Women's Health

Common Pelvic Floor Issues in Women and What You Can Do About Them

Pelvic floor issues are common, and can be easily treatable. The pelvic floor helps to maintain bladder and bowel control, sexual function, and serves as the “home” for the pelvic organs, including the urinary bladder, rectum, and vagina, keeping them in the correct position.

However, pelvic floor disorders can and do occur. Common issues are urinary problems, loss of pelvic organ support or pelvic organ prolapse, and bowel dysfunction. Childbirth is one of the main causes of pelvic floor dysfunction, and the risk for dysfunction increases with the more children a woman has. Other risk factors include being overweight or obese, genetic predisposition, and aging changes.

“Pelvic floor disorders are fairly common”, said Rachel Pauls, MD, a surgeon with TriHealth Urogynecology Associates who specializes in female pelvic medicine and reconstructive surgery.  “Ten to 50 percent of women report urinary leakage, and 50 percent of women who have had children develop prolapse. On top of that, 20 percent of women will undergo surgery for pelvic organ prolapse or urinary incontinence in their lifetime.”

Unfortunately, many women let these issues affect their daily lives for years prior to seeking treatment. Many worry about coughing or sneezing in public for fear of having an accident, or avoid social situations due to urgency and incontinence. But many forms of pelvic floor issues can be easily treated.

A common pelvic floor dysfunction is stress incontinence, which is a leakage of urine that occurs when the bladder is “stressed” by a sudden increase in pressure. It occurs with common activities like sneezing, and is felt to be a result of lack of support to the urethra and bladder neck. It’s the most common type of incontinence overall, and more common type among younger women. This can be treated with pelvic floor muscle exercises like Kegels and physical therapy, said Dr. Pauls. Minimally invasive surgery is also an option if other treatments do not work.

Overactive bladder is another common issue. It’s categorized by urinating more than eight time over 24 hours and more than once at night. Most often the cause is unknown, but many dietary substances can affect bladder nerves, including coffee, carbonated and/or alcoholic beverages, citrus, chocolate, and acidic or spicy foods. Overactive bladder may be treated with diet changes and bladder retraining. The goal is to modify bladder function to extend the time between trips to the bathroom. The bladder needs to be under your control, and not vice versa, said Dr. Pauls. Other alternatives include medications and second line therapies such as Botox.

A third type of pelvic floor disorders is pelvic organ prolapse, which is a relaxation of the pelvic structure, leading to discomfort, problems with sexual activity, and bowel and bladder dysfunction. Preventative measures for this type of dysfunction include pelvic muscle strengthening, good bowel and bladder hygiene, and weight maintenance. Treatment options include doing nothing if it’s not bothersome, a pessary (a soft, removable device inserted into the vagina that supports the areas affected by prolapse), or surgery.

Pelvic floor dysfunction is very common, and can severely impact your quality of life. If you think you may have pelvic floor dysfunction, please make an appointment with your doctor. A subspecialist in Female Pelvic Medicine and Reconstructive Surgery often can provide a diagnosis and treatment plan that will be right for you.

Hear more on this subject from Dr. Pauls

Dr. Pauls presented an in depth look at common pelvic floor issues at the July 19, 2018 session of the TriHealth Physicians Speaker Series. Watch her presentation in the video below and hear more from Dr. Pauls.

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Last Updated: July 20, 2018