Everything You Need to Know About: Pelvic Floor Dysfunction

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An umbrella term, pelvic floor dysfunction covers various disorders that develop when the ligaments and the pelvic floor muscles weaken. In such cases, it becomes tough for a woman to control the movement of the muscles.

Did you know nearly 1 out of every 11 women suffers from pelvic floor dysfunction?

The disorder prevails with age. An approximate of 40% of women in the age group of 60 to 79 suffer from this dysfunction. According to research, women in their 20s also reported having a few symptoms related to the disorder. The older a woman gets, the worse the disorder gets. Taking into consideration the number of women who have consistently increased symptoms, it becomes essential for them to consult physical therapy specialists on a regular basis.

To start off, let’s understand the basics of pelvic floor dysfunction.

The organs in your pelvis are supported by a sort of sling known as the pelvic floor. In case you can’t put your finger on the list of organs:

  • Uterus
  • Bladder
  • Rectum
  • Vagina
  • Urethra

The contraction and relaxation of the muscles in the pelvic floor are what allows you to maintain control over the bowel movements and for women, they can control how their muscles move during sexual intercourse. It becomes essential for patients to keep their muscles contracted rather than relaxed, at times leading to long-term colon damage.

When the pelvic muscles become weak, stretched, or damaged, the small intestine and the pelvic organs may start moving toward the vagina. In patients where the dysfunction has been left untreated, physical therapy specialists say that it may so happen that the organs push themselves outside the body through the vagina.

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There are a few common factors that cause pelvic floor dysfunction:
Obesity

  • Frequent excess pressure on the abdomen
  • Age
  • Normal (vaginal) delivery
  • Injury during a surgical procedure

For women who might have gone through surgeries like hysterectomy are more likely to damage since it weakens the pelvic structure.

The risk increases when women have multiple vaginal deliveries rather than a cesarean delivery. A normal delivery would damage the nerves in the area, causing the muscles to become weak.

If we talk about the lesser-known factors that lead to pelvic floor dysfunction, then we know that when certain fluids accumulate in the abdomen, it puts pressure on the pelvic organs, causing discomfort. Disorder in the connective tissue, tough and fibrous, that provides support and elasticity may also be a factor that causes the dysfunction.

23.7% of women have reported having at least one of the pelvic floor dysfunctions.

Jumping into the details:

According to physical therapy specialists, all the pelvic floor dysfunctions are related to hernias. These have been named in relation to the organ that they affect. Most women are diagnosed with more than one type of dysfunction with the most common symptom being feeling pressure in the area around the vagina.

There are 4 dysfunctions that occur together when these organs descent:

  • Small intestine (enterocele)
  • Rectum (rectocele)
  • Urethra (urethrocele)
  • Bladder (cystocele)

Once the pelvic floor is damaged, it moves to the urinary tract as well. This is the main cause of women not being able to control urination. The control may be limited to leakage or involuntarily emptying the bladder.

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At an individual level, let’s talk about the 4 types of pelvic floor dysfunctions:

1. Enterocele (Small Intestine)

When a woman gets her uterus removed surgically, i.e. through a hysterectomy, the lining of the abdominal cavity and small intestine starts to move downward toward the space between the rectum and the vagina. With the uterus gone, the connective tissue and the ligaments become weak. The problem with enterocele is that there are no symptoms, except for a small population feeling pain in the lower back and pelvis.

2. Rectocele (Rectum)

The walls of the rectum and its connective tissue become weak, causing it to push into the back wall of the vagina. Physical therapy specialists have mentioned that this type of pelvic floor dysfunction causes constipation, i.e. difficulty in bowel movement. They say that women have had to place their finger on the vagina and push it against the rectum to gain control for the time being.

