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Pelvic floor health plays an important role in daily living, affecting bladder, bowel, and sexual functions. Erika Warren, a pelvic health physical therapist at Atrium Health Women’s Care, explains the signs of pelvic floor dysfunction and when it’s time to seek help.

What is Pelvic Floor Dysfunction?

The pelvic floor muscles support organs like the bladder, uterus, and bowel. These muscles should be able to contract quickly, such as when you cough or lift something, and also relax when necessary, such as during bowel movements or urination.

Pelvic floor dysfunction occurs when these muscles are either too weak or too tight, which can lead to various symptoms.

Common Symptoms of Pelvic Floor Dysfunction

If the pelvic floor muscles are not functioning well, you might experience:

• Urine leakage when coughing, sneezing, or lifting
• Stool leakage
• Constipation or the feeling of incomplete bowel movements
• Pain during sex
• Discomfort during gynecological exams
• Frequent trips to the bathroom
• Starting and stopping during urination
• Painful urination
• Pain in the vaginal or rectal area

Warren emphasizes that while many people, especially women, might think it’s normal to experience symptoms like urine leakage or pain during sex after childbirth, these issues are not something you should just live with.

What Causes Pelvic Floor Dysfunction?

Several factors can contribute to pelvic floor problems:

• Pregnancy and childbirth
• Trauma or injury
• High stress and anxiety levels
• Poor sleep habits
• Shallow breathing patterns
• Pelvic surgeries like hysterectomy
• Straining the pelvic muscles
• Hormonal changes during perimenopause and menopause
• Connective tissue disorders

Ways to Improve or Maintain Pelvic Floor Health

While Kegel exercises (which involve tightening and relaxing the pelvic floor muscles) are widely known for improving pelvic health, they aren’t suitable for everyone. Sometimes, they may even worsen the symptoms.

According to Warren:

• It’s not just about strengthening the muscles but also ensuring they can relax and lengthen.
• Consulting a pelvic health physical therapist can help determine the best approach to improve your pelvic health.

What to Expect at a Pelvic Floor Physical Therapy Appointment

If you see a pelvic health physical therapist, here’s what to anticipate:

1. Initial Assessment:
   • Discussion of your health history, symptoms, stress levels, and breathing patterns.
   • Examination of posture and any back or hip issues.
   • Option for an internal exam to assess pelvic muscle function (similar to a gynecologist’s exam), or an external assessment if preferred.
2. Personalized Treatment Plan:
   • A combination of in-office sessions and exercises for home practice.
   • Focus on exercises and breathwork tailored to your needs.
3. Insurance Information:
   • Depending on your insurance, you may not need a referral to see a physical therapist. Check with your gynecologist if a referral is needed.

When Should You Seek Medical Help?

Pelvic floor problems are often dismissed as normal, especially after childbirth, but that shouldn’t be the case. Seek medical advice if:

• You frequently leak urine when sneezing, coughing, or lifting.
• You experience pain during intercourse.
• Something feels off with your bladder, bowel, or pelvic health.

Warren advises trusting your instincts and discussing any concerns with your gynecologist or a pelvic health physical therapist.

Takeaway: Your pelvic health matters. Don’t hesitate to seek help if something doesn’t feel right.

References

• Atrium Health Women’s Care Sexual Health
• Interview with Erika Warren, PT, DPT, CDNT