Constipation is a common bowel problem that can affect comfort, routine, and confidence. Within women’s health physiotherapy, constipation is often assessed alongside pelvic floor function, bowel habits, fluid intake, diet, and activity levels. In some people, related issues such as faecal incontinence or difficulty relaxing the pelvic floor can also contribute.

What Is Constipation?

Constipation usually means bowel motions are less frequent, harder to pass, or leave you feeling incompletely empty. Many people also describe straining, bloating, abdominal discomfort, or spending too long on the toilet. For some women, constipation becomes a pelvic floor problem as well as a bowel problem.

Common signs of constipation

• Fewer bowel motions than usual
• Hard, dry, or lumpy stools
• Straining to empty your bowels
• A feeling of incomplete emptying
• Bloating, pressure, or abdominal discomfort

What Causes Constipation?

Constipation can develop for several reasons. Sometimes it relates to low fibre intake, reduced fluid consumption, a change in routine, or reduced activity. In other cases, it may relate to pelvic floor coordination problems, bowel conditions, medication side effects, pregnancy, surgery, pain, or broader health conditions.

Lifestyle factors

• Not drinking enough water
• Not eating enough fibre or a sudden change in diet
• Lack of regular exercise
• Delaying the urge to open your bowels
• Travel or a change in daily routine
• Stress
• Reduced mobility
• Ageing-related bowel slowing

Medical, pelvic floor, and other contributing factors

• Pelvic floor dysfunction or difficulty relaxing when trying to empty
• Underactive pelvic floor muscles
• Pregnancy, hormonal change, or postpartum recovery
• Bowel conditions such as irritable bowel symptoms
• Neurological conditions such as Parkinson’s disease or multiple sclerosis
• Endocrine conditions such as diabetes or hypothyroidism
• Blockage or obstruction affecting the rectum or colon
• Injury to the pelvic floor, abdomen, or anus
• Surgery
• Some medications
• Long-term laxative overuse
• Obesity or low activity levels

Constipation Symptoms

Constipation symptoms vary from person to person. Some women mainly notice reduced frequency, while others notice straining, pain, or a sense that the bowel does not empty properly. If constipation is ongoing, it can also aggravate pelvic organ prolapse, worsen pelvic floor tension, or contribute to bowel leakage in some situations.

• Needing to strain or push to pass a bowel motion
• Hard or dry stool consistency
• Taking more than a few minutes to empty
• Feeling blocked or unable to finish
• Abdominal bloating, cramping, or discomfort
• Needing finger pressure or support to help empty

Why Does Constipation Sometimes Become a Pelvic Floor Problem?

Constipation may become a pelvic floor problem when the muscles around the rectum and anus do not relax or coordinate well during emptying. In that situation, pushing harder often makes things worse. This pattern can overlap with stress incontinence, urge faecal incontinence, or pelvic heaviness, so a detailed assessment matters.

How Is Constipation Diagnosed?

Constipation is often diagnosed clinically from your symptoms, bowel routine, diet, fluid intake, activity levels, medications, and medical history. Your physiotherapist may also assess posture, breathing pattern, abdominal wall function, toileting habits, and pelvic floor coordination.

In women’s health physiotherapy, an internal pelvic floor examination may be recommended when appropriate and with your consent. This can help assess pelvic floor strength, relaxation, coordination, and support. If further investigation is needed, your doctor may arrange tests such as a bowel diary, imaging, colonoscopy, sigmoidoscopy, or anorectal testing.

How Is Constipation Treated?

Constipation treatment depends on the cause. Physiotherapy often focuses on education, bowel habit retraining, pelvic floor coordination, breathing strategies, exercise, and practical changes that make emptying easier. Healthdirect’s constipation overview also notes that diet, fluid intake, activity, and appropriate medical review all play an important role.

