If you’re here, chances are you or someone you know is navigating life with PCOS. It’s a condition that affects millions of women worldwide, including around 1 in 10 of us here in the UK.
Despite more women speaking openly about it – including high-profile names like Victoria Beckham and Frankie Bridge, as well as health advocates such as Dr Hazel Wallace and Grace Beverley – many of us still spend years searching for answers to our symptoms.
In fact, a recent all-party parliamentary report found that it takes an average of four years to receive a diagnosis, with two-thirds of those diagnosed given no resources to help manage their symptoms.
That’s why conversations about the lesser-known aspects of PCOS matter more than ever. And recently, new research has highlighted an area that’s rarely discussed: its potential impact on posture.
A study published in Nature earlier this year suggests that women with PCOS may be more prone to an increased curve in the lower spine (known as lumbar lordosis), alongside a forward rotation of the pelvis, commonly referred to as an anterior pelvic tilt.
As someone living with PCOS, this research made me sit up – literally. I’ve often wondered why my lower back has such an exaggerated curve and why my abdomen protrudes more than many of my friends. And though, as a health writer, I’m sceptical of terms like “PCOS belly” which swirl on social media, this suggestion of a scientific link between PCOS and posture struck a chord.
I’m not alone. Rosa, 26, from London, also has both PCOS and an anterior pelvic tilt. “I struggle to sit in the same position for long periods,” she explains, “and regularly experience low back pain, especially around ovulation.”
So, can PCOS really affect the way your pelvis sits, and if so, is it something we should be concerned about? I ran the research past leading gynaecologists and pelvic health specialists to find the answers.
For their thoughts, keep scrolling. Below, you’ll find an expert-backed guide to pelvic tilts, PCOS, and how to manage the discomfort that can come with them. For more support in managing the condition, check out our explainer on PCOS, guides to endometriosis symptoms, PMDD symptoms and PMS symptoms, plus a doctor’s guide to how to advocate for yourself in medical settings.
New Research Points To A Link Between Posture And PCOS. But Does It Matter? Experts Weigh In.
What is a pelvic tilt?
In simple terms, your pelvis isn’t supposed to sit bolt upright like a stack of books. It naturally tilts forward or back, depending on your anatomy and muscle balance. But if that tilt is exaggerated, it can change how your spine, hips and pelvic floor function, and sometimes how they feel.
“A pelvic tilt describes the angle at which the pelvis sits relative to the spine and legs,” says pelvic pain specialist, Dr Sonia Bahlani. “When this alignment shifts forward (anterior tilt) or backward (posterior tilt), it alters the curve of the spin, and can impact posture, muscle balance, and how the pelvic floor, lower back and hip function.”
“Think of it like a bowl of water,” suggests women’s health physiotherapist, Sarah Tyler. “In a neutral posture, the bowl stays level. In an anterior tilt, it tips forward and spills the water.”
The experts are clear that everyone has some degree of pelvic tilt. “It’s a part of normal posture,” confirms urogynaecologist Rhiannon Bray. “But the degree to which your pelvis tilts can affect how the spine, hips and core muscles work together.”
So, what did the new research find?
The new study is small but fascinating. Researchers looked at the pelvic alignment of 95 women aged 25 to 35, some with PCOS and some without. None of the participants had given birth, which is important because studies show that pregnancy and birth can significantly influence pelvic alignment.
Within the study group, clear trends emerged. Women with PCOS had a significantly greater anterior pelvic tilt and a more pronounced lumbar lordosis (the deep curve in the lower back). In other words, their pelvis tended to tilt forward more, which could influence posture and the way forces travel through the spine and pelvis.
So, what does this mean in practice? Sexual health specialist Dr Shirin Lakhani explains. “The study suggested that there may be a correlation between those with PCOS and those who experience pelvic tilts and that hormonal imbalance, chronic inflammation and reduced muscle strength often seen in those with PCOS may contribute to these postural changes.”
What do the experts think of the findings?
While the study was small, experts agree it highlights an important point: PCOS may affect the body in ways that go beyond hormones, including how our muscles function and how our posture develops.
“PCOS itself doesn’t directly cause pelvic tilts, but it can influence the factors that contribute to them,” explains Dr Bahlani. Many people with PCOS experience “hormonal imbalances that lead to changes in fat distribution, abdominal weight gain, and insulin resistance,” she says. “These shifts can put extra pressure on the front of the pelvis, tighten the hip flexors and lower back, and over time may encourage an anterior pelvic tilt and a deeper lower back curve.”
Dr Bahlani also points to “chronic inflammation, reduced muscle strength, and altered pain perception” as important factors. “All of these can affect how your muscles are recruited and your posture over time.”
