Pelvic Floor Dysfunction

Pelvic floor dysfunction is a common, generally misunderstood condition wherein the pelvic floor muscles cannot relax and coordinate appropriately with bowel movements. Symptoms can include constipation and straining to pass stool, urinary and fecal incontinence, and a frequent need to urinate. Treatments include biofeedback, pelvic floor physical therapy, and medications.

Contents

• Overview
• Symptoms and Causes
• Diagnosis and Tests
• Management and Treatment
• Outlook / Prognosis
• Living With Pelvic Floor Dysfunction

Overview

The pelvic floor is a group of muscles that, at the base of the pelvis, supports the pelvic organs—the bladder, rectum, and uterus for people assigned female at birth. It controls bowel and bladder functions. These muscles work normally by releasing and contracting together to permit urination and defecation. In cases of pelvic floor dysfunction, this correct relaxation does not occur, which complicates the issue more.

What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction is a condition where a person loses normal control and fails to relax the pelvic floor muscles properly. This might be followed by problems in passing stool, urine, and fecal incontinence, and pain during sexual intercourse. This happens because the pelvic floor muscles do not relax but remain relatively tightened. As such, it prevents the normal passage of both urine and stool.

• Pelvic Floor Anatomy: The pelvic floor is the base that supports pelvic organs.
• Muscle Coordination: Normal function includes relaxation and tightening of pelvic floor muscles.
• Dysfunction: In PFD, the muscles are contracted and stay that way, resulting in a variety of symptoms.

Symptoms and Causes

Pelvic Floor Dysfunction Symptoms

Pelvic floor dysfunction patients can present with the following symptoms, which include :

• Frequent Bathroom Visits: Sense of needing to urinate or have a bowel movement urgently.
• Straining: Feeling difficulty starting or finishing a bowel movement.
• Constipation: A feeling of incomplete evacuation following a bowel movement.
• Incontinence: Loss of control over urine or stool.
• Pelvic Pain: Pelvic pain at times associated with, and at times unrelated to, bowel movements.
• Sexual Dysfunction: Dyspareunia (AFAB) and erectile dysfunction (AMAB).
• Low Back Pain: Non-specific low back pain of chronic nature.

Causes for Pelvic Floor Dysfunction

Pelvic floor dysfunction is often nebulous in its cause but several factors may contribute to its development. These include trauma to the pelvic area from accidents or falls, overuse from excessive straining during bowel movements, and previous surgeries that involved the pelvis. The childbirth event may weaken pelvic floor muscles due to a difficult delivery. Natural weakening of the muscles with age and stress or anxiety are also influential psychological factors.

Connective Tissue Disorders: Disorders of the strength and elasticity of connective tissue.

Conditions That Simulate Pelvic Floor Dysfunction

Pelvic floor dysfunction can be misdiagnosed or coexist with the following disorders:

Interstitial Cystitis: A disorder causing pain in the bladder and pelvis area.

Irritable Bowel Syndrome: The symptoms are similar to PFD mainly constipation and the feeling of incomplete emptying of the bowels.

Pelvic Organ Prolapse: A weakening of the muscles that support the pelvic organs.

Erectile Dysfunction: Tension in the pelvic muscles can also lead to erectile dysfunction.

Prostatitis: Inflammation of the prostate gland may simulate symptoms of PFD.

Anorectal Conditions: Conditions like fissures or fistulas can reproduce similar symptoms.

Diagnosis and Tests

How is Pelvic Floor Dysfunction Diagnosed?

Diagnosis most often starts with a thorough medical history and discussion of symptoms. Some important questions to answer may include the following:

• Do you strain to poop?
• Are you able to empty your bladder?
• Do you feel empty after a bowel movement?
• How often do you poop or pee?

For AFAB people, history of pregnancies and pain during sex.

Diagnostic Tests for Pelvic Floor Dysfunction

Some of the following tests can diagnose pelvic floor dysfunction:

• Physical Exam: It observes control and strength of pelvic floor muscles.
• Anorectal Manometry: Anal sphincter pressure and coordination of pelvic floor muscles.
• Defecating Proctogram: Tests how well the bowel movement works.
• Urodynamics: Tests the functioning of the bladder and how well the flow of urine goes.
• Management and Treatment

Treatment Options for Pelvic Floor Dysfunction

There exist many non-operative treatments available for pelvic floor dysfunction. Pelvic floor physical therapy is when a therapist assists exercises in relaxation and pacing of pelvic floor muscles. Biofeedback: uses sensors and video to monitor muscle activity, helping improve muscle control. Medications Stool softeners and laxatives should ensure regularity of bowel movements. Relaxation techniques - meditation, warm baths, yoga, acupuncture - reduce muscular spasm or tension.

Trigger Point Injections: Injections to relax specific overly tense muscles if other treatments fail.

Outlook / Prognosis

Can You Restore Your Pelvic Floor?

Improvement can take several months of consistent physical therapy and treatment, but many people see significant progress. Biofeedback is especially successful, helping more than 75 percent of people with PFD gain better muscle control.

Does Pelvic Floor Dysfunction Go Away on Its Own?

Pelvic floor dysfunction seldom goes away on its own. If not treated, it could continue to worsen over time. Accurate diagnosis and proper treatment are key in managing symptoms and relief.

Living With Pelvic Floor Dysfunction

Self-Care Tips for Managing Pelvic Floor Dysfunction

Living with pelvic floor dysfunction requires a significant commitment to treatment and lifestyle modifications. This includes the following:

Sticking to a Treatment Plan: Make sure to keep all of your therapy appointments and take medications as prescribed by your doctor.

Avoiding Aggravating Activities: Avoid heavy lifting or any activity that appears to increase pelvic pressure.

Keeping Well Hydrated and Well Fed: Adequate fluid intake and a diet preventing constipation

Symptom Monitoring: Keeping a log of the symptoms and contact with health care providers about its ongoing management

A Word about Getting Help

While discussing pelvic floor dysfunction symptoms might be a matter of discomfort, open communication with one's healthcare provider is just the way to ensure effective treatment. With the appropriate approach, most symptoms are manageable. However, it requires one to reach out and follow through on recommended care plans.

Pelvic floor dysfunction is a manageable condition with proper treatment and some lifestyle changes, with an understanding of the symptoms, causes, and treatment options—realizing that the first step toward relief. It will be worthwhile to remember that consistent adherence to prescribed therapies and openness to health providers are very conducive to significant improvement in quality of life. If you think you have pelvic floor dysfunction, do not hesitate to see a health provider to get the proper treatment tailored for your case.