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Pelvic Floor Dysfunction: A Common Issue Not Commonly Discussed

Feb. 19, 2020

It's never easy to discuss symptoms like incontinence with your doctor, but it could be a sign of pelvic floor dysfunction or dropped pelvic organs — which are more common than you may think. At least one in five women will have surgery for a pelvic disorder during her lifetime, according to Dr. Laura Martinez, urologist at Houston Methodist.

While pelvic dysfunction isn't life threatening, it can severely impact your quality of life. Also, it's important to remember that pelvic problems can happen at any age.

"Pelvic floor dysfunction and disorders are extremely common, but many women don't seek help because they're embarrassed or they don't believe good treatment options exist," Dr. Martinez explains. "No woman should suffer in silence with a pelvic floor disorder. There are many effective, nonsurgical treatment options, such as physical therapy as well as minimally invasive surgical procedures that can provide relief."

What is pelvic floor dysfunction?

The pelvic floor includes muscles, ligaments and connective tissue that support a woman's pelvic organs, including the uterus, bladder and rectum. After the pelvic floor muscles and tissue become weak due to age, surgery or childbirth, that weakness can cause bladder and bowel control problems, or incontinence.

Weak pelvic floor muscles can also cause vaginal prolapse, meaning the uterus, bladder or rectum drops or bulges into the vagina. Moderate to severe bulging may cause a pulling or a heavy feeling in the pelvis, trouble urinating or moving bowels, and lower back pain.

The three most common pelvic floor disorders — urinary incontinence, fecal incontinence and vaginal prolapse — are also the most treatable.

"Many women who have pelvic health issues, especially urinary incontinence, think it's just another side effect of aging they have to live with," Dr. Martinez says. "After receiving treatment, many are delighted to find that their quality of life improves dramatically."

How physical therapy can help improve your pelvic health

Pelvic floor physical therapy restores muscle function and skeletal misalignment, which contribute to bladder and bowel control loss, sexual dysfunction and pelvic pain.

"A physical therapist with specialized training in pelvic floor health can address the muscle and nerve problems that often cause or worsen pelvic floor disorders," says Dr. Martinez. "At your first appointment, which usually lasts one hour, your physical therapist will review your medical and personal history, and discuss your symptoms."

The exam includes assessments of the spine, hips and abdominal muscle wall, as well as an internal pelvic floor muscle exam.

"A pelvic floor muscle examination is the gold standard of setting a baseline of the pelvic floor muscles," Dr. Martinez explains. "When you have pain or discomfort, the physical therapist can identify the muscles causing the issue and assess their strength and coordination."

Subsequent physical therapy sessions consist of education, exercises and biofeedback, using sensors and electrodes to determine a patient's muscle activity. Physical therapy can also reduce muscle spasms and pain and improve joint mobility.

"Depending on the particular condition and how chronic it is, therapy will last four to six weeks," Dr. Martinez says. "Between sessions, you're encouraged to continue physical therapy at home as it realistically fits into your schedule. Our goal is to provide you with the tools you need to continue to improve at home."

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