How do you treat pelvic floor dysfunction?

Fortunately, pelvic floor dysfunction can be treated relatively easily in many cases. If you need physical therapy, you’re likely to feel better but it may take a few months of sessions. Pelvic floor dysfunction is treated without surgery. Non-surgical treatments include:

  • Biofeedback: This is the most common treatment, done with the help of a physical therapist. Biofeedback is not painful, and helps over 75% of people with pelvic floor dysfunction. Your physical therapist might use biofeedback in different ways to retrain your muscles. For example, they may use special sensors and video to monitor the pelvic floor muscles as you try to relax or clench them. Your therapist then gives you feedback and works with you to improve your muscle coordination.
  • Pelvic floor physical therapy: Physical therapy is commonly done at the same time as biofeedback therapy. The therapist will determine which muscles in your lower back, pelvis and pelvic floor are really tight and teach you exercises to stretch these muscles so their coordination can be improved.
  • Medications: Daily medications that help to keep your bowel movements soft and regular are a very important part of treating pelvic floor dysfunction. Some of these medications are available over-the-counter at the drugstore and include stool softeners such as MiraLAX®, Colace®, Senna or generic stool softeners. Your primary care doctor or a gastroenterologist can help to advise you which medications are most helpful in keeping your stools soft.
  • Relaxation techniques: Your provider or physical therapist might also recommend you try relaxation techniques such as meditation, warm baths, yoga and exercises, or acupuncture.

Will I need surgery to treat pelvic floor dysfunction?

There is not a surgery to treat pelvic floor dysfunction because it is a problem with your muscles. In rare circumstances, when physical therapy and biofeedback fail to work, your provider might recommend you see a pain injection specialist. These doctors specialize in localizing the specific muscles that are too tense or causing pain, and they can use a small needle to inject the muscle with numbing medication and relaxing medication. This is called trigger point injection.

What makes pelvic floor dysfunction worse?

It can take several months of routine bowel or urinary medications and pelvic floor physical therapy before symptoms of pelvic floor dysfunction start to improve. The most important part of treatment is to not give up. Forgetting to take your medications every day will cause your symptoms to continue and possibly get worse. Also, skipping physical therapy appointments or not practicing exercises can slow healing.

Any activity that increases the tension or pain in your pelvic floor muscles can cause your symptoms to get worse. For example, heavy weightlifting or repetitive jumping can increase your pelvic floor tension and actually worsen symptoms.

If you have problems with constipation due to hard bowel movements or abdominal bloating and gas pain, then you should consult with your doctor and watch your diet closely. It’s important to drink plenty of water daily (>8 glasses) and eat a healthy diet. Foods that are high in fiber, or fiber supplements, may worsen your bloating symptoms and gas pains. These foods should be avoided if your symptoms get worse.

Who treats pelvic floor dysfunction?

Depending on your symptoms and how much pain you feel, you might be treated by your regular provider, a physical therapist, a gynecologist, a gastroenterologist, a pelvic pain anesthesiologist, or a pelvic floor surgeon.

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