This content is for informational and educational purposes only. It does not constitute a medical opinion, medical advice, or diagnosis or treatment of any particular condition.
Of all the health topics we don’t talk about but should (looking at you, vaginal discharge and endometriosis), pelvic floor dysfunction is near the top of the list. While it's probably not something you’d bring up in your group chat, it’s very real: About a quarter of women experience pelvic floor disorders — one of which is pelvic floor dysfunction. And it can be painful. But thankfully, it’s also treatable.
Remind me. What exactly is the pelvic floor?
The pelvic floor is a bowl-shaped muscular structure that provides support for the bladder, uterus, bowels, and rectum. When it’s functioning correctly, you can relax and tighten the muscles accordingly — allowing you to go to the bathroom without issue. And the pelvic floor also assists in sexual function.
What is pelvic floor dysfunction?
Pelvic floor dysfunction (PFD) is when the pelvic floor muscles don't work like they should, making it difficult to contract and relax the muscles to use the bathroom. It’s common in women who are pregnant or have given birth, because of the strain the baby’s weight and delivery puts on the pelvic muscles. But other things can cause PFD, too. For example: pelvic surgery, trauma to the pelvis (think: car accidents or sexual abuse), overusing the pelvic muscles (think: straining too hard because of chronic constipation), and aging, which alone increases your chances of developing PFD.
Symptoms of PFD can include:
Constipation or incomplete bowel movements
Needing to use the bathroom a lot
Incontinence (think: peeing when you laugh or sneeze)
Pain in the pelvic region
Pain during sex
Lower back pain
What are the treatments for pelvic floor dysfunction?
Treatments for PFD include medication (in some cases, a doctor might prescribe muscle relaxers), pelvic floor therapy (a form of physical therapy), and relaxation techniques.
Pelvic floor therapy can include exercises like kegels, pelvic massage, biofeedback (where a specialist uses video to monitor your pelvic muscles), and electrical stimulation. Plus, it can also treat vaginismus — when the vagina involuntarily contracts when something tries to penetrate it.
Pelvic massage, which is a part of pelvic floor therapy, is essentially an internal massage of the pelvic muscles. And it’s somewhat invasive, according to one woman writing for The New York Times. It feels like “getting a Pap smear and a deep tissue massage at the same time,” she wrote. So some people just aren’t comfortable with it, which is OK. The most important thing? Finding a physical therapist you feel comfortable with. And remember, you're the one in control.
Your physical therapist may also give you homework to help you relax your pelvic floor. That could include kegel exercises, yoga and stretching, breathing exercises, warm baths, and making sure you don’t strain a lot when going to the bathroom. Oh and, while we’re here, don’t put an egg up there.
Pelvic floor dysfunction is a common condition. And it can cause symptoms like constipation and pain around the pelvis during sex. But it doesn’t mean there’s something ‘wrong’ with you. And a doctor can help you find the right treatment, whether that’s through physical therapy or medications.
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