The Pelvic Floor

Heart failure patients need to have a conversation about the pelvic floor! As a heart failure patient, a lot of medicine that we take (especially the diuretics) are hard on the bladder. Also, constipation and other bowel issues can be a sign of pelvic floor distress too!

However, there is treatment out there to help improve pelvic floor function! As a woman, I hear friends talk about pelvic floor issues after childbirth and symptoms are occasional incontinence after sneezing, but unfortunately, it can be so much more than that. Men have pelvic floors and can be impacted as well.

What is the pelvic floor?

The pelvic floor is a group of muscles and ligaments that support the organs of the pelvis: the uterus, vagina, bladder, urethra, and rectum.¹ The three types of pelvic floor dysfunctions are urinary incontinence, fecal incontinence, and pelvic organ prolapse.²

What is pelvic floor dysfunction?

Pelvic floor dysfunction is usually related to too much tension in the muscles of the pelvic floor. Muscles can also be too relaxed, which can contribute to incontinence (leakage from the bladder or bowel) or pelvic floor prolapse. Sometimes patients can have a combination of muscles that are too tense and too relaxed.¹

What causes pelvic floor dysfunction?

The most common causes of pelvic floor dysfunction include:³

• Pregnancy
• Delivery
• Trauma (physical or psychological)
• Surgery
• Obesity
• Other pelvic diseases (endometriosis, interstitial cystitis)

What are the symptoms of pelvic floor dysfunction?

This is not a comprehensive list. Consult with a urologist or pelvic floor specialist for medical advice.

• Urinary urgency, frequency, hesitancy, stopping and starting of urinary stream, painful urination, or incomplete emptying.
• Constipation, straining, pain with bowel movements.
• Unexplained pain in the low back, pelvic, genital area, or rectum.
• Pain during or after intercourse, orgasm, or sexual stimulation.
• Uncoordinated muscle contractions causing pelvic floor to spasm.

How is pelvic floor dysfunction diagnosed?

Healthcare professionals who are specialized in treating pelvic floor dysfunction diagnose the condition during a physical exam. Using external and internal ‘hands-on’ or manual techniques to evaluate the function of the pelvic floor muscles, they can assess the ability to contract and relax these muscles. Healthy muscles should be able to do BOTH.³

Bones and muscles of your lower back, hips, and sacroiliac joint can stress your pelvic floor muscles. Your healthcare provider will check externally and internally for problems such as muscles spasms, muscle knots, and weakness or sacroiliac misalignment.³

How is pelvic floor dysfunction treated?

The list can include self–care, treatment of underlying health conditions that may be contributing to pelvic floor dysfunction, medicines, biofeedback massage, electrical stimulations, and ultrasound. There are also more minimally invasive treatments such as trigger point injections, nerve blocks, and pudendal neuromodulation.³ Personally, there is a medicine that is inserted internally (rectally and vaginally) that helps as well!

What you can do

If you feel that you might be suffering from pelvic floor dysfunction, either not tight enough or too tight, seek help! From personal experience, I found a urologist who was knowledgeable in pelvic floor disorders. I have been told that some colorectal doctors will refer patients to pelvic floor therapists as well.  I would not hesitate in seeking treatment if you feel that you might have a pelvic floor disorder. TRULY.

Spreading the word

At the beginning of my journey I would have found the above treatments a bit odd, and perhaps scary. Now that I have found some measure of relief, I want to spread the word about this treatable issue that can cause significant physical symptoms. Every appointment and treatment I have had, and there have been many, has been very 'patient-centered.' Everyone made sure I was informed and comfortable, and everyone's goal was to simply help me. Seek help for yourself today!