Find Relief From Pelvic Floor Dysfunction and Prolapse
Pelvic floor disorders can cause symptoms that range from uncomfortable to downright debilitating.
You might find yourself searching for a restroom even though you went 20 minutes ago. Or when sensing a sneeze coming on, brace yourself to avoid an embarrassing moment.
Some women even experience severe pelvic pain, backaches, bowel problems or pain during intercourse. And often, they don’t seek the help they need.
“These are not things that women always want to talk about with their providers,” explains Dr. Nathan Kow, urogynecologist at AdventHealth. “They certainly don’t talk to their friends and family about it. Some women believe it’s normal or a rite of passage as they age. We spend a lot of time as gynecologists trying to explain that no, that’s not normal and there are treatment options for it.”
Pelvic Floor Problems Are Common
According to a National Institutes of Health study, almost 25% of women are faced with pelvic floor dysfunction. That number jumps to 37% of women 60 to 79 years old, and nearly half of women 80 or older. While pelvic floor dysfunction becomes more common as women age, pelvic issues need not be categorized as acceptable and untreatable discomforts you must simply learn to live with. But with the right information and a proper treatment plan, you may no longer have to suffer in silence.
Understanding the Pelvic Floor
The pelvic floor is a combination of muscles, ligaments and tissues that act like a hammock to support organs, such as the bladder, uterus, vagina and rectum in the lowest part of the pelvis. Essentially, the pelvic floor prevents these organs from falling down or out of the body and helps make sure they’re functioning properly.
What Causes Pelvic Floor Dysfunction?
Pelvic floor dysfunction refers to a wide range of disorders that occur when muscles of the pelvic floor are weak, tight or torn. If the muscles become weak or the ligaments or tissues are stretched or damaged, the pelvic organs or small intestine may drop down and protrude into the vagina. If the disorder is severe, the organs may protrude all the way through the opening of the vagina and outside the body.
In general, pelvic floor dysfunction is due to weakened pelvic muscles or tears in the connective tissue.
“We typically think of childbirth as the main risk factor, but there are actually a lot of different risk factors the — main one is probably age,” says Dr. Kow.
“As you enter menopause, your tissues weaken, and that’s a big risk factor. Obesity also puts extra pressure on the pelvic floor, and there are genetic factors and family history that we think may contribute. Hysterectomy itself can also be a risk factor for prolapse.”
Symptoms of Pelvic Floor Dysfunction
Pelvic floor dysfunction may cause:
- Burning during urination
- Chronic pelvic pain that radiates to the groin, abdomen and back
- Difficulty with defecation and constipation
- Painful menstrual periods
- Painful sexual intercourse
- Strong or frequent urge to urinate
- Urinary incontinence
- Vaginal burning
Types of Pelvic Floor Dysfunction
The three main types of pelvic floor dysfunction are:
- Urinary incontinence
- Fecal incontinence
- Pelvic organ prolapse
Urinary incontinence is loss of bladder control and is the most common pelvic floor disorder. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. Women experience urinary incontinence twice as often as men.
It can be caused by a number of conditions, including a weakening of the muscles that control the bladder valve. A major symptom is the frequent urge to urinate; other symptoms include pressure on the bladder and a feeling that the bladder has not completely emptied. There are several different types of urinary incontinence and the severity can vary from person to person.
Fecal incontinence is the inability to control bowel movements, causing stool to leak unexpectedly from the rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control. Common causes of fecal incontinence include diarrhea, constipation and muscle or nerve damage. The muscle or nerve damage may be associated with aging or with giving birth.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs when a pelvic organ, such as your bladder drops (or prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. While these conditions are usually not associated with serious health risks, they can cause major discomfort with symptoms that include a heavy feeling or like something is falling out of the vagina, a pulling or pressure in the lower abdomen or pelvis, pain during intercourse and frequent urinary infections due to a reduced ability to release urine from the urethra.
“Prolapse can happen to anything within the pelvis. That can include the bladder, the cervix or uterus, the top of the vagina (or what we call the apex in a woman who has had a hysterectomy) and the rectum,” says Dr. Kow.
“We generally think about prolapse from a female perspective when it comes to the bladder and uterus, but men can also experience rectal prolapse.”
Healing Pelvic Floor Issues
With an expert care team, pelvic floor dysfunction can often be successfully treated without surgery with physical therapy and a combination of other treatment options. Treatments for pelvic floor dysfunction can include:
- Biofeedback: Biofeedback is a non-surgical technique that uses special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them.
- Medicine: Medicine is sometimes prescribed to treat certain bladder control problems, to prevent loose stools or frequent bowel movements.
- Relaxation techniques: Your physician or physical therapist may recommend relaxation techniques such as warm baths and exercises.
- Strengthening exercises: Strengthening exercises, also known as Kegels, involve squeezing and relaxing the pelvic floor muscles. If performed correctly and routinely, these exercises may improve the symptoms of prolapse.
- Surgery: Sometimes, surgery may be necessary.
“We have a lot of different treatment options for prolapse,” explained Dr. Kow. “Some that are not invasive, such as a pessary that relieves pressure in the vagina. We also have surgical options, but surgery really depends what’s going on with your prolapse, and we’d tailor your procedure to you. But surgery won’t cure everything; it has to be the right option for you.”
Can Pelvic Floor Problems be Avoided?
“The easiest thing you can do is Kegel exercises which help strengthen the pelvic floor against things like prolapse and incontinence. Pelvic floor physical therapy also includes muscle training for all muscles in the pelvis,” says Dr. Kow.
“Some things you can modify to reduce your risk, like losing weight, but if you do a lot of heavy lifting at your job you may not be able to change that.”
Seeking Help for Your Symptoms
Many women may not feel comfortable discussing their symptoms with their doctors, but these disorders are actually very common medical conditions that can be treated successfully.
If you have a pelvic health issue, don't hesitate to learn more about your treatment options. We provide urogynecology, colorectal and pelvic rehabilitation services specifically designed to help patients of all ages improve their health and restore quality of life with dignity and a personalized approach to achieving whole health.
Learn more about our urogynecology care here.