Your pelvic floor might not be something you think about every day...or ever, TBH. However, conversations about this crucial muscle group have become increasingly unavoidable: women are sharing their stories about pelvic floor problems on social media (#pelvicfloor has over 600,000 posts on Instagram), pelvic health influencers are cropping up on TikTok, and the field of pelvic floor physical therapy has exploded (partially in response to the rise in “pandemic pelvis”). Plus, there’s a whole new batch of companies creating devices and platforms designed to help your pelvis, like Elvie, Hyivy Health, and Pelvic Gym.
It’s good news that we’re talking more about the pelvic floor because anyone can develop pelvic floor dysfunction (PFD), and identifying it can be difficult. So, if you don’t know what to make of all the targeted ads and buzz about pelvic health, here’s why it’s so important.
What is a pelvic floor?
“[Your pelvic floor is] literally what holds up everything in your pelvis. Like, your organs would just fall out if it wasn't there,” says Dr. Ashley Winter, a urologist and chief medical officer at Odela. It’s a muscle and tissue group that supports the entire pelvic region — like a hammock for the bladder, urethra, vagina, uterus, bowel, rectum, and anus.
Why is pelvic floor health important?
The prevailing narrative about pelvic floor dysfunction (PFD) has traditionally been centered around those who recently gave birth or older people with leaky bladders. But only looking at it through the lens of a few groups of people is problematic. According to one study, about a quarter of US women have experienced a pelvic floor disorder. Men can have PFD too. Although the risk of PFD increases with age and after childbirth, studies show that people can develop it at any age and stage of life.
Plus, misconceptions about PFD can make it difficult to identify. For example: urinary incontinence is just one potential manifestation. In other cases, it’s not the muscles' inability to contract (and hold in urine) that’s the problem — it’s their inability to relax. “We could have knots in our neck, in our back, and we're so used to talking about those knots and getting massages, but you can have the same thing happen in your pelvic floor,” says Dr. Sonia Bahlani, a gynecologist and pelvic pain specialist. Muscle tightness can reduce blood flow, which may impact how the organs function and create pain, reduced sensation, and other symptoms in the pelvis. Over time, tight muscles can become weak muscles, leading to a cycle in which the muscles are unable to contract or relax properly.
Pelvic muscles may develop this chronic tightness after a trigger, like a vaginal infection or painful sex, according to Dr. Winter. “If you touch a hot stove, your muscles contract to pull your hand away,” she explains. “If you have the sensation of something painful … in your own pelvic organs, then your muscles are going to try to pull away from that.”
What are some symptoms of pelvic floor dysfunction?
PFD can look and feel very different depending on the individual because the pelvic floor involves so many different organs and bodily functions. Any time a symptom crops up in that pelvic area — from vaginal discomfort and pain with sex to changes in bathroom habits and lower back pain — know that the pelvic floor could be involved. Here are some potential symptoms of pelvic disorders and where you might feel them:
Difficulty emptying the bladder or starting to urinate
Painful, urgent, or frequent urination
Leakage during activities (like laughing or running) or while coughing
Difficulty controlling gas
Straining during bowel movements
Discomfort or pain during sex
Difficulty keeping tampons in
A general sense of heaviness, fullness, pulling, aching, or pain in the pelvic region
Lower back pain
Jaw pain (yes, pelvic and jaw pain may be connected)
PFD can also be dormant for a while. Meaning, you could have tightness or weakness but no symptoms until there’s a trigger like an infection or sexual encounter, says Dr. Bahlani.
What should I do if I’m experiencing pelvic floor issues?
You can probably say goodbye to your mother's Kegels. Dr. Bahlani says they have "the best PR agent" — but they’re not right for everyone.
Learning the proper exercises for your situation is crucial because incorrect ones can worsen your symptoms. For example, Kegels are often advised for those with incontinence, and they may not be good for people with a tight pelvic floor. Instead, some people with PFD (and especially those with tightness) might benefit from lengthening the pelvic floor through hip-opening stretches, says Dr. Bahlani. You can also try diaphragmatic breathing and other relaxation techniques, which may help increase blood flow in the area and alleviate symptoms.
If you're looking for more hands-on help, a pelvic floor therapist is likely your best option. “[They’re] incredible because they have more time with the patients than a physician does, on average, and they're gonna assess these things on a holistic level,” says Dr. Winter. For example, they might ask you to sit down in a chair to analyze your posture and see how much pressure you put on your pelvis.
They also have tools and techniques like myofascial release (a type of massage) to relieve trigger points. Or they may employ biofeedback, which uses sensors to detect which muscles are firing and when. Your OB-GYN may be able to refer you to one, or you can find a practitioner through the American Physical Therapy Association. Dr. Bahlani says that costs can range from around $40 to $50 for in-network practices or $150 to 250 for out-of-network providers.
The recent conversations and awareness about pelvic floor dysfunction are long overdue. Because anyone can experience it — no matter your gender, age, or whether you've given birth. If you think you're dealing with PFD, it's important to feel empowered to advocate for yourself and consider seeking the help of a specialized PT.
Updated on June 14, 2023 to reflect new information.
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