Treatment for Common Pelvic Floor Disorders

From our friends at Adventist Health Portland

A woman’s pelvic floor is made up of muscles that support the uterus, bladder and bowel. Like any muscle, these can weaken, leading to uncomfortable and sometimes painful disorders that can affect a woman’s life. It can be uncomfortable to sit, intercourse may become painful, and urine or stool may leak uncontrollably.

One in three women will experience a pelvic floor disorder, often the result of pregnancy, childbirth, age, menopause or obesity. Still, many do not seek treatment. They often assume that their symptoms, such as a leaky bladder or frequent urge to urinate, are natural parts of aging. And because symptoms can include fecal or urinary incontinence, some women may also feel uncomfortable sharing their concerns during primary care visits. Providers, however, can talk about symptoms with compassion and understanding and offer treatment options to restore comfort.

Here, we share common pelvic floor disorders, what they feel like and how they are treated.

Pelvic Floor Dysfunction:

The pelvic floor muscles act like a sling to support the bladder, bowel, and uterus. When these muscles become too tense or loose, it leads to pelvic floor dysfunction, causing constipation, urinary or fecal incontinence, and discomfort during intercourse. This common condition affects both men and women, with 1.2 million physician visits annually in the United States.

Fecal Incontinence:

When rectal and anal muscles fail to contract properly, stool can leak unexpectedly. This can result from factors such as frequent constipation, childbirth-related tears, or nerve damage. Treatment options include anti-diarrheal medication, fiber supplements, dietary changes, and strengthening exercises guided by a physical therapist.

Urinary Incontinence:

Inability to control the bladder, often due to weak pelvic floor muscles, leads to urinary incontinence. Stress incontinence, caused by pressure on the bladder, can result from activities like sneezing or lifting. Urge incontinence involves a sudden, frequent urge to urinate. Treatment involves lifestyle changes, including a fiber-rich diet, weight loss for obese individuals, and avoiding irritants like caffeine and alcohol. Pelvic floor exercises, such as Kegels, are also recommended.

Pelvic Organ Prolapse:

Weak pelvic floor muscles can cause the bladder, uterus, or bowel to slip from their usual position, resulting in pelvic organ prolapse. Symptoms include urine leakage, difficulty emptying the bladder, pain during intercourse, constipation, and a feeling of pelvic heaviness. Treatment options range from pelvic floor exercises and dietary changes to minimally invasive surgery for severe cases.

Fistulas:

Pelvic injuries can lead to fistulas, tunnel-like holes between organs causing leakage into the vagina. Commonly forming between the bladder and vagina or rectum and vagina, fistulas can result from pelvic surgery, childbirth tearing, or other pelvic injuries. Symptoms include vaginal soreness, pain during intercourse, abdominal pain, fever, nausea, vomiting, and weight loss. Treatment involves antibiotics to resolve infections and, in some cases, skilled surgical removal of the fistulas.

Dr. Michelle Wheeler, OB-GYN at Adventist Health Women’s Clinic, underscores the significance of addressing these issues, stating, “Pelvic floor disorders can significantly impact a woman’s quality of life, but the good news is that effective treatments are available.”