Pelvic floor dysfunction: symptoms and treatments

Pelvic floor dysfunction refers to a condition where the muscles, ligaments, and connective tissues that make up the pelvic floor are not functioning properly. The pelvic floor muscles are a group of muscles that form a sling-like structure at the bottom of the pelvis. They provide support to the pelvic organs, including the bladder, uterus, and rectum, and help to control urinary and bowel function. These muscles can be weakened or damaged due to various factors, such as pregnancy, childbirth, aging, and certain medical conditions, which can lead to pelvic floor dysfunction and related symptoms.

What are the symptoms of pelvic floor dysfunction?

• Urinary incontinence (leaking urine)

• Fecal incontinence (leaking stool)

• Urinary urgency (feeling a sudden need to urinate)

• Pelvic pain

• Painful intercourse

• Constipation

• Incomplete bowel movements

• Difficulty starting or stopping urination 

If you are experiencing symptoms of a pelvic floor condition, it is important to speak with a St. Luke’s Health primary care provider for an evaluation and proper diagnosis.

What are the causes of pelvic floor dysfunction?

• Pregnancy and childbirth, which can stretch and weaken the pelvic floor muscles

• Menopause, which can lead to a decrease in estrogen and weaken the pelvic floor muscles

• Aging, which can cause a natural weakening of the pelvic floor muscles

• Chronic constipation or straining during bowel movements, which can damage the pelvic floor muscles

• Chronic coughing, which can strain the pelvic floor muscles

• Heavy lifting, which can strain the pelvic floor muscles

• Pelvic surgery, which can damage the pelvic floor muscles

• Certain medical conditions, such as obesity, diabetes, and neurological disorders, which can affect the pelvic floor muscles and their function

What are the treatment options for pelvic floor dysfunction?

The treatment for pelvic floor dysfunction depends on the underlying cause and severity of the condition. Some common treatment options include:

• Pelvic floor exercises: Exercises, such as Kegels, can help strengthen weak pelvic floor muscles and improve their coordination.

• Biofeedback therapy: This therapy uses sensors to monitor muscle activity and provides feedback to help individuals learn how to relax or contract their muscles correctly.

• Electrical stimulation: This therapy uses a low-voltage electric current to stimulate the pelvic floor muscles and improve their strength and coordination.

• Medications: Certain medications, such as muscle relaxants or nerve blockers, may be prescribed to help relieve symptoms of pelvic floor dysfunction.

• Surgery: In severe cases, surgery may be necessary to repair or reconstruct the pelvic floor muscles or correct other underlying conditions.

• Lifestyle modifications: Simple changes, such as maintaining a healthy weight, practicing good bowel habits, and avoiding heavy lifting, can help reduce symptoms and prevent further damage to the pelvic floor muscles.

It is important to work with a urologist to determine the most appropriate treatment plan for your specific condition. Pelvic floor physical therapy is often recommended as a first-line treatment for pelvic floor dysfunction, as it can provide personalized guidance and support to help individuals improve their symptoms and quality of life.

What are pelvic floor exercises or Kegel exercises?

Pelvic floor exercises, also known as Kegel exercises, are a common treatment for pelvic floor conditions. These exercises involve contracting and relaxing the pelvic floor muscles to strengthen them and improve their function. 

To perform pelvic floor exercises, first identify the muscles you need to target. One way to do this is to try to stop the flow of urine while using the bathroom. The muscles you use to do this are the pelvic floor muscles.

Once you have identified the muscles, you can perform pelvic floor exercises by following these steps:

1. Tighten the pelvic floor muscles as if you are trying to stop the flow of urine.

2. Hold the contraction for 3-5 seconds, then relax for the same amount of time.

3. Repeat this cycle of contracting and relaxing the pelvic floor muscles for 10-15 repetitions, three times a day.

Over time, you can gradually increase the length of time you hold the contraction and the number of repetitions you perform.

What lifestyle changes can you make to prevent pelvic floor conditions?

While some pelvic floor conditions cannot be completely prevented, there are steps you can take to reduce your risk and maintain good pelvic floor health. Some lifestyle changes that may help prevent pelvic floor conditions include:

• Maintain a healthy weight: Being overweight or obese can put extra pressure on the pelvic floor muscles, which can weaken them over time.

• Practice good bowel habits: Avoid straining during bowel movements by eating a fiber-rich diet, drinking plenty of water, and avoiding constipation.

• Avoid heavy lifting: Lifting heavy objects can put strain on the pelvic floor muscles, so try to avoid lifting objects that are too heavy for you.

• Practice good posture: Good posture can help improve the alignment of your spine and reduce strain on your pelvic floor muscles.

• Avoid smoking: Smoking can contribute to chronic coughing, which can strain the pelvic floor muscles.

• Practice pelvic floor exercises: Pelvic floor exercises can help strengthen the pelvic floor muscles and improve their function.

• Consider pelvic floor physical therapy: A pelvic floor physical therapist can help teach you exercises to improve your pelvic floor health and function.

By adopting these lifestyle changes and practicing good pelvic floor habits, you can help reduce your risk of developing pelvic floor conditions and maintain good pelvic floor health.