Pelvic Floor Dysfunction: Symptoms and Treatment

What Is Pelvic Floor Dysfunction (PFD)?

Pelvic Floor Dysfunction is a common condition caused by malfunction of the pelvic floor muscles. These are the muscles located in your pelvis, which act as a ‘floor’ to your midsection, and provide stability to many of the vital organs in your lower torso. Think of the way tarpaulin on a truck helps to secure the cargo carried inside. Your pelvic muscles perform a similar task, wrapping around the pelvic bone, and thus securing your insides.

For exactly this reason, these muscles are taut, and they need to relax when you have to pee or poop; to get something out, you have to loosen the tarp somewhere, right? In other words, these are the muscles you use to urinate and defecate; when you need to ‘go’, you loosen them.

However, someone suffering from Pelvic Floor Dysfunction is unable to correctly relax and coordinate these muscles, resulting in problems in the bathroom, frequent need to urinate or defecate, incomplete or painful elimination of waste, incontinence or chronic constipation. There can also be symptoms of abnormality within the reproductive system.

For women, this can be pain during penetrative sexual intercourse. For men, erectile dysfunction can also be an outcome of PFD.

What Causes Pelvic Floor Dysfunction?

Pelvic Floor Dysfunction can be caused by any of traumatic injury, such as in a traffic accident, pelvic surgery, obesity or muscle degeneration due to advanced age. Pregnancy is a common cause in women; after all, another human being has just emerged through this exact region, and this tends to leave a painful aftermath.

Whatever the evolutionary reasons for the traumatic human birth process, one of the casualties is, often, the female pelvic region. As Robbie Williams said famously on the Graham Norton Show, about watching the birth of his child; ‘It was like watching my favorite pub burn down’.

There is also another, not-uncommon cause, and it’s familiar to us as a popular gag in toilet humor. Yes, indeed, we all know the joke about the guy who strained to hard in the loo, but this is actually a real thing, and if you make a habit of it, one consequence can be Pelvic Floor Dysfunction.

Much better to eat your bran cereal, fruit and vegetables, so you can enjoy a smooth expulsion, and don’t have to push as hard as a mother in labor.

What does Pelvic Floor Dysfunction feel like?

PFD can have multiple symptoms. A common one is frequent trips to the bathroom. Also, if bowel movement is starting to feel like an Olympic heat, that can be a sign. Other sufferers might feel they don’t ‘finish’, and have to return to the toilet soon to try again. Others, in a particularly unsavory necessity, might have to use their fingers to complete the task.

If this is happening repeatedly, over time, PFD can be a cause. These symptoms might also overlap with chronic constipation, which can itself be a symptom of PFD, though it can have many other causes. Incontinence is another one, as is pain while peeing or pooping.

For women, since the same pelvic muscles control the vaginal walls, pain during penetrative sex is also an indication of PFD. For men, erectile dysfunction can be a symptom, though it more often has other causes. Outside of the toilet and the bedroom, a chronic pain in your lower back or pelvic region, or your privates, can be a symptom as well.

How Is Pelvic Floor Dysfunction Diagnosed?

Your physician, as always, will start his diagnosis process with certain questions. These can be, for women;

• Do you have a history of urinary tract infections?
• Have you given birth?
• Do you experience pain during sexual intercourse?

For men, the questions can be;

• Do you have difficulty achieving or maintaining an erection?

Both genders will be asked about their bowel movements, and if they experience pain or strain within them. The physician can also ask about any history of Irritable Bowel Syndrome (IBS) or Interstitial Cystitis (IS), which is a chronic inflammation of the bladder wall.

After the diagnostic interview, your physician might decide to perform a pelvic exam. There is no advance preparation required. Other diagnostic tools for PFD are;
Surface Electrodes; Electrodes are placed on the perineum, the area between the testicles and rectum for men, and between the rectum and vagina for women. These are an alternate option if you opt out of an internal exam. The electrodes allow the practitioner to monitor pelvic muscle response.

Anorectal Manometry; This test assesses the strength of your anal sphincters. No, that plural is not a typo, you have two sphincters, the one you are acquainted with, and another inside. Think isolation chamber with external and internal doors. As you might’ve guess, this test involves insertion of a device, an inflatable, up the back passage. The procedure might be somewhat uncomfortable but should not be painful. If it is, immediately inform the testing clinician.

Defecating Proctogram; as the name suggests, this test is checking your pooping performance. A thick liquid is inserted via enema, and then monitored via X-ray as you expel it from your rectum. The X-ray assessment allows your physician to see how your pelvic muscles are responding during bowel movement.

Uroflow Test; This is simply you peeing into a device which measures the flow and consistency of your urination. The purpose is the same as for the proctogram, assessing you well your pelvic muscles are functioning via monitoring of excretion acts.

How is Pelvic Floor Dysfunction treated?

Almost always, without surgery. The most common is simply using the results of the diagnostic tests to guide the patient through targeted self-therapy. A physiotherapist might be needed for special needs and elderly patients.

Self-therapy will involve particular exercises which the patient can easily perform themselves. These include Kegels, named after American gynecologist, Arnold Kegel, who first published a paper on exercises to strengthen pelvic floor muscles for women. Your clinician also teach you other exercises to relax your lower back muscles. Medication used is are normally over-the-counter laxatives to make bowel movement easier.

Relaxation and anti-stress techniques like yoga, meditation or acupuncture are also often recommended.

Visit Pelvic Floor Dysfunction Assessment. NewM Clinic is ready to answer all your questions regarding PFD via virtual care or in-person at the clinic. Do visit now!