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Pelvic Floor Dysfunction

Pelvic floor dysfunction is the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement. Symptoms include constipation, straining to defecate, having urine or stool leakage, and experiencing a frequent need to pee. Initial treatments include biofeedback, pelvic floor physical therapy and medications.

What is pelvic floor dysfunction?

Pelvic floor dysfunction is a common condition where you are unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement. If you’re a woman, you may also feel pain during sex, and if you’re a man you may have problems having or keeping an erection (erectile dysfunction or ED). Your pelvic floor is a group of muscles found in the floor (the base) of your pelvis (the bottom of your torso).

What causes pelvic floor dysfunction?

The full causes of pelvic floor dysfunction are still unknown. But a few of the known factors include:

  • Traumatic injuries to the pelvic area (like a car accident).
  • Pregnancy.
  • Overusing the pelvic muscles (like going to the bathroom too often or pushing too hard), eventually leading to poor muscle coordination.
  • Pelvic surgery.
  • Being overweight.
  • Advancing age.

What does pelvic floor dysfunction feel like?

Several symptoms may be a sign that you have pelvic floor dysfunction. If you have any of these symptoms, you should tell your healthcare provider:

  • Frequently needing to use the bathroom.
  • Constipation, or a straining pain during your bowel movements.
  • Straining or pushing really hard to pass a bowel movement or having to change positions on the toilet or use your hand to help eliminate stool.
  • Leaking stool or urine (incontinence).
  • Painful urination.
  • Feeling pain in your lower back with no other cause.
  • Feeling ongoing pain in your pelvic region, genitals, or rectum — with or without a bowel movement.

Is pelvic floor dysfunction different for men and women?

There are different pelvic conditions that are unique to men and women.

Pelvic floor dysfunction in men:

Every year, millions of men around the world experience pelvic floor dysfunction. Because the pelvic floor muscles work as part of the waste (excretory) and reproductive systems during urination and sex, pelvic floor dysfunction can co-exist with many other conditions affecting men, including:

  • Male urinary dysfunction:
  • Erectile Dysfunction (ED): ED is when men cannot get or maintain an erection during sex.
  • Prostatitis.

Pelvic floor dysfunction in women:

Pelvic floor dysfunction can interfere with a woman’s reproductive health by affecting the uterus and vagina. Women who get pelvic floor dysfunction may also have other symptoms like pain during sex.

Pelvic floor dysfunction is very different than pelvic organ prolapses. Pelvic organ prolapse happens when the muscles holding a woman’s pelvic organs (uterus, rectum, and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.

How is pelvic floor dysfunction diagnosed?

Your healthcare provider will usually start by asking about your symptoms and taking a careful medical history. Your provider may ask you the following questions:

  • Do you have a history of urinary tract infections?
  • If you are female, have you given birth?
  • If you’re female, do you have pain when you have sex?
  • Do you have interstitial cystitis (a long-term inflammation of the bladder wall) or irritable bowel syndrome (a disorder of the lower intestinal tract)?
  • Do you strain to pass a bowel movement?

Your provider may also do a physical exam to test how well you can control your pelvic floor muscles. Using their hands, your provider will check for spasms, knots or weakness in these muscles. Your provider may also need to give you an intrarectal (inside the rectum) exam or vaginal exam.

You may also be given other tests including:

  • Surface electrodes (self-adhesive pads placed on your skin) can test your pelvic muscle control.
  • Anorectal manometry (a test measuring how well the anal sphincters are working) can test pressure, muscle strength and coordination.
  • defecating proctogram is a test where you are given an enema of a thick liquid that can be seen with an X-ray.
  • uroflow test can show how well you can empty your bladder. If your flow of urine is weak or if you have to stop and start as you urinate, it can point to pelvic floor dysfunction.

How do you treat pelvic floor dysfunction?

Fortunately, pelvic floor dysfunction can be treated relatively easily in many cases. If you need physical therapy, you’re likely to feel better but it may take a few months of sessions. Pelvic floor dysfunction is treated without surgery. Non-surgical treatments include:

  • Biofeedback: This is the most common treatment, done with the help of a physical therapist. Biofeedback is not painful and helps over 75% of people with pelvic floor dysfunction. Your physical therapist might use biofeedback in different ways to retrain your muscles. For example, they may use special sensors and video to monitor the pelvic floor muscles as you try to relax or clench them. Your therapist then gives you feedback and works with you to improve your muscle coordination.
  • Pelvic floor physical therapy: Physical therapy is commonly done at the same time as biofeedback therapy. The therapist will determine which muscles in your lower back, pelvis and pelvic floor are tight and teach you exercises to stretch these muscles so their coordination can be improved.
  • Kegel exercises, or similar techniques that require you to contract your muscles, will not help this condition. While surgery is an option, there are less invasive treatment options available.
  • Medications: Daily medications that help to keep your bowel movements soft and regular are a very important part of treating pelvic floor dysfunction. Some of these medications are available over the counter at the drugstore and include stool softeners. Your primary care doctor or a gastroenterologist can help to advise you which medications are most helpful in keeping your stools soft.
  • Relaxation techniques: Your provider or physical therapist might also recommend you try relaxation techniques such as meditation, warm baths, yoga and exercises, or acupuncture.

Does pelvic floor dysfunction go away on its own?

Pelvic floor dysfunction symptoms (like an overactive bladder) typically stay or become worse if they’re not treated. Instead of living with pain and discomfort, you can often improve your everyday life after a visit with your provider.

Is pelvic floor dysfunction curable?

Fortunately, most pelvic floor dysfunction is treatable, usually through biofeedback, physical therapy, and medications. If you start to experience any of the symptoms of pelvic floor dysfunction, contact your healthcare provider. Early treatment can help improve your quality of life and help with your inconvenient and uncomfortable symptoms.


Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility of any damage done by the misuse or use of the information.

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