Pelvic Floor Conditions and Why They Matter

The pelvic floor has become a popular topic over the years, but despite the recent publicity many people still don’t know what the pelvic floor is. It is less of a floor and more of a muscular bowl located inside of the pelvis. These muscles have multiple functions:

1. • They support the pelvic organs (the bladder, colon, and the uterus or prostate)
   • They provide core stability.
   • They help maintain the continence of the bladder and bowels
   • They aid in sexual function (erections and orgasms)
   • They assist the lymphatic system, acting almost like a pump pushing fluid from the limbs up to the heart

Given how many important functions these muscles do every day it’s surprising we don’t talk about them more!

Typically most people don’t learn about these muscles until they are experiencing symptoms related to pelvic floor dysfunction.

Like any muscle, the pelvic floor can develop impairments that impact how those muscles function. Sometimes these muscles become tense, guarded, stiff, or spasmodic or these muscles can lack muscle tone or they are weak or uncoordinated. Sometimes people use the terms hypertonic (tense) or hypotonic (weak) to describe pelvic floor dysfunction. It’s important to recognize that since so many muscles attach to the pelvis, impairments of other structures can impact the pelvic floor muscles. For example, tension in the buttocks can contribute to pelvic floor tension, or scar tissue from an abdominal surgery can impact how the abdominal muscles move which can impact how the pelvic floor muscles function.

Many people associate the pelvic floor as a women’s health issue, but since everyone has a pelvis that means everyone has a pelvic floor, therefore anyone can experience pelvic floor dysfunction.

It is estimated that 25%-30% of women will experience pelvic floor dysfunction at some point in their life and research shows that an estimated 16% of men will experience symptoms related to pelvic floor dysfunction. Various life events, such as pregnancy and menopause, are the reason pelvic floor syndromes are more common in women, but as mentioned pelvic floor dysfunction can occur in any gender.

Symptoms of pelvic floor dysfunction can vary, often symptoms are associated with one of the organs that reside in the pelvis meaning someone can report bowel, bladder, and/or sexual dysfunction. Specifically, a person may report the following:

• • Urinary frequency or urgency
  • Nocturia or waking frequently at night to pee
  • Difficulty urinating
  • Constipation
  • Painful bowel movements
  • Dysuria (pain with urination)
  • Urinary incontinence
  • Fecal incontinence
  • Pain with sex
  • Erectile Dysfunction
  • Premature Ejaculation
  • Pain with Orgasms

Many people with pelvic floor dysfunction often report pelvic pain. A person may report pain in the genitals, the anus, or the perineum. People may report pain with sitting or pain while wearing tight clothing. People may also report low back, hip, abdominal, or groin pain due to issues with their pelvic floor.

Sometimes the cause of pelvic floor dysfunction can be unclear, but there are a few conditions that are associated with pelvic floor dysfunction, a common one being constipation. The increased load on the pelvic floor and any pushing or straining associated with it can put a lot of stress on the pelvic bowl which can result in pelvic floor dysfunction. Certain medical conditions like Endometriosis, Prostatitis, Interstitial Cystitis, or Irritable Bowel Syndrome/Disorder (IBS/IBD) are typically associated with pelvic floor dysfunction. Other life events like pregnancy and childbirth or treatment for cancer, such as a prostatectomy or any radiation to the pelvis can impact the pelvic floor.

Figuring out the cause of a person’s symptoms is important in getting the appropriate treatment.

Since some of the issues mentioned earlier can be due to something like a urinary tract infection (UTI) or certain STIs/STDs, it is important to see a healthcare provider in order to get a proper diagnosis. Although it is also important to know that someone can have pelvic floor dysfunction and an infection at the same time, they do not always occur in isolation.

However, if someone suspects they have pelvic floor dysfunction or have been diagnosed with it there are many treatment options.

The most obvious being pelvic floor therapy which would address any musculoskeletal impairments externally and internally to improve the mobility of the muscles.

This may include manual therapy and specific exercises depending on what the provider finds during their initial examination. They may recommend dietary modifications or lifestyle changes. Depending on someone’s symptoms they may benefit from working with an acupuncturist. Due to the various structures that reside in the pelvis, a person may need to consult a specialist such as a Urologist, Gynecologist, Urogynecologist, Gastrointestinal, Colorectal Specialist, or a Pain Specialist.

Finding the right providers to work with is often essential for someone to get the appropriate treatment and resolve whatever symptoms have impacted their quality of life.

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