Dear Two Moons Readers, I’m Dr. Maria Muto-Rodriguez, a women’s health and pediatric physical therapist, founder of Holistic Physio, and a mother myself, bringing both clinical expertise and lived experience to support women through hormonal shifts and pelvic floor challenges.
Constipation is more than just a minor discomfort - it can be a sign that your hormones and pelvic floor are out of balance. While nutrition and hydration often take the spotlight in gut health discussions, we can’t overlook how pelvic floor health and hormone fluctuations play a significant role, especially for women navigating menstruation, pregnancy, postpartum, perimenopause, or menopause.
In this blog, we’ll explore how hormone health, digestion, and pelvic floor function are deeply connected, and share natural ways to support pelvic floor health and ease hormonal constipation.
Introduction To Hormonal Health
Your pelvic floor and hormone health are closely linked, especially when it comes to gut function. Hormonal constipation is a common but under-discussed issue that arises during key hormonal shifts. For many women, a combination of hormone imbalance and pelvic floor dysfunction results in bloating, straining, or incomplete bowel movements.
Recognizing the interplay between pelvic floor function and gastrointestinal health during periods of hormonal fluctuation is essential for disrupting symptom cycles and achieving effective symptom management. Furthermore, hormonal imbalances may adversely affect mental health, often presenting as mood disturbances and sleep dysregulation.
Understanding Pelvic Floor Health
What Is the Pelvic Floor?
The pelvic floor is a group of muscles, fascia, and connective tissues at the base of your pelvis. These muscles support your organs, maintain continence, and help with core stability and sexual function.
Why Pelvic Floor Health Matters
The pelvic floor plays a critical role in bowel movements. If these muscles are weak, tight, or uncoordinated, it can lead to straining and hormonal constipation, especially during times when digestion is already slowed by shifting hormone levels.
Common Pelvic Floor Issues That Affect Digestion
- Pelvic organ prolapse
- Constipation from muscle tension or poor coordination
- Urinary incontinence
- Pain with bowel movements or sex
Learning how the pelvic floor affects digestion empowers women to treat the root causes, not just the symptoms, of constipation and hormone imbalance.
What Is Hormonal Constipation?
Hormonal constipation refers to bowel irregularity triggered or worsened by changes in hormone levels, particularly estrogen, progesterone, cortisol, and thyroid hormones. This can occur cyclically (such as before your period), during pregnancy, postpartum, perimenopause, or in menopause. Progesterone, in particular, slows digestion, making constipation during menstruation, pregnancy, or postpartum very common. A drop in estrogen can also reduce gut motility and pelvic tissue tone.
Signs of Hormonal Constipation
- Slower bowel movements around your menstrual cycle
- Bloating, straining, or pelvic pressure
- Incomplete evacuation, especially postpartum or during perimenopause
- Constipation linked to stress, fatigue, or poor sleep
If you notice a pattern tied to your cycle or life stage, hormonal constipation may be the missing link.
Root Causes of Hormonal Constipation
Hormone Fluctuations Across Life Phases
- Menstruation: Fluctuations in certain hormones, such as progesterone, can slow digestion, contributing to constipation during menstruation.
- Pregnancy: Hormonal changes of estrogen and progesterone + an increase of mechanical pressure slowing gut motility.
- Postpartum: Hormone shifts, dehydration, and nervousness around straining can delay bowel recovery.
- Menopause: Lower estrogen levels impair digestion and tissue integrity—contributing to gut health hormone imbalance.
Lifestyle Factors
- Low fiber intake
- Inadequate hydration
- Lack of physical activity
Stress and Hormones
Elevated cortisol levels associated with stress can impair gastrointestinal motility and contribute to increased pelvic floor muscle tension, thereby worsening symptoms of hormonal constipation. Prolonged stress exposure may also promote systemic inflammation, compounding hormonal dysregulation and gastrointestinal dysfunction.
Medical Conditions
- PCOS
- Hypothyroidism
- Endometriosis or fibroids
These conditions affect both hormonal balance and pelvic floor health, increasing risk of constipation and hormone imbalance.
