People with pelvic floor dysfunction often experience problems with their bowel and bladder functions. Without treatment, the condition may worsen and disrupt a person’s daily living. What causes pelvic floor dysfunction and what complications may occur?

Pelvic floor dysfunction, defined

The pelvic floor is made up of muscles that run from the front of the pubic bone to the back of the tail-bone, as well as from side to side. Think of it as a basin-like structure that supports the pelvic organs, including the bladder, rectum, vagina, uterus or womb in women, and prostate in men.

Normally, we can coordinate the relaxation and contraction (tone) of the pelvic floor muscles without a problem. This well-coordinated muscle tone allows us to perform bowel and bladder movements smoothly. However, people with pelvic floor dysfunction (PFD) have a problem with their pelvic floor muscle tone. They may have abnormally weak muscles that cannot adequately contract or excessively tight muscles that cannot sufficiently relax. Muscle tone problems often lead to bowel and bladder issues.

Symptoms

When a person has pelvic floor dysfunction, he or she may notice the following symptoms:

• Urination problems, including urinary urgency or frequency, inability to start or stop urine stream, incomplete emptying of the bladder, and painful urination.
• Bowel problems like constipation, straining, and painful bowel movement.
• Pain in the pelvic region, genital area, rectum, or lower back.
• Pelvic floor muscle spasms
• Painful sexual intercourse or pain during sexual stimulation or orgasm

Causes of pelvic floor dysfunction

Medical experts are still trying to figure out the full causes of pelvic floor dysfunction, but they have identified some risk factors.

Pregnancy and childbirth

Pregnancy and childbirth are “active areas” of research about pelvic floor dysfunction.

Several reports indicate pregnancy as a common cause of PFD, with women often developing the condition after giving birth. Experts explain that the pelvic floor muscles experience straining during delivery, especially when the labor is long and difficult. The pressure on the muscles may contribute to problems in the pelvic floor tone.

In other studies, researchers found out that PFD risk increases with the number of childbirths a woman goes through. Additionally, the risk heightens if the mother undergoes assisted delivery with vacuum or forceps. Giving birth via Cesarean section may reduce the risk, but it doesn’t eliminate it.

Overusing the pelvic floor

According to experts, prolonged strain or pressure in the pelvic floor may be one of the causes of pelvic floor dysfunction. “Overuse” can happen due to:

• Overweight or obesity, as it adds pressure to the pelvis
• Pushing too hard during bowel movements especially with chronic constipation
• Chronic coughing because of an underlying condition such as uncontrolled asthma or chronic obstructive pulmonary disease (COPD)
• Heavy lifting

Weak pelvic floor muscles

PFD may also be the result of weak pelvic floor muscles. The muscles can weaken due to aging or even genetics. Experts highlight that genes also dictate the strength of a person’s muscles, bones, and tissues. People born with weak pelvic floor muscles may experience PFD.

Trauma and surgery

People who went through a physically traumatic incident that affected their pelvis may develop PFD. Pelvic surgery, such as hysterectomy, also increases the risk.

Possible complications and treatment

If left unmanaged, pelvic floor dysfunction causes more severe problems in a person’s bowel, bladder, and sexual functions. To prevent the worsening of existing symptoms, people with PFD must consult their healthcare provider.

Fortunately, mild pelvic floor dysfunction cases are manageable with self-care tips (avoid straining, warm baths, etc.), medication, and treatment like biofeedback therapy.

In biofeedback therapy, the expert will teach you how to “retrain” your muscles. They may use different sensors and video monitors to evaluate what happens when you try to control your pelvic floor. Afterward, they’ll give you their feedback based on what they observed. From there, you can start working with them on a care plan that will help you coordinate your muscles properly.

For more advanced or problematic pelvic floor problems such as prolapse, moderate to severe stress incontinence, or fecal incontinence, it is best to seek a specialist’s help. Consult with a Urogynecologist–an obstetrician-gynecologist with subspecialty training of female pelvic floor dysfunction–for further evaluation.

Learn more about Pelvic Related Issues here.