Definition

The pelvic floor is a set of muscles that supports the bladder, bowels, and sexual organs. Pelvic floor dysfunction is a failure to relax these muscles to urinate or have a bowel movement.

Causes

The exact cause of pelvic floor dysfunction is not known, but may include:

  • Trauma from an accident
  • Childbirth, especially with episiotomy
  • Psychological factors
  • Nerve or muscle problems
Female Pelvic Organs
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Risk Factors

Factors that may increase your risk of pelvic floor dysfunction include:

  • Childbirth—risk increases with each birth
  • Obesity —causes extra strain on muscles
  • Prior pelvic surgery
  • Prior radiation therapy

Symptoms

Symptoms may include:

  • An urgent or frequent need to urinate
  • Pain when urinating
  • Constipation , straining, or pain with bowel movements
  • Pain in the lower back
  • Pelvic pain
  • Pain during sex (in women)

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

Your pelvic muscle control may be tested. This can be done with:

  • Electrodes on the area between the vagina and rectum or the area between the testicles and rectum to measure muscle activity or nerve function
  • A device placed in the vagina or rectum to measure strength of pelvic floor muscles
  • X-rays of your bowel during a bowel movement
  • A urine flow test to measure speed and force of your urine flow

Treatment

Treatment will depend on the severity of the symptoms. Talk with your doctor about the best plan for you.

Treatments that may help control symptoms include:

  • Biofeedback—a technique to help train your pelvic muscles
  • Relaxation technique—to reduce stress. Stress can increase symptoms.
  • Physical therapy—exercises and plans to help learn to relax and coordinate the muscles when urinating or having a bowel movement
  • Medications—such as muscle relaxers

Prevention

Maintaining a healthy weight can help to reduce stress on the pelvic floor muscles.

RESOURCES

Family Doctor—American Academy of Family Physicians  http://www.familydoctor.org 

National Institute of Neurological Disorders and Stroke  http://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Public Health Agency of Canada  http://www.phac-aspc.gc.ca 

References

Frequently asked questions about pelvic floor disorders. The University of Chicago Medicine website. Available at: http://www.uchospitals.edu/specialties/pelvic/faq/pelvic-floor-disorders.html#P72%5F4797. Accessed November 28, 2017.

Kann, B. Pelvic floor dysfunction expanded version. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/pelvic-floor-dysfunction-expanded-version. Accessed November 28, 2017.

Pelvic floor dysfunction. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5Fpelvic%5Ffloor%5Fdysfunction. Updated February 14, 2014. Accessed November 28, 2017.

Pelvic floor dysfunction. Interstitial Cystitis Association website. Available at: http://www.ichelp.org/about-ic/associated-conditions/pelvic-floor-dysfunction/. Updated March 25, 2015. Accessed November 28, 2017.

Revision Information

  • Reviewer: EBSCO Medical Review Board James Cornell, MD
  • Review Date: 11/2018
  • Update Date: 04/19/2017