Pelvic Floor 101—By Michelle Musial, MPT
Ever wonder what the heck a pelvic floor is? And, if it’s normal to pee your pants after giving birth? Or, if having painful sex is “all in your head?” We are excited to share with you our eye-opening interview with Michelle Musial, Masters of Physical Therapy, who demystifies the elusive pelvic floor. Contrary to popular belief, the pelvic floor is not something made-up. It is anatomically real, and there are issues that can develop with it that seriously compromise women’s quality of life.
What is the pelvic floor?
The pelvic floor (muscles) refer to the group of muscles that span from the pubic bone to the tailbone, that collectively function involuntarily to support the pelvic organs. They relax to allow for voiding (another word for urinating and bowel movements). They also relax and contract for roles in sexual function and labor and delivery. These muscles work in groups superficially and deep, and function 24 hours per day.
What are common symptoms of pelvic floor disorders?
There is such a wide variety of symptoms associated with pelvic floor disorders, that it might not even be on your radar that issues you are having could be pelvic floor related. The most obvious and broad symptoms are urinary incontinence and fecal incontinence. Yet, incontinence can manifest itself very differently in each woman, so it might not be apparent that the symptoms a woman is experiencing is related to incontinence. If you have loss of urine or bowel control when you cough, sneeze, lift, exert yourself, or feel the urge to go, these are not normal and a form of incontinence and, thus, pelvic floor dysfunction.
Other symptoms of pelvic floor disorders might not seem so obvious. If you have pain with penetration, including pain with sexual intercourse, limiting use of tampons, and pain with gynecologic exams, this is not normal and symptoms of pelvic floor disorder. If you have pubic pain, tailbone pain, perineal pain, abdominal pain, bloating, constipation, or essentially anything “not feeling right” underneath, this is not normal and symptoms of pelvic floor disorder. Other forms of dysfunction are pelvic organ prolapse, which is the descension of the uterus, bladder or rectum through the vagina.
What causes pelvic floor disorders? How common are they?
Pelvic floor dysfunction is almost always multifactorial. Contributing factors to dysfunction include a pelvic floor being either too toned or not toned enough, too relaxed or not relaxed enough. Past medical history, including abdominal surgeries, participation in certain sports, number of pregnancies and delivery methods, genetic factors, behaviors used for toileting, breathing patterns and dysfunction can all be contributing factors to pelvic floor dysfunction. It’s important to note that C-sections are NOT sparing or protective against pelvic floor dysfunction.
Pelvic pain is unfortunately under-researched, possibly because it primarily affects women. And, it is extremely underreported, as women who disclose their pain to medical professionals are often not taken seriously, are told "to just relax", or told to "deal with it," without being offered true treatment. I don't have a recent citation at this time for how common pelvic floor dysfunction is, but it is very common. Just think how big the aisle at the grocery store is for incontinence management. That is just for incontinence.
*This article is for informational purposes only and is not meant to replace medical care. As always, check with your doctor to discuss your feelings when pregnant to make sure the feelings you are having are normal and not antenatal depression.