I had gone for my annual gyno visit and he noticed my PF muscles were very tight and tender but never said to do anything. I researched it and read that there is a correlation between them and constipation. At my next gi visit I asked him and he said it definitely could have an impact on my constipation and referred me to a PF therapist. Sometimes they do special tests that can measure if you aren’t able to correctly relax and contract the appropriate muscles or push out the stool (not painful but kind of uncomfortable and embarrassing) you can look them up. They aren’t normal gi tests. The PF therapy helps with all that. I’ll admit, it is awkward at first, but it has definitely helped me. Side benefit. Sex has been totally painful for me for years and every dr said it was post-menopausal dryness and gave me creams that never worked. I can now enjoy it pain-free at 64! It just might be work checking into if nothing else is working.