A pelvic floor disorder is when you are unable to properly relax and coordinate the muscles in your pelvic floor. One in five people will suffer from a pelvic floor disorder during their lifetime. In fact, one-third of all women and 50 percent of women over the age of 55 are currently affected by a pelvic floor disorder. Although these conditions become more common as women age, they do not have to be a normal part of aging.
Pelvic floor disorders are preventable and there are many treatment options for people with these conditions. Washington University colon and rectal surgeons are part of a team of specialists who provide compassionate, multidisciplinary care for people with pelvic floor disorders.
What is a Pelvic Floor Disorder?
The pelvic floor muscles are the muscles between the tailbone and the pubic bone in the pelvis. Pelvic floor muscles support the pelvic organs and help with controlling urination and bowel movements. These muscles are voluntary muscles, meaning, we can control them just like an arm or leg. When you are unable to control the muscles of your pelvic floor, this is known as pelvic floor disorder or dysfunction (PFD).
Pelvic floor dysfunction manifests itself in several ways. Some of the symptoms include:
- An urgent need to urinate
- Painful urination
- Incomplete emptying of their bladder
- Urine or stool leaking
- Constipation, straining or pain during bowel movements
- Pain or pressure in the vagina or rectum
- Pain during sex
- Erectile dysfunction in men
- A heavy feeling in the pelvis or a bulge in the vagina or rectum
- Pain in the lower back
- Muscle spasms in the pelvis
What Causes a Pelvic Floor Disorder?
Although the exact causes of pelvic floor dysfunction are still undetermined, many factors are known to weaken the muscles of the pelvic floor. Aging may either add to the deterioration of preexisting pelvic floor dysfunction during the life span of a woman or interact with other potential predisposing factors, such as:
- Pregnancy and childbirth
- Overuse of pelvic muscles (common in those with constipation)
- Heavy lifting and straining
- Injury to the pelvic region
- Prior surgery or pelvic radiation
- Congenitally weak connective tissue
Why are Pelvic Floor Disorders More Common in Women as They Age?
Shifts in hormones may lead to weaker or stiffer muscles in the pelvic floor. Connective tissues become more rigid and provide less support. Women also experience a lot of stress and changes to the pelvic region throughout their life during pregnancy, childbirth and menopause, and therefore become more susceptible to pelvic floor issues. Though aging is associated with pelvic floor dysfunction, it is not a direct cause of this condition.
What Can I Do to Prevent Pelvic Floor Dysfunction?
Maintaining a healthy lifestyle as you age can help reduce the risk of developing a pelvic floor disorder. Your doctor might recommend eating a healthy diet high in fiber, getting regular exercise and stopping smoking.
Kegel exercises (also called pelvic floor exercises) strengthen your pelvic floor muscles and can also be helpful to prevent dysfunction.
To perform a Kegel exercise:
- Make sure your bladder is empty, then sit or lie down.
- Tighten your pelvic floor muscles. Hold tight and count 3 to 5 seconds.
- Relax the muscles and count 3 to 5 seconds.
- Repeat 10 times, 3 times a day (morning, afternoon, and night).
How are Pelvic Floor Disorders Treated?
If you have a pelvic floor disorder, treatment can greatly improve your condition. For many people, non-surgical treatments can cure pelvic floor disorders. For most people, this usually involves:
- Behavior changes, such as avoiding pushing or straining when urinating and having a bowel movement and drinking appropriate types and amounts of liquid
- Medicines, such as low doses of muscle relaxants like diazepam
- Physical therapy and biofeedback, which can help you learn how to relax and coordinate the movement of your pelvic floor muscles
Depending on your individual case, your treatment options may include advanced and noninvasive surgeries. Our doctors are experts in transvaginal surgery and minimally invasive techniques like laparoscopic and robotic procedures. Minimally invasive surgery typically results in less pain, shorter hospital stays and quicker recovery times than traditional open surgery.
Who Can I See About Pelvic Floor Disorders?
The COPE Center (Center for Colorectal and Pelvic Floor Disorders) was the first practice in St. Louis to bring together diagnosis and treatment for pelvic floor disorders. Our board-certified urogynecologists diagnose and treat both common and complex pelvic floor disorders. Our access to Washington University’s interdisciplinary group of colon and rectal and urologic specialists is unique in the region.
Furthermore, since pelvic floor disorders are more common among women, it’s important to note that the Section of Colon and Rectal Surgery has two female physicians: Dr. Kerri Ohman and Dr. Radhika Smith. They provide care for patients who make a gender-based request when seeking treatment for problems they consider private.