Frequently Asked Questions of the Pelvic Floor:

What is the pelvic floor?

• The pelvic floor consists of muscles, ligaments, nerves, and connective tissues in the pelvis that help support the vagina, bladder, uterus, and organs. This girdle also helps with the stability of the Low Back and pelvic region. It helps with lubrication for a healthy vagina and for sexual reasons. The PF also helps as a sump pump for the lymphatic system. Both men and women have a pelvic floor.

• 

What is a pelvic floor disorder?

• A PF disorder is when the muscles, ligaments or connective tissues of the “hammock” become weakened or injured. The 3 main disorders that are related to the pelvic floor are: Urinary Incontinence, Fecal Incontinence, and Pelvic Organ Prolapse.

• Urinary Incontinence:

  • Stress Incontinence (leakage with laughing, coughing, sneezing)

  • Urge Incontinence (getting close to the door and NEED to urinate)

  • Mixed Incontinence (stress and urge)

  • Neurogenic Bladder (causes from cerebral palsy, post-stroke, Parkinson’s)

    • Resource: https://my.clevelandclinic.org/health/diseases/15133-neurogenic-bladder

• Fecal or Bowel Incontinence: 

  • Can range from leakage of stool during release of gas to a complete loss of stool

  • Causes:

    • Diarrhea

    • Constipation

    • Muscle or Nerve Damage (childbirth, epesiotomies, surgeries)

    • Rectal Prolapse (rectum bulging through the anus)

    • Rectocele  (rectum bulging into the vaginal wall)

• Pelvic Organ Prolapse:

  • A hernia or bulging of the pelvic organs (uterus, bladder, rectum) through the vaginal wall.

  • Most common after childbirth

  • Treatments include:

    • Pelvic Floor Exercises from a Physical Therapist

    • Biofeedback Re-education

    • Anti-gravity positioning (inversion)

    • Pessaries (silicone devices placed in the vagina to stabilize the organs and vaginal wall)

    • Surgeries

  • Resource: https://www.nafc.org/pelvic-organ-prolapse/

What causes a pelvic floor disorder?

• There are many reasons that are known and unknown for causing a disorder in the pelvic region.

• Including, but not excluding:

  • Trauma from Childbirth

  • Number of births

  • Surgeries or radiation in the pelvic region

    • ie. hysterectomies, cesearean sections, cervical cancer

  • Overweight or obesity

  • Heavy lifting (repetitive and poor lifting techniques)

What is a pelvic floor dysfunction? 

• The difference between a PF disorder and dysfunction is that a dysfunction relates to the inability to control the PF muscles. This results in problems with coordination due to the poor connection between the brain and the pelvic floor. Your doctor may categorize the problem into 1 of the 3 dysfunctions: Bladder Dysfunction, Bowel Dysfunction or Pelvic Pain. 

• Pelvic Pain: 

  • Endometriosis

  • Vulvar pain

  • Vaginismus

  • Coccydynia

  • Vestibulodynia

  • Levator Ani Syndrome

• Bladder Dysfunction: 

  • Urinary incontinence

  • Urinary frequency/urgency

  • Overactive Bladder

  • Interstitial Cystitis

• Bowel Dysfunction: 

  • Fecal Incontinence

  • Constipation

  • Irritable Bowel Syndrome

What are symptoms of a pelvic floor disorder or dysfunction? 

• Urinary problems

  • urgency, frequency, leaking, straining to urinate

• Bowel problems

  • constipation, leakage, straining, hemorroids

• Pain or pressure in pelvis or rectum

• Pain with sitting

• Pain with intercourse for women

• Heavy feeling in the vaginal opening or rectum

• Low back pain, sacral pain, tailbone pain

• Abdominal tightness or pain

Who can help diagnose, treat, and prevent pelvic floor disorders? 

• PHYSICAL THERAPISTS

• Urogynecologists

• Urologists

• Gastroenterologists

• Obstetricians

• Gynocologists

• Naturopathic Doctors

• Midwives

• Nurse Practitioners

Other practitioners that play a major role in helping with PF disorders: 

• Mental Health Counselors

• Psychologists

• Sex Therapists

• Radiologists

• Plastic/Reconstructive Surgeons

• Family Practitioners

• Acupuncturists

• Massage Therapists