Pelvic‌ ‌Floor‌ ‌Dysfunction Explained ‌ ‌

Pelvic floor dysfunction is tabooed to speak about more often than not.
Pelvic floor dysfunction is tabooed to speak about

Pelvic floor dysfunction is extremely common. What’s uncommon about it is how often we address or discuss it. Women are either feeling ashamed to talk about it or do not believe that there are any viable solutions out there that could help them regain their quality of life. 

So, this leads to another common issue associated with the pelvic floor – women suffering in silence when they shouldn’t. 

What is Pelvic Floor Dysfunction?

Pelvic floor dysfunction is an umbrella term that encompasses a variety of conditions that result from the inability to properly coordinate and control the muscles in the pelvic floor.

Your pelvic floor consists of muscles, ligaments, and other tissues that attach to the back, front, as well as sides of the pelvic bones, creating a hammock-like structure at the bottom-section of the abdominal-pelvic cavity. It is necessary for a variety of functions such as facilitating bodily functions, providing support for the internal organs, and more. 

Dysfunction occurs from these muscles and tissues being either weak or excessively tight. Yet, it can also result from the combination of the two. This impairs the body’s ability to provide optimal support for the pelvic organs and impairs other functions of the pelvic floor.

The pelvic floor is an extremely strong and resilient structure. However, its tissues can accumulate damage through factors such as natural tearing during childbirth, episiotomies, certain STIs, fibroids, and other ailments, injuries, or trauma. As a response to that, the body heals itself by developing scar tissue.

While scar tissue is strong and consists of similar compounds as the original tissue, the way its fibers layer on top of each other during the healing process makes them less elastic. This can limit the range of motion of the muscles and fascia, connective tissue that is present throughout the entire body.

The limited range of motion can create tightness and pulling throughout the entire pelvic floor, resulting in pain or contributing to the development of pelvic floor disorders. 

Pelvic Floor Dysfunction in Numbers

When it comes to the statistics of how many women suffer from pelvic floor dysfunction, medics agree on one thing – it’s extremely common. The rest is just estimates. 

The precise numbers of women who are affected by pelvic floor dysfunction aren’t actually known. Medical professionals estimate that, at the minimum, one in every four women experiences at least one disorder. However, this could be considerably higher, with some sources indicating that the prevalence of pelvic floor dysfunction could be as high as 46%

Women frequently experience more than one issue, and the likelihood of pelvic floor dysfunction increases with age

It is extremely difficult to track the exact numbers of the women affected. There is much stigma around the topic of pelvic floor health, and many women are hesitant to discuss pelvic floor issues with their healthcare providers, especially if they are male, or may have been conditioned to believe that what they experience is normality rather than a health issue. 

Moreover, medicine and STEM fields, in general, have been historically predominantly male, with female gynecologists being the majority only in recent years. Therefore, the gynecology field has been shaped primarily by men. 

While men can and do experience pelvic floor dysfunction, there are critical key biological differences between men and women which prevents male healthcare specialists from being able to fully empathize with women and, as a result, provide holistic solutions that benefit them in the long term.

Woman at ob-gyn

Pelvic Floor Dysfunction Symptoms

Pelvic floor dysfunction can vary in severity. Some cases can be obvious whereas others may be much milder and can easily go unnoticed or disregarded by either a healthcare provider or the woman herself. 

So, how do you know that you suffer from it? There are various clear signs and symptoms of pelvic floor dysfunction that you should be aware of. They are:

  • The feeling of pain or numbness during sexual intercourse and inability to enjoy it and reach orgasm,
  • Continuous pain in the pelvic area such as in the genitals or rectum,
  • Constipation or needing to strain, push hard, or change position to pass bowel movements,
  • Stress incontinence or leaking urine when sneezing, coughing, laughing, or exercising,
  • Urgent need to go to the bathroom or inability to hold urine or fecal matter,
  • Frequent need to urinate,
  • Painful urination,
  • Needing to have more than one bowel urine movement in a short period of time,
  • Having a hard time emptying bowels and bladder and needing to stop and start various times,
  • Passing wind accidentally,
  • Excessive queefing,
  • Inexplicable lower back pain,
  • A feeling of discomfort, heaviness, pulling, or dropping in the vagina,
  • A lump or bulge coming out of the vagina.

 

Causes and Risk Factors for Pelvic Floor Dysfunction

Doctors still state that the exact causes of pelvic floor dysfunction aren’t yet fully known. However, different life events, conditions, and risk factors increase its likelihood. These are:

1. Pregnancy and Childbirth

Pressure caused by the increasing weight in the abdominal cavity, prolonged labor, overstretching and damage of the pelvic tissues, the use of forceps, episiotomies, multiple babies or pregnancies, and incorrect positioning of the baby can increase the risk of pelvic floor dysfunction. Even if a woman gives birth via C-section, she can still develop pelvic issues. 

2. Trauma or Injury to the Pelvic Area

Direct injuries or trauma caused by factors such as a fall, car accident, or sexual abuse can lead to the damage of pelvic floor tissues. It can weaken or tear the tissues which can lead to the development of scar tissues that tend to be less elastic than the original tissues. Nerve damage can also occur, leading to pelvic floor disorders. 