Still, the experts caution against jumping to conclusions. “This was a very small population of women – 52 in the PCOS group, all of a similar BMI, none of whom had given birth” says Tyler. “More research is needed before we can say these findings apply to the wider PCOS population.”
Is a pelvic tilt a problem?
So, if women with PCOS may be more prone to a forward-tilted pelvis, does that automatically mean something is wrong? The short answer, according to the experts, is no.
“It’s a myth that an anterior pelvic tilt is automatically bad for you,” says Bray. “Some degree of forward tilt is completely normal – it’s how the spine, pelvis and hips stay balanced. Problems only arise when that tilt is excessive or linked with pain, muscle weakness or pelvic-floor symptoms.”
In other words, the tilt itself isn’t the enemy. Issues only appear when the tilt itself becomes exaggerated or starts affecting other parts of the body.
For women with PCOS, these effects on the surrounding muscles and pelvic floor may feel more pronounced. Bray explains it’s not that the tilt is inherently worse, but that hormonal and metabolic factors can influence muscle tone, inflammation, and how the body handles load. When an anterior pelvic tilt is excessive, “it can change how forces travel through the lower back, hips, and pelvic floor,” she says. “For women with PCOS, who may already have differences in muscle function and metabolism, the combination of hormonal and mechanical factors can make these symptoms more noticeable.”
So, is a pelvic tilt something to panic about? No. But if you’re experiencing lower-back niggles, bladder pressure, or pelvic-floor symptoms, and you have PCOS, it could be one piece of a bigger puzzle.
What should you do if you’re worried about your pelvic tilt?
If you’re experiencing lower-back soreness, pelvic heaviness, or urinary urgency, and you have PCOS, it could be worth exploring whether a forward-tilted pelvis is playing a role. Experts recommend starting with a women’s health physiotherapist.
“The first step is understanding what might be happening in your body,” explains Bray. “A specialist women’s health physiotherapist can assess how your pelvis and lower back are aligned, the strength and coordination of your core and pelvic floor muscles, and the flexibility of your hips and hamstrings.”
It’s also important, she reminds us, to look at pelvic tilt within the bigger picture of PCOS. “Hormone balance, inflammation, muscle mass, fitness, and lifestyle all influence posture. The goal isn’t to ‘fix’ posture but to support your body so it can function efficiently.”
She recommends:
1. Strengthening and stretching your muscles
“Strengthen your core, glutes, and hamstrings to stabilise the pelvis and ease pressure on the lower back,” says Bray. “Stretch tight hip flexors and front-thigh muscles to reduce the forward pull on the pelvis.”
2. Visiting a pelvic physiotherapist
“Physiotherapy can help you to become more aware of your natural posture and teach balanced movement patterns, rather than forcing a rigid stance,” she adds.
3. Consider your sleep, stress and nutrition
“Adequate protein and vitamin D support muscle health, while quality sleep and stress management reduce inflammation and improve overall movement efficiency,” says Bray.
While many of these strategies can be done at home, the experts are clear that you shouldn’t hesitate to ask your GP for a referral if you are worried about pelvic pressure, heaviness, urgency, or incontinence.
“Ultimately, posture is dynamic,” concludes Dr Bahlani. “There’s no ‘perfect’ position, but supporting your hormonal, muscular, and nervous systems together is what promotes long-term pelvic health.”
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Not Just A Period – Dr Hazel Wallace
Dr Hazel Wallace, who has spoken openly about her own PCOS journey, is a wealth of knowledge when it comes to female health conditions. Her most recent book, Not Just A Period, is designed to arm anyone who bleeds on how to work with, not against, their cycle, and in turn, boost energy, mood, and quality of life.
Movement and mobility are crucial in supporting posture and easing lower back pain. A foam roller is a great (and more affordable) alternative to a sports massage, which can really upgrade the effects of your stretching routine.
Core Steady Resistance Bands
Strengthening the glutes, hips and hamstrings doesn’t have to require a gym membership. With the help of a set of resistance bands, you can make big gains from home, supporting your posture, joints, bones and hormonal health.
Can I correct my pelvic tilt?
While pain or discomfort from a pelvic tilt can often be managed with movement, breathing exercises, and mobility work, “no treatment can alter an anterior pelvic tilt long term,” explains women’s health physiotherapist Sarah Tyler. She cites a 2020 review showing that no non-surgical intervention has been shown to reduce an exaggerated pelvic tilt.
That’s why it’s important not to chase a ‘perfect posture’ which doesn’t exist. Instead, Tyler recommends focusing on “good mobility, function, and strength of the whole core.” A specialised women’s health physiotherapist can assess your body and guide you through targeted pelvic-floor exercises and breathing techniques to manage any extra pressure caused by a tilt.