The Pelvic Floor and Constipation Connection
Pelvic floor dysfunction and hormonal constipation often create a reinforcing cycle. A tight or uncoordinated pelvic floor, commonly influenced by elevated stress or decreased estrogen, can make it difficult to fully empty the bowels, even with sufficient fiber and hydration. On the other hand, chronic straining due to hormonal constipation of gut imbalances can weaken the pelvic floor over time, increasing the risk of prolapse, pain, or further dysfunction.
How Pelvic Floor Dysfunction Worsens Constipation
- Muscles don’t relax properly during a bowel movement
- You need to push or change positions to go
- Sensation of incomplete emptying
- Pelvic heaviness or pressure
- Increased symptoms during hormonal shifts like menstruation or menopause
If this sounds like your experience, addressing both hormone health and pelvic floor function is key.
Natural Ways to Support Pelvic Floor Health and Hormonal Constipation
Dietary Support
- Increase fiber intake gradually to 25–35g/day
- Drink at least 2-3L of water daily
- Eat hormone-supportive foods like flaxseed, leafy greens, and fermented veggies
- Use magnesium citrate or herbal teas (under provider guidance)
- Seed cycling (flax, pumpkin, sunflower, and sesame seeds)
Seed cycling is a natural approach to supporting hormonal balance by consuming specific seeds during different phases of the menstrual cycle. Two Moons supplements simplify this process by providing a convenient capsule form: flax and pumpkin seeds are blended in the first bottle, designed for use during the follicular phase (days 1–14) to help support healthy estrogen levels. The second bottle contains sunflower and sesame seeds, intended for the luteal phase (days 15–28) to promote optimal progesterone production. These seeds are rich in lignans, essential fatty acids, and micronutrients that may help regulate hormones, reduce PMS symptoms, and support overall menstrual health.
In addition to seed cycling, maintaining a balanced diet and staying well-hydrated are crucial for insulin resistance and optimizing hormone function. Supplementing with magnesium citrate can further enhance hormonal support by improving bowel regularity, easing PMS-related symptoms, and promoting relaxation, particularly during the luteal phase.
Movement & Pelvic Floor Exercises
- Daily walks and yoga to improve gut motility
- Diaphragmatic breathing to relax pelvic floor
- Targeted pelvic floor and core connection exercises, like pilates
- Strength training to support bowel and hormone function
These are effective, natural ways to support the pelvic floor and relieve hormonal constipation.
Stress Regulation
- Breathwork (e.g. 4-7-8)
- Journaling or grounding practices
- Prioritizing sleep for hormone repair
Herbal and Natural Remedies (with guidance)
- Ginger or peppermint tea for bloating
- Adaptogens like ashwagandha to support stress-related hormone imbalance
- Hormone-supportive supplements as needed (chasteberry, contained in Two Moons seed cycling capsules, evening primrose)
When to Seek Professional Help
If you’ve experienced more than two weeks of constipation, bloating, pelvic pressure, or disrupted menstrual cycle and bowel movements, it’s time to seek help.
Who to Consult:
- A pelvic floor physical therapist
- A functional medicine or hormone-specialized dietitian
- An OB/GYN or endocrinologist
- A GI specialist for advanced testing
Final Thoughts
Your pelvic floor doesn’t exist in isolation, it’s influenced by your hormones, digestion, movement, and stress. If you're struggling with hormonal constipation, it’s not "just in your head" or "something to live with."
Healing is possible when you address the full picture: pelvic floor health, hormone balance, and gut regulation. Addressing hormone-related conditions is essential for achieving overall well-being and improving quality of life.
✨ Want expert support? Download my free pelvic health guide or book a discovery call to start your personalized healing plan. Let’s get your body back in sync - naturally.
While this blog discusses health topics, it is not a substitute for professional medical advice. Always consult your doctor or other qualified healthcare provider regarding any question you might have regarding your health.
About the Author
Dr. Maria Muto-Rodriguez is a women’s health and pediatric physical therapist and the founder of Holistic Physio, a concierge practice based in NYC. She specializes in pelvic floor therapy, postpartum recovery, and early motor development. As a mother herself, Maria combines clinical expertise with lived experience to help women heal, feel empowered in their bodies, and guide their babies toward healthy milestones. Her mission is to provide holistic, personalized care that meets each family where they are.
