What Is a Pelvic Floor Disorder?

It’s a medical condition that millions of American women have, but people rarely talk about.

You may not be familiar with its name, what its symptoms are or how it’s treated. It’s a pelvic floor disorder, and chances are, someone you know has one.

What exactly is a pelvic floor disorder?

Pelvic floor disorders occur when ligaments, connective tissue and muscles in the pelvis are stretched, damaged or weakened, so that they shift away from their natural alignment. Pelvic floor disorders can affect the vagina, uterus, bladder, intestines or rectum.

Are they common? Who’s at risk?

About one in three women in the United States have a pelvic floor disorder, and almost one in four have one or more. Vaginal birth, hysterectomy or injury to the pelvic region are common causes of pelvic floor disorders, but aging, obesity and activities that strain the abdomen, such as heavy lifting or excessive pushing during bowel movements, are also factors.

What are the symptoms?

Pelvic floor disorders have different kinds of symptoms, ranging from lower back discomfort and a feeling of heaviness in the pelvic area to urinary incontinence and constipation.

“Often, symptoms are associated with shame and embarrassment,” says Christine Hsieh, MD, a colorectal surgeon at Keck Medicine of USC and assistant professor of clinical surgery at the Keck School of Medicine of USC. “Women may minimize symptoms or brush them off as unimportant — but, they are important.”

Vaginal and uterine symptoms can include:

• A bulge inside your vagina, either visible or invisible
• An aching, fullness or sagging feeling that worsens throughout the day
• Difficulty urinating or frequent urination
• Painful intercourse
• Trouble with bowel movements
• Bleeding from the skin in the vaginal area that is not related to your period

Bladder symptoms can include:

• Urinary incontinence
• Strong, sudden urges to urinate
• Urinary tract infections
• Urine leaks, when coughing or laughing
• Difficulty completely emptying the bladder

Intestinal and rectal symptoms can include:

• Leaky stool
• Inability to control gas
• Constipation
• Not getting to the bathroom in time, when you have to go
• Frequent feelings like you have to go

“I typically recommend that my patients with bothersome constipation or incontinence symptoms keep a gastrointestinal diary — these days, it’s fairly easy to do on a smartphone,” Hsieh says. “What we’re looking for are patterns, triggers and frequency of symptoms or events, and this helps to determine the treatment plan.”

How are pelvic floor disorders treated?

Treatment options can vary from lifestyle adjustments and exercises to surgery.

“Noninvasive therapies for prolapse and urinary symptoms include behavioral and pelvic floor physical therapy, oral medications, botulinum toxin injections to the bladder and neuromodulation, which is a minimally invasive technique that stimulates nerves related to bladder function,” says David Alan Ginsberg, MD, a urologist at Keck Medicine and professor of clinical urology at the Keck School. “There are also surgical options to correct both stress urinary incontinence and prolapse, which often can be done on an outpatient basis.”

Even though a pelvic floor disorder can be embarrassing to discuss, it’s important to open up to your doctor, so you can get proper medical care.

“I hope women realize that open dialogue about these issues with their doctor can go a long way to helping to improve or eliminate them,” Hsieh says.

“Specialists within this field are here to help diagnose and treat this condition and to help improve your quality of life,” Ginsberg adds.

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