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Your pelvic floor might be doing its job a little too well. When stress hits, many of us brace without noticing and that tension can land deep in the core, shaping everything from pelvic pain to how safe we feel in our own body. We sit down with Karla Ehlers, a pelvic health occupational therapist and founder of Ocupelvic Health and Wellness, to connect the dots between nervous system states and pelvic floor dysfunction in a way that feels practical, human, and doable.

We talk about the pain cycle: fear and past trauma can trigger a protective “guarding” response, which ramps up the sympathetic nervous system, which then feeds more pain and more threat. Karla explains why fight or flight is not the villain, we need it for energy and everyday function, but we also need an off-ramp back to parasympathetic regulation. You will hear concrete examples of where people hold tension most, including pelvic floor tightening, jaw clenching, upper ab gripping, and glute squeezing, plus how sensory stress like constant noise can push the body further into dysregulation.

We also dig into interoception, the skill of sensing what is happening inside your body. Chronic pelvic pain, chronic stress, and neurodivergence can make those signals either harder to read or so loud that everything feels like danger. Carla offers a steadier approach: build functional awareness first, notice early signals before they reach 10 out of 10, and practice small releases that support lasting change.

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