You may know conscious breath work, or pranayama, can help manage pelvic pain. But how?

Pain is directly affected by the autonomic nervous system. Think of the two arms of the nervous system—sympathetic and parasympathetic—as the gas and the brake.

If we are experiencing pain, our sympathetic nervous system (fight-flight-freeze response) acts as the gas.

The fight-flight-freeze response reacts to real or perceived danger, releasing adrenaline, cortisol, and other stress hormones. This increases your heart rate and blood pressure, but decreases the immune response and digestive system.

The parasympathetic nervous system (rest and digest) acts as the break and decreases the body’s stress response.

Using your breath consciously asks the nervous system to shift the balance from fight-flight-freeze to rest and digest.

Studies show that conscious breathwork decreases heart rate and decreases blood pressure. This is one reason why pranayama is beneficial for people experiencing persistent pain.

Pelvic floor movement with breath

Another reason why breathing is helpful for people experiencing pelvic pain is the relationship between the diaphragm and the pelvic floor.

When we inhale, the diaphragm and the pelvic floor descend toward our feet. When we exhale, they both ascend toward our head.

This helps provide a sump pump-like motion in the abdominal and pelvic cavities, and offers mechanical support to the low back and pelvis.

I explain how the diaphragm and pelvic floor work together in this video:

Go for expansion

When we are stressed or experience persistent pelvic pain, your nervous system could be on high alert and you might tend to breathe more shallow. With shallow breathing, your belly doesn’t expand on inhalation or allow the ribs to glide outwards away from the midline of the body.

Try pranayama at home

Here are some breathing exercises and tips you might find helpful to try at home.


  • When you inhale, feel your belly expand.
  • When you inhale, imagine your sitz bones separating.
  • When you inhale, feel your ribs expanding out to the side. First start by feeling your lower ribs expand. Work your way up feeling the expansion all the way up in to the armpits.
  • Try and breath into the diagonal back corners of the rib cage. This is often where we grip our back and offering breath and rib expansion can combat stiffness.

Feedback for diaphragmatic breathing

Lay down on your back with a heavy book on your belly. Feel your abdomen rise up towards the ceiling as you inhale. You’ll see the book lifting as well. No need to push the book, just allow it to offer some feedback into the diaphragm.

Lightly wrap a resistance band around your ribs. As you inhale, you’ll feel some resistance to the outward glide of your ribs on inhalation. The band will offer you resistance and tactile feedback.

Pair the breath with movement

In addition to using the breath consciously while in different body positions, you can use your breath consciously as you move, stretch, or practice yoga. It offers a lovely way to mindfully connect. Confused about when you should inhale and when you should exhale during a yoga practice? Read my opinion on this blog.

Pranayama breath exercises


Dirga is the three part breath. We inhale into the belly, then the ribs, then allow the collarbones to float up.

Read more about Dirga breath.


Ujjayi breath, also known as the ocean-sounding breath, creates a calm cooling and cleansing vibe. It’s counter-intuitive to evoke the leader of the dark side for a calming breath, but you know you are doing it right when you sound like Darth Vader.

Read more about Ujjayi breath.

Letting Go Breath

Letting Go Breath is a lovely breath that can be performed quietly or audibly, creating a big sigh of tension out of the body.

Read more about the Letting Go Breath.

Nadi Shodhana

Also known as alternate nostril breathing, nadi shodhana is an easy way to feel centered and calm your nervous system.

You can use the second fingers of your right and left hands, or shape your right hand in Vishnu mudra (4th and 5th fingers bend halfway and keep first three fingers straight)

  • Close off your right nostril gently with your thumb
  • Exhale, then inhale through the left nostril.
  • Switch the nostril plug to the left side with your 4th finger
  • Exhale and inhale through the right nostril.
  • Switch the nostril plug to the right side using your thumb
  • Continue for 10 breaths or as desired

Keep your breath smooth, long, meditative and gentle to balance the hemispheres of the brain, soothe the nervous system, and quiet the mind.

Let me know your thoughts about using breathing techniques for managing pelvic pain in the comments below!