Frequently Asked Questions About Pelvic Floor Disorders

• What is the pelvic floor?
• What are pelvic floor disorders?
• What are the symptoms of pelvic floor disorders?
• Are pelvic floor disorders a normal part of aging?
• What causes pelvic floor disorders?
• Who treats pelvic floor disorders?
• When should I seek help for pelvic floor disorders?
• What causes pelvic pain?
• What role do pelvic floor muscles play in bowel problems?
• What is pelvic floor dysfunction, and what are the symptoms?
• How is pelvic floor dysfunction treated?

Q. What is the pelvic floor?
A. Both men and women have a pelvic floor. In women, the pelvic floor is the muscles, ligaments, connective tissues and nerves that support the bladder, uterus, vagina and rectum and help these pelvic organs function. In men, the pelvic floor includes the muscles, tissues and nerves that support the bladder, rectum and other pelvic organs.

For many people, particularly women, the pelvic floor does not work as well as it should. Almost one-quarter of women face pelvic floor disorders, according to a study funded the National Institutes of Health. The study found that pelvic floor disorders affect about 10 percent of women ages 20 to 39, 27 percent of women ages 40 to 59, 37 percent of women ages 60 to 79 and nearly half of women age 80 or older.

Q. What are pelvic floor disorders?
A. Pelvic floor disorders occur when the "sling" or "hammock" that supports the pelvic organs becomes weak or damaged. The three main types of pelvic floor disorders are:

• Urinary incontinence, or lack of bladder control
• Fecal incontinence, or lack of bowel control
• Pelvic organ prolapse, a condition in which the uterus, bladder and bowel may "drop" onto the vagina and cause a bulge through the vaginal canal

Q. What are the symptoms of pelvic floor disorders?
A. People with pelvic floor disorders may experience:

• Urinary problems, such as an urgent need to urinate, painful urination or incomplete emptying of their bladder
• Constipation, straining or pain during bowel movements
• Pain or pressure in the vagina or rectum
• A heavy feeling in the pelvis or a bulge in the vagina or rectum
• Muscle spasms in the pelvis

Q. Are pelvic floor disorders a normal part of aging?
A. While pelvic floor disorders become more common as women get older, they are not a normal or acceptable part of aging. These problems can have a significant impact on a person’s quality of life. Fortunately, these disorders often can be reversed with treatment.

Q. What causes pelvic floor disorders?
A. Childbirth is one of the main causes of pelvic floor disorders. A woman’s risk tends to increase the more times she has given birth.

Women who are overweight or obese also have a greater risk for pelvic floor disorders.

Having pelvic surgery or radiation treatments also can cause these disorders. For example, these treatments can damage nerves and other tissues in the pelvic floor.

Other factors that can increase the risk include repeated heavy lifting or even genes.

Q. Who treats pelvic floor disorders?
A. A variety of experts can treat these problems, and often, a combination of experts provides the best outcome for patients. At the University of Chicago Center for Pelvic Health, women and men are treated by a multidisciplinary team of specialists that includes:

• Urogynecologists, who are obstetrician/gynecologists who specialize in the care of women with pelvic floor disorders
• Urologists, who specialize in the treatment of urinary disorders in women and men
• Colorectal surgeons, who provide surgical treatment of the digestive system
• Gastroenterologists, who treat the digestive system
• Plastic and reconstructive surgeons, who use advanced reconstructive techniques to rebuild damaged tissues in the pelvis
• Physical therapists, who can help women and men learn exercises to improve their symptoms
• Radiologists, who perform advanced studies to determine the cause of pelvic floor disorders
• Nurses, who are often the first line of contact for patients and can help coordinate care through the Center for Pelvic Health

Q. When should I seek help for pelvic floor disorders?
A. Many people don’t feel comfortable talking about personal topics like pelvic floor disorders and symptoms such as incontinence. But these are actually very common medical problems that can be treated successfully. Millions of people have the same issues, but many don’t seek treatment and compromise their quality of life.

If you have a pelvic health issue, don’t hesitate to learn more about your treatment options. If your doctor doesn’t treat these issues regularly, seek out an expert. The University of Chicago Center for Pelvic Health includes urologists, urogynecologists and other caregivers who treat their patients with dignity and compassion.

Q. What causes pelvic pain?
A. Pelvic pain is discomfort that occurs in the lower abdomen below the belly button. More common in women than in men, pelvic pain can be a sign of other health problems, some of which may be serious.

In women, pelvic pain may be caused by:

• Endometriosis, a condition in which the tissue that normally lines the uterus grows on the ovaries, bladder or other organs
• Chronic pelvic inflammatory disease, an infection that affects the female reproductive organs
• Fibroids, which are noncancerous tumors that grow in the uterus
• Interstitial cystitis, an inflammation of the bladder that may cause urinary urgency or pelvic pain
• Digestive diseases such as colitis, diverticulosis and diverticulitis

If you have pelvic pain, see a doctor who treats these problems regularly. Many treatments are available to help reduce your discomfort. And if left untreated, pelvic pain could lead to a more serious problem.

Q. What role do pelvic floor muscles play in bowel problems?
A. The pelvic floor muscles play an important role in the process of having a bowel movement. The muscles of the pelvis must relax and contract in a coordinated way to eliminate stool.

However, some people cannot control these muscle movements and need to strain or assume different positions to achieve a bowel movement.

Q. What is pelvic floor dysfunction, and what are the symptoms?
A. Pelvic floor dysfunction is when you are unable to control the muscles that help you have a complete bowel movement. It can affect women and men. The symptoms include:

• Constipation, straining and pain with bowel movements
• Unexplained pain in the lower back, pelvis, genitals or rectum
• Pelvic muscle spasms
• A frequent need to urinate
• Painful intercourse for women

Experts do not know for sure what causes pelvic floor dysfunction. However, people who have it tend to contract their pelvic floor muscles rather than relax the muscles, which allows the bowel to empty.

Q. How is pelvic floor dysfunction treated?
A. Treatment can have a dramatic effect on pelvic floor dysfunction. For most people, this usually involves:

• Behavior changes, such as avoiding pushing or straining when urinating and having a bowel movement. This also might include learning how to relax the muscles in the pelvic floor area. For example, warm baths and yoga can help relax these muscles.
• Medicines, such as low doses of muscle relaxants like diazepam
• Physical therapy and biofeedback, which can help you learn how to relax and coordinate the movement of your pelvic floor muscles

More Information

• FAQ: Pelvic Floor Disorders
• FAQ: Pelvic Organ Prolapse
• FAQ: Urinary Incontinence
• FAQ: Fecal Incontinence