What is the Vagus Nerve?
The Vagus Nerve- we actually have two, right and left- is the longest and most extensive of the twelve cranial nerves in our bodies. It starts in the brainstem and weaves its way through the neck, thorax, abdomen all the way to the pelvic floor. It contains 75% of our parasympathetic system’s nerve fibers and is involved in many key functions:

1. Relaxation and stress response: the parasympathetic nervous system, and particularly the Vagus Nerve, is responsible for our rest and digest state which counteracts the fight/flight response of the sympathetic nervous system. Vagus Nerve activity acts to slow down the heart rate and lower blood pressure, promotubg feelings of calm and relaxation.
2. Breathing: The Vagus Nerve helps modulate the depth and rate of breathing by relaying messages between the lungs and the brainstem. It slows down the breathing rate, promoting deeper and more relaxed breathing.
3. Digestion: the Vagus Nerve stimulates the release of digestive juices and enzymes which helps with nutrient absorption, and it regulates gut motility which helps with bowel and bladder emptying.
4. Inflammation: The Vagus Nerve plays an important role in counteracting and reducing the body’s inflammatory response via what is known as the neural inflammatory reflex. When the brain receives information that there is inflammation in an area of the body, the Vagus Nerve output in turn suppresses it. Techniques to strengthen the Vagus Nerve’s ability to response include meditation and breathing techniques. And Neurostimulation of the Vagus Nerve is a relatively new approach to treating inflammation-mediated diseases (Neuroimmune Circuits Activated by Vagus Nerve Stimulation, Kuwabara, S., Goggins, E., Tanaka, S. doi: 10.1159/000518176. Epub 2021 Aug 17).
5. The Gut and Brain: there are extensive connections between the brain and the gut (our so-called “second brain”), and the Vagus Nerve fibers play a huge role in messaging back and forth about the state of digestion, the microbiome, motility, level of stress, etc.

What is the pelvic floor?
The pelvic floor is a group of muscles and connective tissues that stretch from the pubic bone to the tailbone, supporting the pelvic organs including the bladder and urethra, reproductive organs, bowel, rectum and anus. The pelvic floor has a crucial function in maintaining urinary and bowel continence, as well as facilitating sexual function. A healthy pelvic floor can contract, squeeze, lift and relax.
Common disorders of a weak pelvic floor include stress urinary incontinence, anal incontinence, and pelvic organ prolapse. Disorders of an overactive pelvic floor include overactive bladder, chronic pelvic pain, painful vaginal penetration, and erectile and/or ejaculatory dysfunction.

What connects the Pelvic Floor and the Vagus Nerve?
The winding extensive branches of the Vagus Nerve extend all the way to the pelvic floor. In many pelvic pain conditions there is muscle guarding of the pelvic floor. This muscle guarding can occur as a result of: visceral pain such as endometriosis pain, low back dysfunction, persistent sitting postures including prolonged cycling, and chronic anxiety.

Let’s look at chronic anxiety to show how a cycle of pain creates chronic pelvic pain:
-high anxiety elicits a stress response throughout the body
-certain muscles in your body including the pelvic floor muscles get tense and stay tense
-chronically tight pelvic floor muscles can cause pain or increase existing pain
-because anxiety lowers pain tolerance, painful sensations get stronger
-these painful episodes reinforce the idea that you need to be on high alert, fueling the cycle.

How can we access the Vagus Nerve to help the Pelvic Floor be as healthy as possible?
Techniques such as deep breathing exercises, meditation, and vagal maneuvers, have been proven to help activate the parasympathetic response and promote relaxation throughout the body.
Pelvic floor exercises, such as kegels, can be beneficial in strengthening the pelvic floor muscles and improve muscle tone.