GLP-1 medications like Ozempic®, Wegovy®, Mounjaro® and Zepbound® have transformed weight loss and diabetes management. While these medications can provide significant health benefits, constipation is one side effect that deserves more attention—not just for your digestive system but for your pelvic floor.
Why Do GLP-1 Medications Cause Constipation?
GLP-1 medications slow digestion, helping you feel fuller longer. But slower gastrointestinal movement can also mean fewer bowel movements and harder stools.
Additionally, people taking GLP-1 medications may be eating and drinking less overall, which can mean less fiber, water and food volume to stimulate the colon.
The result? Constipation can become a frustrating cycle.
Why Constipation Matters for Your Pelvic Floor
Every bowel movement involves your pelvic floor. When stool is difficult to pass, it’s common to strain, hold your breath, bear down or sit on the toilet for extended periods.
Repeated straining increases pressure through the abdomen and pelvic floor and can contribute to or worsen:
- Pelvic organ prolapse symptoms
- Hemorrhoids
- Urinary leakage
- Difficulty emptying the bladder
- Pelvic pain
- Difficulty fully emptying your bowels
If you already have a cystocele, rectocele or uterine prolapse, constipation can make symptoms like heaviness, pressure, and bulging feel significantly worse.
It’s Not Always About the Medication
There are several options for managing constipation, including magnesium, stool softeners, polyethylene glycol (Miralax) and fiber supplements such as psyllium (Metamucil). The best option depends on the cause and severity of your constipation, so talk with your healthcare provider about what is appropriate for you.
And don’t overlook the basics: stay hydrated, gradually increase fiber, move regularly, respond to the urge to have a bowel movement, avoid prolonged sitting on the toilet and consider using a footstool to improve positioning.
But sometimes, constipation isn’t simply a matter of what you’re taking—it’s how your pelvic floor is functioning.
Where Pelvic Floor Physical Therapy Fits In
Your pelvic floor muscles need to relax and coordinate properly to empty your bowels. Some people unknowingly tighten these muscles, hold their breath or bear down against a pelvic floor that isn’t relaxing.
This is known as pelvic floor dyssynergia, and adding more fiber or laxatives may not fully address the underlying problem.
A pelvic floor physical therapist can assess how your muscles are functioning and teach you how to:
- Relax and coordinate your pelvic floor during bowel movements
- Improve breathing and pressure management
- Optimize toileting mechanics
- Reduce straining
- Improve bowel emptying
- Manage symptoms associated with prolapse
Sometimes the answer isn’t “push harder.” It’s learning how to relax better.
The Bottom Line
Constipation may be a common side effect of GLP-1 medications, but it doesn’t have to be something you simply live with. Addressing bowel health early can help reduce pelvic floor strain, improve prolapse symptoms and make bowel movements more comfortable.
If you’re taking a GLP-1 and experiencing constipation, pelvic pressure, heaviness, or difficulty emptying your bowels, pelvic floor physical therapy may be an important piece of the puzzle.
At Uplift Pelvic Health & Performance, we help patients address the root causes of bowel and pelvic floor dysfunction—not just the symptoms.
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