3. Excess Weight

Carrying excessive weight can place additional strain on and damage pelvic tissues. Pressure on the nerves can also contribute to the pelvic area functioning inefficiently. 

4. Age

As women reach the age of menopause, their pelvic dysfunction risk increases as well. This is due to aging naturally affecting the elasticity of tissues as well as hormonal changes in the body. The loss of estrogen which happens with menopause also deteriorates muscle tone and elasticity. 

5. Genetic Predisposition

Women with a family history of pelvic floor disorders have a higher risk of developing them too. While it’s unclear why exactly this occurs, it’s believed that this may be due to genetically inherited weaker muscles. 

6. Chronic Constipation, Coughing, or Sneezing

Chronic constipation, chronic lung diseases, allergies, smoking habit, and similar continuously increase intraabdominal pressure. The continuous strain on the muscles, ligaments, and connective tissues caused by this pressure can considerably weaken them over time.

7. Heavy Lifting or Rigorous Exercise

Hardcore training or high-impact exercise such as gymnastics can overload and overstretch the pelvic tissues.  If this happens without a gradual increase in intensity or proper attention to the pelvic area, it can increase the risk of pelvic floor disorders. 

Women who exercise regularly without complementing their exercise routine with stretching, especially in the pelvic region, can develop tense and tight pelvic muscles. These too can result in pelvic floor issues.

8. Surgery

Hysterectomy, the surgical removal of the uterus, or any other form of surgery in the pelvic area can cause damage to the pelvic tissues, leading to an increased risk of prolapse of the other pelvic organs

9. Lifestyle Habits

Diet and a sedentary lifestyle can worsen pelvic floor disorders. Certain food choices can increase the frequency of constipation leading to more straining and forcing whereas a sedentary job or lifestyle can decrease pelvic muscle tone. 

10. Socioeconomic Status

Various studies indicate that women of lower income can have a higher risk of having pelvic floor issues. Due to their limited access to quality healthcare, they may either not address these disorders or address them too late, resulting in their condition being considerably more serious and costly. 

Common Pelvic Floor Disorders that Women Experience

1. Pelvic Organ Prolapse

Types of pelvic organ prolapses (POP)

This occurs when the organs in the pelvic cavity get pulled out of their place and into the vaginal canal or the anus, creating a bulge. There are various forms of pelvic organ prolapse:

  • Cystocele: the bladder is pulled into the vagina, it’s the most common form of prolapse,
  • Urethrocele: the urethra, the tube through which urine flows, is pulled into the vaginal canal,
  • Uterine prolapse: the uterus is pulled into the vaginal canal,
  • Vaginal vault prolapse: prolapse of the vagina into the vaginal canal,
  • Enterocele: small intestine prolapse into the vaginal canal,
  • Rectocele: rectum is being pulled into the vaginal canal or the anus.

 

An interview with a Pelvic Health Expert, Beth Shelly, on how the nervous system affects prolapse

2. Urinary Incontinence

Urinary incontinence is urine leakage or the inability to control urine flow. There are two forms of urinary incontinence:

  • Stress incontinence: a woman suffering from it leaks urine when there is pressure on the bladder. Sneezing, coughing, laughing, exercise, or sudden movement cause stress and pressure on the bladder and the sphincter muscles aren’t reflexive enough to pinch the urethra shut. This type is the more common one, and it tends to affect women who are younger. 
  • Urge incontinence: this happens when a woman feels a sudden need to go to the bathroom even if her bladder isn’t full, yet may not be able to get there on time. Urge incontinence also causes women to urinate numerous times a day and is more prevalent in older women. 

 

A number of women, however, experience a mix of the two – stress and urge incontinence. 

3. Bowel or Fecal Incontinence 

This form of incontinence happens when a woman is unable to fully control her bowel movements. The severity can range from occasionally leaking a small amount of feces, for instance, when passing gas, to completely losing control of bowel movements. 

4. Hypertonic Pelvic Floor

While common, this pelvic floor disorder gets considerably less attention. It’s when the pelvic muscles and tissues aren’t weak but, on the contrary, tense and tight. This can happen due to excessively training and strengthening them through a regular exercise routine or just doing exercises specifically such as Kegels

A hypertonic pelvic floor is unable to relax or contract any further. Due to being continuously under stress, the tissues also tire and unable to support the body’s movements or functions. 

Can You Heal or Reverse Pelvic Floor Dysfunction?

If left untreated, pelvic floor dysfunction tends to worsen. However, we do have good news for you – you can treat and heal it, especially if you start early. Keep in mind that not all treatment methods are equally effective and you need to approach pelvic floor issues holistically rather than with a single isolated treatment method. 

Holistic methods can also prevent you from developing pelvic floor dysfunction in the first place. 

Watch this video to uncover the secrets on healing your prolapse or pelvic floor dysfunction!

Heal Pelvic Floor Dysfunction Holistically with Courses and 1-1 support at Women Cycles

At Women Cycles, we are committed to breaking the stigma that surrounds pelvic floor health. Women shouldn’t suffer when they don’t have to. There are holistic options that can not only help you heal but also prevent pelvic floor dysfunction without surgery or harsh medical intervention. If you’d like to learn more, check out our online courses on pelvic floor health. Designed by women like you, they can help you skip the embarrassment, shame, and judgment and get straight to making you feel better.

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