Pelvic Floor Dysfunction: Common and Easily Treatable

Approximately one in four women will be affected by Pelvic Floor Dysfunction. This condition is extremely common and highly treatable, yet only 10 to 20 percent of the women affected will seek treatment. Why? What is pelvic floor dysfunction?

Pelvic floor dysfunction (PFD) is a condition where the muscles in the pelvic floor are weakened. The pelvic floor is a group of muscles that form a “sling” across the pelvis. These muscles are responsible for keeping pelvic organs (like your bladder, uterus, and rectum) in place so they can function properly.

Weakening of these muscles may cause embarrassing symptoms and even pain for some. How do you know if you have PFD?

Symptoms of Pelvic Floor Dysfunction:

  • Frequent, incomplete bowel movements
  • Frequent and/or painful urination
  • Incomplete emptying of the bladder and a weak urine stream
  • Constipation/ straining during bowel movements
  • Bowel or urinary incontinence
  • Painful intercourse
  • Painful bowel movements
  • Unexplained chronic pain, muscle spasms or “fullness” feeling of the pelvis, rectum, and genitals

Patients who have pelvic floor dysfunction, essentially lack the muscle control to contract and relax the pelvic muscles. In some cases, the muscles are excessively tight and for others the muscles are too relaxed. Either way it leaves patients unable to control the muscles in their pelvic floor and many of these symptoms, especially pain and incontinence, can greatly impact the quality of life.

Causes for Pelvic Floor Dysfunction:

There are many possible causes for pelvic floor dysfunction. However, many of the risk factors thought to be responsible include:

  • Traumatic accidents to the pelvis
  • Emotional Trauma
  • Strenuous exercise (such as weight lifting)
  • Pregnancy
  • Vaginal childbirth complication
  • Obesity
  • Aging
  • Interstitial cystitis (IC)
  • Infections

More than 30% of women who deliver vaginally will experience some sort of pelvic floor trauma.

The good news is even though this condition is extremely common, especially among women 20-80 years of age, it is easy to diagnose and highly treatable.

Tests Used for Diagnosing Pelvic Floor Dysfunction:

Your doctor will first discuss with you your symptoms and any possible causes including physical and possible emotional trauma. Then, you will have a physical exam using external and internal hands-on or manual techniques, to evaluate pelvic floor muscle function. This exam is designed to help determine if you can contract and relax these muscles properly.

Other Testing may Include:

  • Urodynamic testing – measures pressure in your bladder when resting and filling. We insert a catheter into your urethra and bladder to fill your bladder with water. A pressure monitor measures and records the pressure within your bladder
  • Ultrasound– used to evaluate the muscles of the pelvic floor
  • Dynamic defecography – a test used to evaluate the pelvic floor and rectum while the patient is having a bowel movement

Treatment Options for Pelvic Floor Dysfunction:

Pelvic floor dysfunction is highly treatable, and many times can be done without any serious intervention. The goal is to strengthen, or relax if necessary, pelvic floor muscles without overly stressing them.

Your doctor may recommend physical therapy and home exercises to begin treatment. In fact, over 75 percent of cases see improvement through use of Biofeedback and Physical therapy. What can you expect with some of the available treatment options?

  • Physical therapy – This treatment plan may involve manual therapy or massage both externally and internally to stabilize your pelvis before using other treatment options. Manual therapy takes time and patience, and may require one to three sessions per week. Many patients see improvement after six to eight weeks. Your therapist may also incorporate therapies like Biofeedback to help you relax or strengthen the muscles of the pelvic floor.
  • Home Exercise – Because the goal of PFD therapy is to learn to control and, especially, relax the pelvic floor, therapists will teach techniques for use at home. This usually begins with general relaxation, stretching the leg and back muscles, maintaining good posture, and visualization — part of learning to sense your pelvic floor muscles and to relax them.
    • Your therapist may also walk you through a commonly known pelvic floor exercise called a Kegel, which is designed to strengthen the pelvic floor. However, because only 25 percent of women can perform a Kegel correctly they will ensure you are doing it properly for maximum effect.
  • Self-Care– Avoid pushing or straining when urinating and ask your healthcare provider how to treat constipation.
  • Medication— Low doses of muscle relaxants can help in some cases.
  • Good posture– Maintaining good posture to keep pressure off your bladder and pelvic organs, and using stretching or other techniques such as yoga to avoid tightening and spasms in the other pelvic muscles, also helps.
  • Surgery- In some cases surgical intervention can be helpful in repairing pelvic floor damage causing the dysfunction.

While pelvic floor dysfunction is common, it can be embarrassing and painful for you as the patient. We at Western Michigan Urological Associates can help alleviate immediate pain and help you develop a plan to improve your quality of life and alleviate symptoms of pelvic floor dysfunction. Ask Your Primary Care Provider for a Referral.

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