Hormonal Prepartum Changes and Postpartum Complaints

In Pregnancy/Postpartum by Stephanie PrendergastLeave a Comment

By Stephanie Prendergast, MPT, Cofounder, PHRC Los Angeles


Hormones play a vital role in day-to-day function. They allow for the organs to communicate with each other so that we can filter toxic waste, grow muscle, sleep well . . . . and even grow a human! Let’s take a look at what happens during pregnancy:

Estrogen goes up, elevating to 30 times its normal levels! This allows for increased blood flow, uterine growth, and placenta development.

Progesterone goes up too! Progesterone affects the lining of the uterus to keep the embryo and fetus attached to the wall. It also helps to promote milk production and store fat so we have enough energy to feed the fetus and prepare for birth.

Relaxin is a hormone that inhibits uterine activity, softens the cervix, and helps to relax some pelvic girdle joints and pubic symphysis to prepare for birth.


Far too often we see that pains are blamed on Relaxin and then no action is taken to address them. Oftentimes, the pains can be from musculoskeletal causes which means that PT is essential during pregnancy to address this.

Oxytocin helps to stimulate uterine contractions in labor and birth, contributes to the milk ejection reflex, and helps us bond with the newborn baby.

Prolactin contributes to milk development.


common postpartum complaints

When it comes to being postpartum, you’re not alone if you’re  feeling a bit uncomfortable. That is normal! You just gave birth and your body is adjusting to no longer being pregnant. These are the most common postpartum complaints we hear from our postpartum patients:

Urinary difficulties- Those with urinary incontinence leak urine when they sneeze, cough, or run. Some feel a frequent or sudden urge to urinate, even when their bladder isn’t full. Others are unable to start the flow of urine at will or empty their bladder completely when urinating.

Fecal incontinence- Many postpartum patients have difficulty controlling gas or bowel movements.

Perineal pain- This symptom is common in postpartum patients, especially those who tore during childbirth or are recovering from an episiotomy. (The perineum is the area of skin between the vagina and the anus.) In addition, tight pelvic floor muscles cause some to experience persistent perineal pain, even after their wound heals.

Pelvic pain- Some patients have pain during sex for many months or even years after childbirth. Some also have chronic vulvar pain, burning or itching. Others have pain during bowel movements. These symptoms are often caused by tight pelvic floor muscles, which can lead to inflamed tissue and nerves.

Pelvic organ prolapse- When pregnancy and childbirth weaken the pelvic floor muscles, the uterus, bladder, and/or bowel can slip out of place. Rehabilitating these muscles can help prevent or improve this condition.



Are you unable to come see us in person in the Bay Area, Southern California or New England?  We offer virtual physical therapy appointments too!

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page

Melissa Patrick is a certified yoga instructor and meditation teacher and is also available virtually to help, for more information please visit our therapeutic yoga page

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