Guide To Pelvic Floor Dysfunction

Many people suffer from pelvic floor dysfunction and other issues for years. Unfortunately, there is very little understanding of the problems and treatment available for them.

It is interesting to know how many people suffer in silence and eventually learn about pelvic floor problems they are going through on their own. They also seek information through search engines or talk to other people who have had similar issues or sometimes from their physician or specialist.

Did you know that pelvic floor dysfunction can affect people of all ages?

This is because of the common muscular and nerve issues associated with it, which weaken the muscles in the area. Additionally, any type of surgical procedure that affects those muscles can cause dysfunction. Stress or pressure on the abdomen due to pregnancy, a large baby, or even being overweight or obese can contribute as well.

Pelvic floor dysfunction impacts not only physical comfort and discomfort but also interrupts sexual health and psychological well-being. That’s why anyone who suspects they may be suffering from this condition should visit their doctor immediately for an accurate diagnosis and treatment plan tailored to their needs.

Pelvic Floor Physiotherapist Can Help!!!

It is crucial to spread awareness to help people with pelvic floor dysfunction get diagnosed earlier and to be able to see a pelvic floor physiotherapist to address their pelvic floor problems.

What is a Pelvic Floor?

The pelvic floor consists of several muscles, ligaments and tissues which support the bladder, rectum and sexual organs (uterus and vagina for women and prostate, penis for men) by wrapping them around the pelvic bone.

The contraction and relaxation of this muscle system manage the bowels and bladder function. Therefore, it is only through the relaxation of that muscle system that urination, defecation, and intercourse for women and men are allowed.

When this supportive system does not function well, a common health issue appears called pelvic floor dysfunction (PFD), causing several distressing symptoms.

What is Pelvic Floor Dysfunction (PFD)?

Pelvic floor dysfunction appears when the supportive muscle system becomes weaker or tense. This condition, in which the patient experiences difficulty in controlling the pelvic floor muscles, can lead to pelvic organ prolapse, which could result in other conditions like

• Cystocele
• Enterocele
• Rectocele
• Uterine prolapse
• Vaginal vault prolapse

In most cases, the symptoms are present in both genders without significant differences and develop gradually and are less noticeable at the start.

PFD can deteriorate with time if not treated appropriately, resulting in more significant issues such as infection or bowel or bladder problems. 

Who is affected more by PFD?

Statistics show that women suffer more from pelvic floor dysfunction than men. Relevant research has reported that approximately one-third of adult women experience PFD, while a considerable percentage have to endure surgery for treatment. At the same time, pelvic floor issues increase with age.

On the other hand, the prevalence in men appears to be dramatically lower. However, pelvic floor dysfunction in men tends to associate more with prostatitis, post-prostate surgery, erectile dysfunction and premature or painful ejaculation, issues that often coexist with pelvic floor disorders.

Types Of Pelvic Floor Dysfunction

There are multiple types of pelvic floor dysfunction. The major types of pelvic floor dysfunction can include:

Bladder dysfunction: Inability to empty the bladder completely (either not at all or in a minimal quantity) caused by muscle spasms. Urinary leaks or incontinence is the involuntary release of urine caused by a lack of bladder control.

Bowel dysfunction or Fecal incontinence: There is an inability to control bowel movements.

Sexual dysfunction: includes difficulty achieving orgasm or pain during intercourse.

Pelvic organ prolapse: Descent of a woman’s internal organs from the normal anatomical position, usually after pregnancy and childbirth. It can include uterine prolapse, Cystocele, Rectocele, Enterocele and Urethrocele.

Pelvic Floor Dysfunction Symptoms

Pelvic Floor Dysfunction can be an uncomfortable and challenging condition to live with. The symptoms vary from person to person and depend on the severity of their condition, and the symptoms can include

• Pelvic pain includes pain in the low back, groin, genitals, perineum and rectum area.
• Urinary frequency and urgency
• Difficulty emptying the bladder
• Painful bowel movements or constipation
• Sexual pain – Pain during intercourse for women and men
• Pressure in the pelvic area, including the rectum

What are the causes of pelvic floor dysfunction?

