What’s the link between POTS and the pelvic floor?
Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, often causing a rapid heartbeat, dizziness, fatigue, and exercise intolerance when standing. But what many people don’t realize is that POTS is also closely linked with pelvic floor dysfunction—and connective tissue health may be the missing link.
What Is POTS?
POTS causes the heart rate to spike by 30+ beats per minute (or more) when moving from lying to standing, without a significant drop in blood pressure. Along with cardiovascular symptoms, many people with POTS experience:
Urinary urgency or incontinence
Constipation or digestive issues
Pelvic heaviness or pain
Difficulty with core and pelvic muscle coordination
These symptoms often stem from nervous system dysregulation—but also from the quality of connective tissue supporting the pelvic organs and structures.
The Role of Connective Tissue
Many individuals with POTS also have hypermobile joints or connective tissue disorders, such as Ehlers-Danlos Syndrome (EDS). These conditions can cause ligaments and fascia to be more lax or stretchy, which may lead to:
Pelvic organ prolapse
Joint instability
Muscle overcompensation or chronic tension
Poor postural control
When the pelvic support system is compromised, the pelvic floor often tries to pick up the slack—resulting in overactivity, weakness, or pain.
How Pelvic Floor Therapy Can Help
Pelvic floor physical therapy can be a powerful tool in managing the complex interplay between POTS, connective tissue disorders, and pelvic dysfunction. Treatment may include:
Gentle, personalized pelvic floor muscle retraining
Core and postural support to reduce stress on joints
Breathwork and body mechanics to minimize symptom flare-ups
Bowel and bladder education for better function and comfort
Strategies to support prolapse and reduce pelvic heaviness
At our clinic, we understand the unique challenges of living with POTS, EDS, and pelvic floor dysfunction. Our approach is gentle, personalized, and rooted in whole-body care.