What is Your Pelvic Floor and Why Is Everyone Talking About It?
Have you ever felt like you lost control of your bladder or bowels? Do you sense something bulging out from the bottom of your pelvic area? Or maybe you're having pain during sex. If so, you might have an issue with your pelvic floor muscles and this is known as a pelvic floor dysfunction.
Despite the embarrassing nature of these concerns, pelvic floor dysfunction is a common problem that can affect people of all ages, and it’s highly treatable.
Did you know that one in three women experience pelvic floor dysfunction at some point in their lives? Statistics in the U.S. show that 25 percent of women older than 20 have experienced pelvic floor symptoms, and the frequency of pelvic floor disorders increases with age especially over the age of 60.
But first, what is the pelvic floor?
The pelvic floor is a group of muscles that connects the pubic bone to the tailbone. Think of the pelvic floor muscles as a sling or hammock that supports the pelvic organs, which include the bladder, bowel and uterus or prostate.
The pelvic floor muscles work together to support our pelvic organs and keep them in place. They also help us control when we need to urinate or have a bowel movement, and even contribute to our sexual function.
Even though we might not have learned about the “pelvic floor” in school, these muscles play a vital role in our body. We need pelvic floor muscles to relax for us to urinate and to empty our bowels. Yet, they are required to create adequate tension when we cough or sneeze to avoid accidental leakages.
Have you heard of pelvic floor dysfunction?
Pelvic floor dysfunction or disorders refer to a group of conditions that affect the muscles, ligaments and connective tissues that support the pelvic organs.
Symptoms of pelvic floor problems include urinary or bowel leakage, descent of pelvic organs from their normal position, or pain during sexual intercourse.
The medical terms for common pelvic floor disorders are urinary incontinence, anal (fecal) incontinence, pelvic organ prolapse (displacement of pelvic organs) and dyspareunia (pain during sexual intercourse).
To help you understand more about the specific pelvic floor disorders, let’s look at their symptoms, common risk factors, and possible treatments.
“I can’t control my bladder!“
Urinary incontinence is the accidental leakage or unwanted loss of urine known as stress urinary incontinence or urge urinary incontinence. A condition that combines stress and urge urinary incontinence is called mixed urinary incontinence.
Urinary incontinence can affect up to half of all women at any point of their lives. If you find yourself avoiding exercise or trips outside the home because you’re worried about “leaks” or accidents, it’s probably time to get an expert’s help.
Urinary incontinence can feel like:
- Urine leakage when you cough, sneeze, laugh, or exercise
- Having a sudden and urgent need to urinate
- Needing to urinate often, even during the night
- Leaking urine when you are unable to get to the toilet in time
- Dribbling urine after you have finished urinating
- Feeling like your bladder is not completely empty after you have urinated
Although it’s commonly faced by older women, urinary incontinence can also be caused by a variety of factors, including childbirth, obesity, and medical conditions such as diabetes and neurological disorders.
“I can’t hold my stools in!”
When you experience accidental leakage of stool or the accidental loss of bowel control, this is known as anal or fecal incontinence. Anal incontinence is more common in older adults, but it is also a common problem that can affect people of all ages.
Anal incontinence can feel like:
- Leakage stool or gas
- Having to rush to the toilet for an urgent bowel movement
- Feeling like you have to go to the toilet all the time
- Trouble holding in stool or gas
- Pain or discomfort in the rectum or anus
Weakened pelvic floor muscles and decreased functions of the rectum contribute to anal incontinence. Common factors which increase the incidence of anal incontinence are age, childbirth, pelvic surgery, chronic constipation and certain neurological disorders.
“I feel like something is bulging or protruding from my vagina.”
Pelvic organ prolapse is the medical phrase that describes the condition when one or more organs in the pelvis (bladder, rectum or uterus) shifts or descends from their normal position. You’ll notice part of an organ is protruding through an abnormal opening in your muscles. Pelvic organ prolapse is also categorised as a type of hernia.
Pelvic organ prolapse can feel like:
- Something is falling down or bulging out in your pelvic area
- Pressure or heaviness in your lower abdomen or vagina
- Discomfort or pain during activities like standing, walking, or having a bowel movement
While pelvic organ prolapse generally increases with age, it could also occur due to pregnancy, childbirth, hormonal changes, chronic constipation, obesity, genetics or connective tissue disorders.
“I experience pain while having sex with my partner.”
Dyspareunia is pain or discomfort which you may experience during sexual intercourse. The pain is often persistent or recurrent, and can be caused by various factors, including pelvic floor muscle dysfunction.
Dyspareunia can have a complex interplay of physical, psychological, and medical factors contributing to its cause.
When the muscles and ligaments in the pelvic floor are weak or tight, it can cause pain during sex. Simultaneously, in anticipation of pain, muscles around the vagina might tighten involuntarily prior to penetrative sex. This can make it difficult or even impossible for couples to have enjoyable and pleasurable sexual experiences.
Dyspareunia can feel like:
- Sharp, dull or aching pain which can occur before, during, or after sex
- Pain that may be felt in the vagina, vulva or pelvic area
- Discomfort that may feel like a burning, itching or stinging sensation. It can also feel like pressure or tightness.
Where to seek treatments to improve my pelvic floor?
By now, you may have noticed certain symptoms that could potentially be pelvic floor dysfunction in either yourself or someone close to you. If this is the case, we recommend that you check it out by having a professional medical examination.
We advise you to seek out relevant medical specialists such as a urologist, (a specialist of the urinary tract) or a gynaecologist (a specialist in women’s health), or a urogynaecologist (a specialist of both the urinary tract and women’s health).
Seeing a medical specialist helps to rule out medical conditions that can only be treated with medicines such as antibiotics for a urinary tract infection.
You could also make an appointment with a pelvic health physiotherapist (our Dr. Esther Lim) who specialises in providing physiotherapy that is designed to help patients improve their pelvic floor muscle function and reduce symptoms related to pelvic floor dysfunction.
Depending on your condition, the physiotherapist will recommend a treatment plan that is tailored to your specific needs.
Physiotherapy treatment at Performance Wellness is more than just pelvic floor exercises (commonly known as kegel exercises). Your treatment plan may include pelvic floor myofascial release, strengthening and conditioning of core muscles (that work synergistically with the pelvic floor), real-time ultrasound or electromyography (EMG) biofeedback training, and clinical pilates.
Now that you know all about your pelvic floor muscles and the disorders that may affect it, we hope you are more informed and empowered to seek help if you experience any symptoms.