Physicians and other associated health care professionals relate PFD with causes that weaken the areas of muscles or injure the connective tissue, such as :

• Obesity
• Pregnancy or a difficult childbirth
• Menopause
• A traumatic injury to the pelvic region
• Pelvic surgery
• Nerve damage
• Advancing age
• Genetics
• Toilet behaviour.

How is the diagnosis made?

The diagnosis of pelvic floor dysfunction is made by reviewing the medical condition and history, evaluating patient symptoms, and examining the pelvic floor muscles for spasms, asymmetry in muscles, weakness, or misalignment in the hips/pelvis.

The most common examination can be external or internal and is a painless procedure which can involve:

• The placement of surface electrodes on the perineum (area between genitals and rectum) or on the sacrum (bone at the spine’s end) to evaluate the response of the muscle system.
• The use of a perineometer – a small, tampon-like sensing device inserted into the rectum or vagina and measures the pelvic floor muscle strength, pressure, and coordination. Anorectal manometry is a test to measure the sphincter function.
• The use of x-rays and a thick liquid enema to perform a defecating proctogram in the lower bowel and anus. This monitors the lower bowel function during defecation.
• Urodynamic testing is a measure of how much urine is voided during urination and how fast. With this type of test, the doctor can determine the cause of specific urinary difficulties like unstable bladder function, urethral or sphincter function, incontinence and urinary retention.

Treatment for pelvic floor dysfunction

The aim of Pelvic floor dysfunction treatment is mainly to reduce muscle tension and relax the muscle system of the area for the patients to gain better control of their bowels and bladder. The most common techniques used in the realm of physiotherapy for PFD treatment that has been scientifically supported with evidence are: 

Biofeedback

This is the more simple therapeutic method, performed with the assistance of a physical therapist. It is painless and considerably helpful. Electro pads are placed on the skin, or small probes are inserted into the anus or the vagina while the movement of the pelvic floor muscle system is monitored. Biofeedback is a method that the patients can also do on their own with appropriate equipment.

Pelvic floor physical therapy

Pelvic floor physio is regularly combined with manual biofeedback. A set of exercises is suggested to the patient by the therapist after the clinical exam and after determining the specific areas that require treatment.

Pelvic floor muscle training (PFMT)

PFMT is a method proven to be significantly effective for PFD treatment. In addition, research has shown that pelvic floor rehabilitation using pelvic floor muscle training gives greater results and offers progress in objective muscle strength, length, prolapse severity or subjective improvement in prolapse symptoms.

Electrical Muscle Stimulation

The electrical current transferred (low-grade and therefore absolutely safe) to either the vagina or the anus through a small-sized probe stimulates the muscles to generate muscle contractions, which then helps to facilitate and strengthen the muscles of the pelvic floor area.

Ultrasound/Low-Level Laser Therapy (LLLT)

Therapeutic ultrasound and Low-Level Laser Therapy are beneficial for the treatment of pelvic pain. It helps in decreasing muscle tension and enhancing blood circulation. It also helps with treating scar tissue after a C-section or Episiotomy.

Lifestyle modifications

Daily lifestyle factors and habits that focus on self-care can significantly assist the treatment process. For example, meditation combined with some breathing exercises, practicing yoga, having warm baths, or trying acupuncture for relaxation is some of the effective stress-relieving and relaxing methods for the body.

Furthermore, consuming more fibre and fluids or intake of certain medications such as laxatives can also help improve the condition.

Refraining from causing excess pressure during urination or defecation has proven to be helpful.

In most cases, many people who experience PFD avoid the conversation because it raises feelings of embarrassment. However, it is a well-known fact that research and reports do not usually reflect the full extent of the problem.

However, suppose any of the symptoms mentioned above occurs. In that case, it is highly recommended that people contact their physician or a therapist specializing in pelvic floor dysfunction who can suggest the best treatment for them.

Pelvic Floor Physiotherapist can Help!!!

It is important to join hands and spread awareness to help clients with pelvic floor dysfunction be diagnosed earlier and to be able to see physiotherapists earlier to address their pelvic floor problems.

Need Help With pelvic floor dysfunction? Contact us to learn more about how our Pelvic floor physiotherapist can help.