Pelvic floor disorders: it's more common than you think

Estimates show 25% of women are affected by pelvic floor disorders. In the United Statas alone, doctors perform over 300,000 surgeries each year to correct pelvic floor problems. These numbers may be even larger because many women suffer in silence, never discussing it with their doctor. However, help is available. By recognizing the risks and warning signs, and taking appropriate action, pelvic floor disorders can be corrected and possibly avoided all together.

What is the pelvic floor?

The pelvic floor refers to a group of muscles located at the base of the pelvis. These muscles support the pelvis structure and separate the inside of the body from the lowest part of the pelvis where the external genitalia, urethra, vagina, and anus are located. The muscles extend all the way from the coccyx (tailbone) to the rectum, and to the sides of the pelvic bone, forming a “hammock” to secure the pelvic organs. Openings within the pelvic floor—the urethra, vagina, and anus—depend on these muscles for proper functioning.

What causes pelvic floor disorders?

Prolonged strain to the pelvic area can weaken the muscles, leading to pelvic floor problems. These conditions range from urinary or anal urgency, to incontinence, and even pelvic organ prolapse (when pelvic organs press into or out of the vagina). All of these can significantly impair a woman’s quality of life.

Vaginal deliveries pose the greatest risk for pelvic floor problems, particularly if the baby is big or there is perineal trauma. Other risk factors include chronic constipation or straining, obesity, chronic cough, and excessive strenuous exercise. Recent studies indicate high caffeine intake, smoking and consumption of carbonated beverages may also increase the risk of some pelvic floor disorders. Age – especially moms who deliver their first child at a mature age — and family history also increase the possibility of pelvic floor problems.

Talk to your doctor

If you believe you are at high risk for a pelvic floor disorder, or if you are experiencing symptoms, talk with your doctor. Symptoms of a weakening pelvic floor include an urgency to urinate or have a bowel movement, or leakage of urine or stool. A full feeling in the vagina may indicate organ prolapse.

With proper and early intervention, your condition may be corrected. If you are non-symptomatic but at high risk, screening is also available to evaluate your risk of developing the disease. There is no harm to getting screened.

We can help

Whether you just had a baby, or you’ve struggled with incontinence for years, help is available at Texas Children’s Pavilion for Women. Our goal is to empower women by offering state-of-the-art programs and procedures, starting with the least invasive option. For some women with minor incontinence, slight behavioral modifications may resolve the issue while some may require medication. Physical therapy is usually a good option, and in extreme cases, we may recommend surgery.

We use new evidence-based treatment strategies like implants to control the bladder and Botox injections for various incontinence issues. The Pavilion for Women is one of only a few facilities to offer pelvic floor imaging and can provide a complete diagnostic workup if necessary.

Proven physical therapy

At the Pavilion for Women, we have a specialized physical therapy program for women with pelvic floor issues. This program is an important part of the healing process, especially for women who had a sphincter or anus injury during delivery. During therapy, we follow you carefully to make sure a fistula or fecal incontinence does not develop. The therapy program is available to anyone with a pelvic floor disorder, and women with a long history of incontinence.

Kegel exercises may improve pelvic health

This simple exercise, when preformed regularly by pregnant women, decreased the risk of incontinence during the postpartum period. It is uncertain, however, if Kegel exercises will help prevent prolapse. More studies need to be done to evaluate the long-term benefits, but generally, healthy muscles should protect against pelvic floor problems. There is certainly no risk in doing these exercises; just make sure you are doing them correctly

Eat right and watch the weight

Constipation and excessive weight can put unnecessary strain on the pelvic floor. Eating a healthy diet, rich in fiber and fluids, will keep the digestive system moving, avoiding constipation. This is especially important after pelvic corrective surgery. Obesity significantly increases the risk of incontinence, so keeping your weight within the normal BMI range of 18.5 to less than 25 is recommended. You can calculate your BMI here (link to https://www.cdc.gov/obesity/adult/defining.html).

Take action now

Pelvic floor disorders are very common among women. Many of the risk factors can be minimized through behavior modification and lifestyle choices, while others can not be changed. It is important to know and manage your risk, and take action when necessary.