Pelvic Floor Dysfunction

What is Pelvic Floor Dysfunction?

Some women have problems with the pelvic floor muscles and develop a condition called pelvic floor dysfunction. The pelvic floor is made up of muscles that support the bladder, uterus, and rectum like a hammock. The pelvic floor muscles attach to the pelvic bone and sacrum. PFD can be too much tension (high-tone) in the pelvic floor, very relaxed (low-tone) muscles in the pelvic floor, or a combination of both.

What are the Symptoms of PFD?

Symptoms of PFD include:

• Urinary urgency, frequency, hesitancy, stopping and starting or urine stream, painful urination, or incomplete emptying

• Constipation, straining, incomplete emptying, or pain with bowel movements

• Unexplained pain in your low back, pelvic region, genital area, or rectum

• Pain during or after intercourse, orgasm, or sexual stimulation

• Uncoordinated muscle contractions causing the pelvic floor muscles to spasm

• Symptoms of interstitial cystitis

How is PFD Diagnosed?

First, a careful history is taken of the individual’s symptoms, medical problems, and any history of trauma. Then the physician or nurse practitioner performs an internal examination to identify any abnormality, and to evaluate the function of the pelvic floor muscles ability to contract and relax. Sometimes other diagnostic tests are performed to complete the evaluation.

How is PFD Treated?

The goal of PFD therapy is to correct the dysfunction and any defects that contribute to the dysfunction. If the muscles are in spasm, the goal is to relax the muscles and avoid stressing them. Often, this is done with pelvic floor muscle rehabilitation therapy (PMR). Approximately 80% of patients with PFD experience significant improvement with PMR. Your provider will also work with you on proper posture, avoiding pushing or straining, stretching, and building core muscles to stabilize the pelvis. Low doses of muscle relaxants are available for more difficult cases. Occasionally, a physical therapist specially trained in PFD will also work with the patient. If the muscles are in deep spasm and unresponsive to traditional therapy, an injection with medications or Botox®, called a trigger point injection, may be necessary to relax the muscles.

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