3. Urethrocele (Uterus)

With the weakening of the connective tissue and ligaments, the uterus pushed down toward the vagina, in different ways:

  • Moves partially through the opening
  • Touches only the upper part of the vagina
  • Moves down through the opening (procidentia)
  • Moves down toward the opening

Depending on where and how fast the uterus is moving, a woman may show varied symptoms. Some of the pains may include the tailbone, lower back, during sexual intercourse, etc. There are chances that some women may not even show any of the symptoms. The lower part of the uterus that has begun protruding may develop sores that cause infection, discharge, or even irregular bleeding.

4. Bladder (Cystocele)

The connective tissue around the bladder weakens, causing it to drop and ram against the front wall of the vagina. Due to pressure on the abdomen, women could pass urine involuntarily. The pressure could be caused due to laughing, coughing, or jerks during walking or running. Urine retention becomes a big issue if the condition becomes serious. There are chances that in spite of not having control over the muscles, the bladder wouldn’t empty and cause a urinary tract infection, according to physical therapy specialists.

In the age group of 40 to 59, there are 26.5% of women who suffer from pelvic floor dysfunction.

There is one more type that should be covered. The descent of the top portion of the vagina onto the lower portion. This causes the vagina to flip. In fact, in some cases, the top portion falls so far deep that it pushes itself out of the vagina. Women feel intense pain when they walk or sit due to prolapse. A kink could develop in the urethra hiding the inconsistency in urination.

How a pelvic floor dysfunction diagnosed?

Self-diagnosis is the first step to this procedure. Keeping an eye out for the most common symptoms (as mentioned above) can be helpful in visiting the doctor at an early stage.

There is a general procedure that is followed to examine women who have observed symptoms related to the dysfunction. The pelvic examination is carried out with an instrument called a speculum that stretches the walls of the vagina apart for the doctor to insert their finger in it. After this, they insert another finger into the rectum to determine the condition of the enterocele or rectocele.

Different doctors have different methods of carrying out the same examination. Mostly women are asked to bear down, so as to cough, with one foot on a stool. The pressure that is felt by the pelvis will tell the doctor how bad the dysfunction is.

At times, to diagnose the severity of the dysfunction, doctors measure the amount of leakage from the bladder, the urine flow, and the amount of urine that stays in the bladder after urinating.

Say if a woman cannot pass urine or does so involuntarily, then the doctor would insert a viewing tube inside the urethra or bladder to understand what the course of treatment should be, surgery or medicine.

What do you do if you are diagnosed with pelvic floor dysfunction?

There are various exercises that can be followed and implemented as a part of your regular routine. The most common one being the Kegel exercise. It would help with the symptoms but will not stop the movement of the organs.

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Physical therapy specialists suggest Kegel exercises since they are known for providing strength to the pelvic muscles. The muscles around the rectum, vagina, and urethra are squeezed as tightly as possible for 2 seconds and kept in a relaxed position for about 10 seconds. Once your muscles get used to this set, the time is increased to squeezing the muscles for 10 seconds at a time. It works best if the form is repeated at least 10 times.

Since these muscles are not visible through clothes, the exercise can be carried out at any time, while sitting, standing, or laying down.

There have been observations where women have not been able to concentrate on contracting the correct set of muscles. The solution is easy if you too faced the same problem:

  • Using biofeedback devices
  • Cone-shaped inserts are used for the vaginal muscles
  • An electrical probe is inserted to contract the right muscles.

15.1% of women who were underweight and normal weight were diagnosed with pelvic floor dysfunction while 26.3% of overweight women suffered and the highest number, 30.4% of women suffered due to being obese.

Now that you have all the required information with a lot of facts, the concept of pelvic floor dysfunction should have cleared out. You must have realized that the condition is treatable. There is no shame in contacting a professional regarding the same.

At Physical Healthcare of Jacksonville, the finest team of experts are available to help you. We create individual therapy plans depending on your condition. Don’t just cope up with your pain problems. You want to heal it permanently by receiving help from our physical therapy specialists in Jacksonville. Book your appointment now!

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