Pelvic floor dysfunction or disorders occur when the muscles and ligaments of the pelvic floor don’t work properly. The condition might cause embarrassing symptoms like incontinence or pain, but millions of people suffer from pelvic disorders. Pelvic symptoms can vary from person to person. Some people experience pain with intercourse or bladder/bowel problems. There’s no need to be embarrassed. It’s much better to find out what’s causing your discomfort and get the treatment you need. Let’s take a look at pelvic floor disorders and what can be done about the symptoms.
What Is the Pelvic Floor?
The pelvic floor is composed of the muscles, ligaments, connective tissue and nerves that work together as a sort of basket in your pelvis. In women, the pelvic floor supports the bladder, uterus, vagina and rectum. In men, the pelvic floor supports the bladder, rectum and other organs. The pelvic floor helps the rectum work properly as well. Since this area of your body has so many parts, disorders of the pelvic floor can vary widely in their severity and symptoms.
What Are the Symptoms of Pelvic Floor Disorders?
There is no single set of symptoms for pelvic floor disorders. Some people may experience only one or two symptoms, while others might have more complex problems. The symptoms of pelvic floor dysfunction can include:
- Having, or feeling you need to have, several bowel movements in a short time
- The feeling of incomplete emptying or that you can’t finish your bowel movements
- Constipation or pain when straining to have a bowel movement
- Frequent need to urinate and a urine stream that stops and starts again
- Painful urination
- Lower back pain
- Pain in your groin, pelvis, genitals or rectum or muscle spasm in the area
- Painful intercourse
- Organ prolapse – pelvic organs (uterus, bladder or bowel) may bulge into the vagina
Who Suffers from Pelvic Floor Disorders?
Pelvic floor disorders are more common in women and in people as they age. However, pelvic floor problems are not a normal part of aging — that is, not everybody has this problem as they get older. Up to 50 percent of women are affected by some kind of pelvic floor disorder at some time in their life. Also, 11 percent of women will require some kind of surgery for urinary incontinence or pelvic prolapse at some point in their life.
What Are the Risks Factors for Developing Pelvic Floor Disorders?
Giving birth is one of the major risk factors for developing pelvic floor dysfunction. Plus, women who have given birth multiple times are at a higher risk. Repetitive heavy lifting may also increase your risk of developing this disorder. Some studies show that obesity and menopause may also lead to a higher risk of pelvic floor disorders.
Surprisingly, vaginal birth delivery might not increase the risk of pelvic floor disorders. Instead, simply being pregnant might be the actual risk. In one study, 184 first-time mothers who had Caesarean section deliveries were compared to 100 women who delivered vaginally. The study results showed that there was no significant difference in pelvic symptoms up to 10 months after giving birth.
If you have had pelvic surgery or radiation treatment, this can also increase your risk. Finally, there also might be a genetic component to developing pelvic disorders as they seem to run in families. A possible explanation might be that people inherit a gene that causes connective tissue to be weak or more elastic, which can eventually to pelvic symptoms.
Role of Hormones and Pregnancy in Pelvic Floor Disorders
Estrogen and progesterone are the main hormones produced during pregnancy. Progesterone may cause ligaments and joint laxity, including in the pelvis. This is part of the reason why the uterus can stretch and grow large enough to fit a full-term baby. The increased laxity due to progesterone, plus the weight of the baby, put pressure on the pelvic floor. In the end, this alone might be enough to result in pelvic floor disorders, especially after repeat pregnancies.
How Are Pelvic Floor Disorders Diagnosed?
To make a diagnosis, doctors first ask you questions about your symptoms and past medical history. Next, the doctor will examine you checking for any evidence of prolapse or other signs that might indicate that you have pelvic dysfunction. You may also need to have an MRI scan or another special testing to confirm the diagnosis and to rule out other causes of your symptoms.
Who Treats Pelvic Floor Disorders?
There are several different types of professionals that treat pelvic floor disorders. Each one might have a different role or approach to the problem. Some examples are:
- Urogynecologists – Trained in urology and gynecology, these doctors usually specialize in pelvic floor disorders
- Urologists – Surgeons that treat a variety of urinary disorders in women and men
- Colorectal surgeons – They treat intestinal problems, including pelvic disorders that involve the rectum
- Gastroenterologists – Specialists who treat a wide variety of intestinal and digestive disorders
- Plastic and reconstructive surgeons – These specialists use techniques to repair or rebuild damaged tissue
- Physical therapists – Professionals that teach special exercises to help relieve symptoms
When Should I Seek Help?
Many people feel uncomfortable talking about topics like pelvic pain or incontinence. Still, the sooner you seek treatment, the better the chances are something can be done to relieve your symptoms. If you have any of the symptoms mentioned earlier, it’s probably a good enough reason to see a healthcare professional.
How Is Pelvic Floor Dysfunction Treated?
Some treatment techniques for pelvic floor disorders include:
- A common treatment for pelvic floor dysfunction, the technique is guided by a physical therapist trained in treating pelvic disorders. Biofeedback is painless and does not require surgery. More than 75 percent of people with pelvic floor dysfunction experience significant improvement with biofeedback. The treatment makes use of special sensors and video to observe the pelvic floor muscles as you learn to control them. By having better pelvic muscle tone and control, this can greatly reduce your symptoms.
- Kegel exercises can also be part of a physical therapy program. You’ll be asked to tighten your pelvic muscles as if you were holding back your urine. Hold the muscles tight for several seconds, relax, then repeat the process. You can do this exercise several times a day to strengthen your pelvic floor.
- Some physicians may choose to prescribe a muscle relaxant to deal with pelvic floor muscle spasms or pain.
- If your pelvic floor disorder is due to rectal prolapse or rectocele, you may need surgery. A rectal prolapse occurs when the inner rectal lining drops down into the anus. A rectocele means the rectum protrudes through the vaginal wall. Special tests (defecating proctogram) can help your doctor decide if one of these problems applies to your situation.
What Are Some Other Causes of Pelvic Pain?
Not all pelvic pain is caused by pelvic floor disorders. For instance, the following conditions can also cause pelvic discomfort or pain:
- Endometriosis – When the lining of the uterus grows over your ovaries, bladder or other organs
- Chronic pelvic inflammatory disease – An infectious disease that affects the female reproductive organs causing pain and inflammation
- Fibroids – Benign tumors that grow in the uterus; these can cause pain and can grow very large in some cases
- Interstitial cystitis – The urinary bladder gets inflamed and causes you to feel like you have to urinate often and can also cause pelvic pain
- Intestinal diseases – These can include inflammatory bowel disease, Crohn’s disease, colitis, diverticulosis and diverticulitis
- Arthritis – Occurrences of arthritis in the hips or other joints may cause pelvic pain.
- Cancer – Some cancers of the pelvis, reproductive organs and intestinal structures can cause pelvic pain.
If you are worried you might have pelvic floor dysfunction, or if you have any of the symptoms described in this article, see your doctor and find out about your treatment options.
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