We’re Kerstin Recker and Helen Grimshaw, co-founders of Peli Health. One of us came through an emergency c-section with excruciating pelvic pain and no guidance on what came next. The other started noticing pelvic symptoms during perimenopause and had no idea they were connected to her hormones. Between us, we visited multiple doctors trying to get answers, and heard, more than once, that the solution was to “have a glass of wine and relax.”
Different life stages, same story: a system where pelvic health education for women is almost entirely absent. And when you turn to Google or TikTok trying to make sense of what your body is doing, you’re met with a wall of information that’s impossible to navigate - especially when you’re already overwhelmed and just trying to understand what’s happening to you.
That’s what led us to build Peli Health. A place where women can find trusted, clinician-vetted education and support, before they need to see a doctor, between appointments, and as ongoing preventive care. Not a scroll through conflicting advice, but a resource that actually helps you understand your body and know what questions to ask.
Your pelvic floor and your hormones have been in a relationship for your entire life. A complicated one, sure. But once you understand what they are actually doing to each other, a lot of things start to make a lot more sense.
First, a Quick Anatomy Refresher (We Promise It Is Not Boring)
Your pelvic floor is a group of muscles sitting at the base of your pelvis, holding up your bladder, bowel, and uterus. Think of them as the underappreciated foundation of your whole core. They contract and relax with every breath, every step, every cough, and yes, every sneeze-near-a-trampoline situation.
They are also deeply responsive to hormones, particularly estrogen. And this is where things get interesting.
Estrogen does not just manage your cycle. It keeps your pelvic floor muscles strong and elastic, maintains the lining of your vagina and urinary tract, and supports the connective tissue holding everything in place. So when estrogen shifts - which it does at several key points in your life - your pelvic floor is one of the first places to feel it.
When Does This Actually Happen?
There are a few life stages where the hormonal-pelvic connection becomes particularly relevant.
During and After Pregnancy
During pregnancy, a hormone called relaxin causes the ligaments and connective tissue in your pelvis to loosen. Helpful for growing a baby, less helpful for your pelvic floor stability. After birth, estrogen and progesterone drop sharply, and your pelvic floor, which has been working overtime for nine months, needs real support to recover.
This applies whether you had a vaginal delivery or a c-section. Both affect the pelvic floor, just in different ways. And yet most women are sent home with minimal, if any, guidance on what to do next. Wild, right?
According to the University of Chicago Medicine, at least 1 in 3 women will experience a pelvic floor disorder in her lifetime, most of whom never receive any formal support for it.
In Perimenopause and Beyond
Perimenopause - the transition that can start in your mid-to-late thirties and last for years - brings gradually declining and fluctuating estrogen levels. Research shows this is when a lot of women start noticing pelvic symptoms for the first time.
Common signs that hormonal changes are affecting your pelvic floor include:
- Leaking when you sneeze, jump, or laugh (we see you, trampoline parks)
- A sudden urgent need to urinate that is hard to ignore
- Vaginal dryness, burning, or discomfort
- Pain during sex
- A feeling of heaviness or pressure in the pelvic area
- Constipation or straining
None of these are just a normal part of ageing that you have to put up with. They are signals worth taking seriously.
So What Can You Actually Do?
Good news: quite a lot. And none of it starts and ends with Kegels.
Understand That It Is Not Always About Strengthening
Here is the thing about Kegels. They get recommended to basically every woman for basically every pelvic complaint. But research suggests that up to 50% of women perform them incorrectly when unsupervised, which means half the people trying to help their pelvic floor may actually be making things worse. Your pelvic floor can be too tight, too weak, or struggling with coordination, and the right approach depends entirely on which one applies to you.
For many women going through hormonal transitions, the issue is tension and dryness rather than weakness. A pelvic floor physical therapist can assess exactly what is going on and build a plan that actually fits your situation.
Work With Your Breath and Your Whole Body
Your pelvic floor does not operate in isolation. It is part of a system that includes your diaphragm, deep core, and lower back. Diaphragmatic breathing, gentle movement like walking, swimming, or yoga, and learning to manage intra-abdominal pressure through your breath can all have a meaningful impact on how your pelvic floor functions day to day.
Support Your Hormones Nutritionally
What you eat matters more than you might think. A diet rich in phytoestrogens (found in flaxseeds, sesame seeds, and legumes), omega-3 fatty acids, and fibre can help support hormonal balance and reduce inflammation.
One practice gaining traction in this space is seed cycling - eating specific seeds during different phases of your cycle to support estrogen and progesterone production naturally. It sits at the intersection of nutrition, hormone health, and cyclical living, which is an area Two Moons has explored in depth if you want to go further.
Take Sleep and Stress Seriously
Chronic stress raises cortisol, which can suppress estrogen and contribute to pelvic floor tension. Poor sleep disrupts hormone regulation across the board. The APTA Pelvic Health Section includes stress and sleep management as part of a comprehensive pelvic health approach, not as soft lifestyle suggestions, but as real physiological levers worth addressing alongside any targeted pelvic work.
Track What Is Happening
Whether you use an app or a good old notebook, tracking your symptoms alongside your cycle can help you spot patterns, communicate more clearly with healthcare providers, and get a sense of how your body is changing. Knowledge is genuinely power here.
The Bottom Line
Your pelvic floor and your hormones are linked in ways that most of us were never taught about — not in school, not by our doctors, not really anywhere.
That is not your fault. But it does mean a lot of women are managing symptoms quietly, without realising that proper support exists.
Part of the problem is access. In the US alone, 40 million women experience pelvic floor dysfunction, yet there are only around 10,000 pelvic floor physical therapists - many of whom are out of network and expensive. Even when women do make it into a doctor’s office, the appointments are often too short to cover what they actually need to know.
What that support looks like will be different for everyone. Some women need hands-on physiotherapy. Others need education first — to understand what is even happening in their bodies, and what questions to ask. Both are valid starting points.
Peli Health was built for exactly this gap. Founded by two women who had their own difficult experiences navigating pelvic health without guidance, the platform offers evidence-based education, in depth expert Q&As, a symptom tracker developed with clinical oversight, and a community — all in one place. It goes beyond the physical too, covering nutrition, mental health, sexual health, and mindfulness, because pelvic health rarely exists in isolation.
If you want to take a more informed, proactive approach to your pelvic health, visit pelihealth.com to get started.
Medical note: This blog post is for informational purposes and is not medical advice. Always consult a qualified clinician about diagnosis and treatment options.
About the Authors
Kerstin Recker is a healthtech founder and equitable tech advocate with a background in scaling startups and Fortune 500 companies across AI and health tech. As co-founder of Peli Health, a centralized pelvic health platform, she is dedicated to making technology more diverse and accessible. Kerstin leads with a commitment to inclusivity, ensuring femtech remains impactful for all.
Helen Grimshaw is the co-founder of Peli Health, a pelvic care management platform transforming women’s healthcare. With deep expertise in global tech projects, commercial operations, and PR, she drives Peli's growth as a femtech leader. Helen is a passionate advocate for healthtech innovation, focused on improving pelvic care outcomes for patients and providers worldwide.