Pelvic Floor Issues Are Common & Treatable for Women December 16, 2015 By Linda Fox, MD, pelvic medicine and reconstructive surgery specialist Women endure many uncomfortable conditions, like menstrual cramps, menopause, and childbirth. But we don’t have to tolerate the discomfort and embarrassment caused by pelvic floor disorders. Aging increases the likelihood of pelvic floor disorders, but they are not a normal part of aging. Symptoms include accidentally leaking urine when you exercise, laugh, cough or sneeze, having to go all the time, difficulty emptying the bladder, problems having a bowel movement, accidental bowel incontinence or pain or discomfort in the pelvis. Fewer than half of women with these symptoms seek treatment within a year. But there is no need to be embarrassed and help is available. Start by talking to your physician and ask to see a specialist who specializes in treating female pelvic problems. Incontinence can be greatly improved in most cases, and treatment is available to improve the quality of life for women with prolapse. Understand the Anatomy The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis. The pelvic floor supports the bladder, uterus, rectum and vagina. Weakened pelvic muscles or connective tissue supporting the pelvic floor can cause problems with bladder or bowel incontinence and uterine prolapse. In addition to aging, pregnancy and childbirth may also increase the risk of pelvic floor conditions. Many risk factors can be controlled, such as being physically active but cautious with extreme sports, and limiting caffeine or excessive intake of fluids. Weight loss and smoking cessation have also been shown to decrease symptoms. Pelvic floor conditions require specialized treatment, and recently I have undertaken extra training to meet the requirements of the American Board of Obstetrics and Gynecology and become board certified in female pelvic medicine and reconstructive surgery. Types of Incontinence There are different types of incontinence. Stress incontinence occurs during exercise, coughing, sneezing, laughing or body movement that puts pressure on the bladder. Urge incontinence is the strong, sudden need to urinate due to bladder spasms or contractions. People may experience one or the other type, or both. To better understand what’s causing your symptoms, we may recommend urodynamic testing to assess how your bladder and urethra are working. Our goal with treatment is to start with the least invasive method first. Some treatments work well for one patient, but not for others. And all treatments take time to work. Prolapse Causes & Treatment About half of all women will experience a form of pelvic organ prolapse when the tissues become too weak or stretched to hold the pelvic organs in the correct position. Risk factors include pregnancy, childbirth, menopause, previous surgery, obesity, aging and genetics. There are different types of prolapse, and women may experience different symptoms, such as a bulge or lump in the vagina, a pulling or stretching feeling in the groin, vaginal pain, pressure, irritation, bleeding or spotting, difficulty with bowel movements, delayed or slow urinary stream and difficult or painful sexual intercourse. Treatment for prolapse depends on how much the symptoms are bothering you. A conservative approach is to watch and see how things go, making dietary changes, and doing pelvic floor exercises or physical therapy. Other non-surgical and surgical treatments are also available to help you experience a better quality of life.
