Symptoms of Pelvic Floor Dysfunction
Pelvic floor dysfunction occurs when the muscles that support the bladder and urethra become too weak or too relaxed. Symptoms vary from person to person and by cause, but can be uncomfortable enough to affect quality of life, including straining during bowel movements, which can be painful. Risk factors that increase the likelihood of pelvic floor dysfunction include age, obesity, and pregnancy. Left untreated, it can interfere with the normal function of vital organs and may lead to pelvic organ prolapse, an abnormal bulge in the vagina, or ongoing stress incontinence. It is not typically dangerous for most people, and can often be prevented with proper diet, exercise, and a healthy lifestyle.
Treatment Options for Pelvic Floor Dysfunction
Treatment options range from home remedies to medication to surgery, based on each patient's specific needs, though most cases can be managed with non-surgical methods. A doctor may prescribe medication, physical therapy, or a pessary depending on severity, and pelvic floor dysfunction can often be treated with pelvic floor therapy and biofeedback. A fiber-rich diet can also help relieve symptoms by improving digestion and making bowel movements easier.
Pelvic floor physical therapy uses exercises and manual techniques to relax the muscles, and may be recommended by an OB-GYN or a urologist to ease symptoms and improve bladder control. Therapists often use biofeedback, video recordings of contractions or externally placed electrodes, to monitor pelvic muscle activity and test for muscle spasms, and they teach exercises such as skin rolling and joint mobilization to improve coordination, sometimes repeated over several months. Massage and myofascial release may also be used to relax the muscles and make bowel movements easier. In more severe cases, such as large rectoceles, or when injections of anti-inflammatory or pain reliever medications don't provide relief, a doctor may recommend a surgical procedure.
Preparing for Pelvic Floor Therapy
Pelvic floor therapy begins with a thorough evaluation: the physical therapist reviews your medical history, performs an orthopedic exam, and assesses the function of your pelvic muscles. From there, treatment may include diaphragmatic breathing techniques, Kegels, and pelvic floor manual therapy to improve circulation, increase core stability, and promote flexibility, all of which help strengthen the pelvic muscles important to bowel function and sexual intercourse.
A physical therapist may also recommend electrical stimulation, which delivers a painless electrical impulse to help relieve muscle spasms and pain, either alone or alongside prescribed exercises. In some cases, a probe inserted into the vagina and connected to a computer screen helps assess pelvic floor muscle function, giving the therapist a clearer picture to discuss with the patient, including bladder control and sexual intercourse.
Pelvic floor physical therapy isn't for everyone, and treatment plans are customized to each patient's needs, a full course can take anywhere from six to twelve visits, often including exercises to continue at home.