What is pelvic floor dysfunction?
07 August 2023
From embarrassing leaks to uncomfortable prolapses, the symptoms of pelvic floor dysfunction can be distressing and debilitating.
The good news is that there are plenty of ways to treat them. Unfortunately, however, the intimate nature of these symptoms means many people fail to seek the help they need to get better. Here's what you need to know.
What is your pelvic floor?
Your pelvic floor is made of several layers of muscles, nerves, and connective tissue or ligaments.
It extends lengthways from your pubic bone to your coccyx or tailbone and widthways between your sitting bones.
Often described as acting like a hammock - or a trampoline - for your pelvic organs, it has three openings: the urethra, the vagina, and the anus.
Why is your pelvic floor important?
The pelvic floor supports your pelvic organs, creating inner stability and allowing you to control your bladder and bowel function and, in pregnant women, to give birth when the time comes.
The pelvic floor muscles also act together with the deep abdominal muscles to provide support - or core stability - for the spine and pelvis, making them equally crucial for both movement and balance.
What's more, if you're sexually active, you may find stronger pelvic floor muscles can improve satisfaction for both partners.
Know your numbers
Only 47% of women who experience pelvic floor dysfunction symptoms seek medical advice.1
Fact or fiction?
Pelvic floor dysfunction can affect men too Fact. Pelvic floor dysfunction in men can lead to issues such as urinary incontinence and erectile dysfunction.2
What causes weak pelvic floor muscles?
While childbirth is probably the most well-known cause of weak pelvic floor muscles, it's far from the only reason you may need to take action to strengthen your pelvic floor.
Other activities, experiences, and conditions that can have an impact include:
- Chronic constipation - leading to regular straining while on the loo
- Abdominal or pelvic surgery - such as a laparotomy
- Hormonal imbalances - notably the drop in oestrogen after menopause
- High-impact sports - such as boxing or martial arts
- Heavy lifting - including excessive weight training
- Obesity - especially over the longer term
- Chronic chest conditions - due to the strain placed by repetitive coughing
What are the symptoms of pelvic floor dysfunction?
Organs associated with the pelvic floor include the bladder, urethra, vagina, anus, and rectum. Common symptoms linked to pelvic floor dysfunction therefore include:
- Urinary incontinence, or loss of bladder control. This could be stress incontinence that causes leaks during activities such as sneezing or exercising. Or it could be urge incontinence that causes leaks because the urge to urinate comes on suddenly and uncontrollably.
- Pelvic organ prolapse. Generally resulting in a vaginal bulge, this condition is commonly linked to childbirth or surgery and can be diagnosed via physical examination, sometimes coupled with other tests such as an ultrasound or an MRI scan.
- Faecal incontinence, or the inability to control bowel movements. This can be caused by childbirth, by chronic constipation, or by rectal prolapse.
- Defecatory dysfunction, or difficulty in emptying the bowels. The symptoms of this condition include discomfort, constipation and leakage of gas, diarrhoea, or solid stools.
- Voiding dysfunction, or the inability to completely empty the bladder. Most common in children, this is generally caused by pelvic muscles contracting rather than relaxing, meaning the bladder cannot be completely emptied.
Did you know?
Women of all ages - as well as men and children - can develop pelvic floor problems, and not necessarily due to pregnancy or childbirth.3
What treatment is available for pelvic floor dysfunction?
The treatment available will depend on the symptoms you are experiencing. For urinary incontinence, options could include:
- Pelvic floor exercises
- Urethral inserts
- Surgery
- Diet and lifestyle changes
For pelvic organ prolapse, meanwhile, the most suitable treatment will depend on the severity of the prolapse and the related symptoms, your age and general health, and whether you're planning to have children in the future. Options include:
- Pelvic floor exercises
- Hormone treatment
- Surgery
- Vaginal pessaries
For faecal incontinence and defecatory dysfunction, treatment options include:
- Pelvic floor exercises
- Dietary changes
- Surgery
And finally, for voiding dysfunction, treatment options include:
- Stool softeners
- Urinary tract infection treatments
- Dietary changes
Know your numbers
One in four women has never done pelvic floor muscle exercises.4
How can I strengthen my pelvic floor muscles?
As you can see from the section above, exercise is one of the main forms of treatment for almost all pelvic floor dysfunction symptoms.
Staying active is therefore the best way to ensure your pelvic floor remains able to provide the support your body needs, and both Pilates and yoga are known to be excellent for pelvic floor strength.
There are also pelvic floor exercises you can do without diverging from your normal daily routine, whether you're at home, at work or travelling on public transport, for example.
You can learn how to do these by following the steps below, while for more detailed advice and practical help strengthening your pelvic floor, you can use this directory to find a qualified physiotherapist near you.
The anytime, anywhere pelvic floor exercise
- Sit upright on a firm chair with your weight evenly spread between your sitting bones.
- Try to imagine that you need to both stop yourself from passing wind and to halt the flow of urine mid-stream at the same time.
- The aim is to feel a slight lift and tightening inside the vagina, without tightening your bottom muscles or holding your breath.
- Once you recognise this feeling, do a series of say 10 short contractions and 10 long contractions - and repeat at least once a day.