Pelvic Floor Dysfunction
What is pelvic floor dysfunction?
Pelvic floor dysfunction is a common condition where you’re unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement. If you’re a woman, you may also feel pain during sex, and if you’re a man you may have problems having or keeping an erection (erectile dysfunction or ED). Your pelvic floor is a group of muscles found in the floor (the base) of your pelvis (the bottom of your torso).
If you think of the pelvis as being the home to organs like the bladder, uterus (or prostate in men) and rectum, the pelvic floor muscles are the home’s foundation. These muscles act as the support structure keeping everything in place within your body. Your pelvic floor muscles add support to several of your organs by wrapping around your pelvic bone. Some of these muscles add more stability by forming a sling around the rectum.
The pelvic organs include:
- The bladder (the pouch holding your urine).
- The uterus and vagina (in women).
- The prostate (in men).
- The rectum (the area at the end of the large intestine where your body stores solid waste).
Normally, you’re able to go to the bathroom with no problem because your body tightens and relaxes its pelvic floor muscles. This is just like any other muscular action, like tightening your biceps when you lift a heavy box or clenching your fist.
But if you have pelvic floor dysfunction, your body keeps tightening these muscles instead of relaxing them like it should. This tension means you may have:
- Trouble evacuating (releasing) a bowel movement.
- An incomplete bowel movement.
- Urine or stool that leaks.
Pelvic floor muscles (female)
Pelvic floor muscles (male)
What causes pelvic floor dysfunction?
The full causes of pelvic floor dysfunction are still unknown. But a few of the known factors include:
- Traumatic injuries to the pelvic area (like a car accident).
- Overusing the pelvic muscles (like going to the bathroom too often or pushing too hard), eventually leading to poor muscle coordination.
- Pelvic surgery.
- Being overweight.
- Advancing age.
Does pregnancy cause pelvic floor dysfunction?
Pregnancy is a common cause of pelvic floor dysfunction. Often women get experience pelvic floor dysfunction after they give birth. Your pelvic floor muscles and tissues can become strained during pregnancy, especially if your labor was long or difficult.
Is pelvic floor dysfunction hereditary?
Pelvic floor dysfunction can run in your family. This is called a hereditary condition. Researchers are looking into a potential genetic cause of pelvic floor dysfunction.
What does pelvic floor dysfunction feel like?
Several symptoms may be a sign that you have pelvic floor dysfunction. If you have any of these symptoms, you should tell your healthcare provider:
- Frequently needing to use the bathroom. You may also feel like you need to ‘force it out’ to go, or you might stop and start many times.
- Constipation, or a straining pain during your bowel movements. It’s thought that up to half of people suffering long-term constipation also have pelvic floor dysfunction.
- Straining or pushing really hard to pass a bowel movement, or having to change positions on the toilet or use your hand to help eliminate stool.
- Leaking stool or urine (incontinence).
- Painful urination.
- Feeling pain in your lower back with no other cause.
- Feeling ongoing pain in your pelvic region, genitals or rectum — with or without a bowel movement.
Is pelvic floor dysfunction different for men and women?
There are different pelvic conditions that are unique to men and women.
Pelvic floor dysfunction in men:
Every year, millions of men around the world experience pelvic floor dysfunction. Because the pelvic floor muscles work as part of the waste (excretory) and reproductive systems during urination and sex, pelvic floor dysfunction can co-exist with many other conditions affecting men, including:
- Male urinary dysfunction: This condition can involve leaking urine after peeing, running to the bathroom (incontinence) and other bladder and bowel issues.
- Erectile Dysfunction (ED): ED is when men can’t get or maintain an erection during sex. Sometimes pelvic muscle tension or pain is the cause, but ED is a complex condition so this may not be the case.
- Prostatitis: Pelvic floor dysfunction symptoms closely resemble prostatitis, which is an infection or inflammation of the prostate (a male reproductive gland). Prostatitis can have many causes including bacteria, sexually transmitted infections or trauma to the nervous system.
Pelvic floor dysfunction in women:
Pelvic floor dysfunction can interfere with a woman’s reproductive health by affecting the uterus and vagina. Women who get pelvic floor dysfunction may also have other symptoms like pain during sex.
Pelvic floor dysfunction is very different than pelvic organ prolapse. Pelvic organ prolapse happens when the muscles holding a woman’s pelvic organs (uterus, rectum and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.
Is pelvic floor dysfunction related to interstitial cystitis?
Interstitial cystitis is a chronic bladder condition that causes pain in your pelvis or bladder. Pain from the bladder can cause pain in the pelvic floor muscles and then loss of muscle relaxation and strength which is pelvic floor dysfunction. So, having one of these conditions increases your risk of having the other.
If you’re taking certain medications for interstitial cystitis, including antidepressants, these might cause constipation. Constipation can lead to worsening of your pelvic floor dysfunction symptoms. Check with your provider in case your prescription might be causing this problem.