment is different when your muscles are tight.
How to stay regular this winter
The reassuring part: the basics are simple, and they work.
- Keep your fluids up. Warm drinks help – a warm drink can be soothing and help move things through the digestive system.
- Don’t let your fibre drop. You don’t have to eat cold salads to get fibre in winter. Porridge and oats, hearty vegetable soups, roast vegetables, wholegrains, beans and lentils, and fruit like pears and kiwifruit all keep fibre up.
- Keep moving. A daily walk, some gentle movement, or a stretching routine can all help your gut to keep moving. A little movement after meals is especially helpful. Gyms are a good option in winter too, when the weather is bad.
- Answer the call promptly. When you feel the urge, go – don’t hang on or you may lose the opportunity. Your bowel tends to be most active in the morning and after meals, so take advantage of that if you get the urge to go.
Pelvic floor tips for emptying the bowel
Small changes to how you sit on the toilet that protect your pelvic floor and make things easier:
- Don’t strain. Holding your breath and forcing down hard puts a lot of pressure on your pelvic floor, and pelvic organs. If it’s not happening, it’s better to get up and come back later than to push hard.
- A squat like position. Sitting on the toilet, lean forward from the hips (keeping your back straight) and put your elbows on your knees OR place your feet on a small stool so your knees are higher than your hips. These techniques change the angle of the bowel, allowing the right muscles to relax, making it much easier to empty.
- Bulge your tummy outwards. Let your tummy relax and bulge gently outwards. The idea is to open and let go, not to clench and force.
These small tweaks take the strain off your pelvic floor and make emptying easier.
When to get it checked
If constipation is persistent, if you’re straining regularly or you feel you can’t empty properly, it’s worth seeking help. Constipation that affects the bladder, or causes a sense of pressure or heaviness “down below,” also needs to be sorted, rather than just soldiering on.
If anything about your bowels has changed noticeably, it’s worth a check-in with your GP. A pelvic health physio can help with bowel problems too – assessing how your pelvic floor is working, teaching you how to empty without straining, and sorting out habits that protect your pelvic floor long term. (We’ll be sharing a fuller guide to bowel health soon – this is the seasonal snapshot.)
Ready to feel more comfortable this winter?
You don’t have to put up with feeling blocked-up and sluggish in winter – or with straining in a way that isn’t doing your pelvic floor any favours. A pelvic health assessment can sort out issues with constipation and your pelvic floor and show you exactly what will help.
Our team here in Wellington works exclusively in pelvic health, for all genders, so this is what we do every day – with care and discretion. Get in touch to book an assessment.
Frequently Asked Questions
Why do I get more constipated in winter?
Winter quietly changes a few habits that may affect your bowels. You feel less thirsty so you drink less water, which makes stools harder and drier. Comfort food tends to replace fresh fruit and salads, so fibre drops. You move less in the cold, which slows the gut. And on freezing mornings it’s tempting to ignore the urge to go – but delaying lets stool sit longer and harden. Put together, these make constipation much more common in the colder months.
Are constipation and your pelvic floor related?
Yes. When you’re constipated it’s tempting to strain, and chronic straining is a well-recognised risk factor for pelvic organ prolapse, where the pelvic organs lose some of their support. It’s also important that the pelvic floor isn’t overly tight as that can also cause issues with emptying. Having good, coordinated and strong pelvic floor muscles, that relax well, can help you empty better.
Does constipation affect your bladder?
A full bowel can contribute to bladder urgency, because a loaded rectum presses on the bladder behind it. One of the first things to check if you’re having to rush to the toilet to empty your bladder is whether you are constipated.
What’s the best position to go to the toilet?
Resting your feet on a small stool, or sitting with your elbows on your knees puts you in a more natural, squat-like position that makes stool easier to pass. Lean forward from the hips, with your back straight, let your tummy relax and bulge gently outwards, and breathe rather than hold your breath. The idea is to relax and let go, not to clench and force.
When should I see someone about constipation?
If constipation is persistent, if you’re straining regularly, if you feel you can’t empty properly, or if it’s affecting your bladder or causing a sense of pressure or heaviness, it’s worth getting it checked rather than soldiering on. A pelvic health physio can assess how your pelvic floor is working and teach you how to empty without straining. If anything about your bowels has changed noticeably, it’s also worth seeing your GP.
Feeling blocked-up and sluggish this winter? Book a pelvic floor assessment in Wellington and let’s get you sorted.
Also in this series
- The Knack: A Simple Trick to Stop Leaking When You Cough or Sneeze
- Nocturia: Why Winter Makes Night-Time Toilet Trips Worse
Other helpful links
