Pelvic floor disorder: You want me to see a physical therapist for what?

Kristin Phillips

Are you experiencing urinary incontinence or sexual dysfunction? It could be caused by pelvic floor disorder, a condition that causes a wide array of health problems for women. WVU Medicine physical therapist Kristin Phillips, DPT, explains more about this condition.

What is pelvic floor disorder?
Pelvic floor disorder is a broad term used to describe a number of issues experienced due to a dysfunction of the pelvic floor muscles. The pelvic floor muscles are the group of muscles that sit inside the pelvis. These muscles help control bowel and bladder function, and they support internal organs. They can become weak, uncoordinated, or have too much tension in them. You may have heard terms like urinary incontinence, fecal incontinence, sexual dysfunction, or pelvic organ prolapse (when the bladder drops slightly and pushes against the vagina); these diagnoses and others could all be caused by pelvic floor disorder. It’s important to meet with your primary care provider and your gynecologist to rule out any other causes of your complaints, but it is very possible that underlying pelvic floor muscle problems are the cause or at least a contributing factor.

What are the symptoms?
Symptoms can include leaking urine or feces, pelvic or abdominal pain, difficulty with or incomplete bladder or bowel emptying, constipation, painful intercourse, or other sexual dysfunction. Someone with a pelvic floor disorder may also experience high urinary frequency, strong urinary or bowel urgency, or a feeling of pelvic heaviness.

What causes pelvic floor disorder?
Pelvic floor disorder may be caused by pregnancy and delivery or other trauma to the pelvis, hips, or back. As women age and with menopause, the pelvic floor muscles may undergo changes that can cause them to become weak. Chronic constipation or straining with bowel movements can lead to a weakening of the pelvic floor muscles. Sometimes, the cause of a pelvic floor disorder is unknown.

How common is pelvic floor disorder?
Pelvic floor disorder is quite common. Some estimate that it affects one-quarter of women ages 20-39, one-third of women aged 40-59, and one-half of women aged 60-79 in the United States. These numbers will likely only increase over the next few decades.

Why don’t more women seek treatment?
Despite how common this problem can be, many women do not seek treatment. They may feel embarrassed to bring these concerns up to their doctor. Often times, many people think this is normal and simply something that they have to learn to live with. It may be common, but it doesn’t have to be normal. Talk openly with your provider to come up with a treatment plan that meets your personal needs.

How can a pelvic floor physical therapist help?
A pelvic floor physical therapist has specialized training in the muscles of the pelvic floor, abdomen, bowel, bladder, and sexual function. During your first visit with a pelvic floor physical therapist, they will take a thorough history to determine what may be causing your problem. An examination of the muscles of the hips, abdomen, and pelvis will be completed. Any other relevant areas will also be assessed. Based on the findings, the physical therapist will work with you in setting goals for your treatment and then develop a plan accordingly.