• Education about bowel function and triggers
• Advice about fibre intake and meal timing
• Fluid intake recommendations
• Movement and exercise advice
• Pelvic floor exercises or downtraining, depending on what your assessment shows
• Toileting position and bowel emptying strategies
• Breathing and abdominal coordination practice
• Splinting or support strategies where appropriate
• Advice about when to discuss stool softeners or medication with your doctor

Other treatment options

Some women also need input from their GP or specialist, particularly if constipation is persistent, worsening, linked to medication, or associated with bleeding, unexplained weight loss, or significant pain. Medical treatment may include medication review, short-term laxatives, suppositories, enemas, or management of an underlying bowel or hormonal condition.

When Should You Worry About Constipation?

You should arrange prompt medical review if constipation is new and significant, keeps worsening, or happens with bleeding, unexplained weight loss, vomiting, severe abdominal pain, or a major change in bowel habit. Ongoing constipation with pelvic heaviness, leakage, or difficult emptying also deserves assessment rather than repeated self-treatment.

What Results Can You Expect?

Many people improve when the main contributing factors are identified and addressed properly. That may include better bowel habits, improved fluid and fibre balance, easier pelvic floor relaxation, and better emptying mechanics. If symptoms are left untreated, constipation can gradually affect comfort, confidence, bladder function, and pelvic floor health.

Will You Need Surgery?

Most women with constipation do not need surgery. However, surgery or specialist management may be considered when symptoms relate to a significant structural problem, obstruction, prolapse, or another condition that does not respond to conservative care.

People also ask about constipation

Can physiotherapy help constipation?

Yes. Physiotherapy may help constipation when bowel habits, posture, breathing, pelvic floor coordination, exercise, or emptying technique are contributing. It is especially useful when straining, incomplete emptying, or pelvic floor dysfunction are part of the picture.

Are pelvic floor exercises always the answer for constipation?

No. Some women need strengthening, while others need to learn how to relax and coordinate the pelvic floor better. The right approach depends on your assessment findings, symptoms, and diagnosis.

Can constipation affect pelvic organ prolapse?

Yes. Repeated straining can increase pressure through the pelvic floor and may aggravate prolapse symptoms in some women. That is one reason early management matters.

Should I keep using laxatives for constipation?

That depends on the cause and the type of laxative. Some people benefit from short-term support, but repeated or long-term use should be discussed with your doctor or pharmacist to make sure it is appropriate.

Can constipation and bowel leakage happen together?

Yes. Constipation can sometimes sit alongside bowel urgency, staining, or leakage, especially when stool becomes difficult to empty or pelvic floor control is reduced. A proper assessment can help separate the main drivers.

Related information

1. Women’s Health Physiotherapy
2. Pelvic Floor Exercises
3. Prolapse
4. Faecal Incontinence (Women)
5. Urge Faecal Incontinence
6. Women’s Health Physiotherapy Appointment FAQs

What to do next

If constipation is affecting your comfort, routine, or pelvic floor health, book an assessment with a physiotherapist who has a special interest in women’s health. Early assessment can help identify whether the main issue is bowel habit, lifestyle, pelvic floor coordination, prolapse, or another contributing factor.

The right plan may include practical changes to your routine, pelvic floor rehabilitation, and medical referral when needed.

References

1. Healthdirect. Constipation – symptoms and treatment. Healthdirect Australia. Accessed March 11, 2026.
2. Ihara E, Manabe N, Ohkubo H, et al. Evidence-Based Clinical Guidelines for Chronic Constipation 2023. Digestion. 2025;106(1):62-89. doi:10.1159/000540912
3. Van Der Schoot A, Katsirma Z, Whelan K, Dimidi E. Systematic review and meta-analysis: Foods, drinks and diets and their effect on chronic constipation in adults. Aliment Pharmacol Ther. 2024;59(2):157-174. doi:10.1111/apt.17782
4. Lambiase C, Bellini M, Whitehead WE, et al. Biofeedback efficacy for outlet dysfunction constipation: Clinical outcomes and predictors of response by a limited approach. Neurogastroenterol Motil. 2025;37(1):e14948. doi:10.1111/nmo.14948