Pelvic Support

We all have a pelvic floor, a collection of connective tissue, muscles, ligaments, and nerves that uphold and secure internal organs. In men, the pelvic floor supports the bladder, rectum, and other structures. In women, it is the bladder, rectum, vagina, and uterus that are supported by these tissues.

As a woman ages, the support provided by her pelvic floor diminishes. According to one study, more than one-quarter of women aged 40 to 59 experience one or more pelvic floor disorders. In the next age category of 60 to 79 years of age, approximately 37% of women are affected by weakness in the pelvic floor.

What Is a Pelvic Floor Disorder?

Pelvic floor disorder is classified as a condition caused by looseness or damage of the supportive “sling” beneath pelvic organs. Three common pelvic floor disorders are:

• Urinary incontinence
• Fecal incontinence
• Pelvic organ prolapse

What Could Cause Pelvic Floor Disorders?

As you can see from statistics, aging is one factor in the development of pelvic floor disorders. However, it is important to understand that each woman has a large amount of control over the strength of her pelvic floor at any age.

Pelvic support may weaken as a result of:

• Pregnancy and childbirth, due to the changes in reproductive tissues and the stretching of pelvic structures during delivery. The more vaginal births that a woman has, the greater the likelihood of pelvic floor disorders.
• Obesity has been cited as a risk factor for pelvic floor weakness.
• Pelvic surgery may lead to weakness if tissues and/or nerves are disrupted.
• Frequent heavy lifting places a great deal of stress on the pelvic floor and may cause weakness over time.

Pelvic Floor Disorder Symptoms

• Urinary incontinence causes sensations such as a strong urge to urinate, but little output. This condition may also lead to accidental urine leakage when laughing or performing other physical tasks.
• Constipation or painful bowel movements may occur. On the other hand, a weak pelvic floor may lead to fecal incontinence or accidental leakage.
• The sensation of pressure on the rectum or vagina, or pain in one or both of these areas.
• Pelvic muscle spasms.
• Bulging from the vagina or rectum if pelvic organ prolapse has occurred.

What Is Pelvic Organ Prolapse?

Pelvic organ prolapse describes the “dropping” of one or more pelvic organs. This may be the uterus (uterine prolapse), the vaginal vault, or top of the vagina (vaginal vault prolapse), the bladder (cystocele), the rectum (rectocele), or another pelvic structure.

Diagnosing Pelvic Floor Disorders

A gynecologist or other healthcare professional may diagnose pelvic floor disorders by conducting a detailed medical history to include previous pregnancies and deliveries, weight, family history, frequency and severity of symptoms, and other health matters. An initial physical examination may involve a basic vaginal and / or rectal exam to assess muscle strength. Such examinations may be performed in both a lying and standing position, and may include “stress” such as straining or coughing.

Pelvic Floor Disorder Treatment

There are several ways to improve pelvic support and minimize symptoms of pelvic floor disorders. Every person may respond differently to various therapies, and may want to support optimal outcome with lifestyle habits such as:

• Adding more fiber to the diet to prevent constipation.
• Adding a laxative or stool softener to minimize straining.
• Limiting caffeine, which has a diuretic effect that increases urination.
• Bladder training, which involves scheduled urination.
• Weight management.
• Pelvic floor exercises (Kegels).

Medical treatments for pelvic floor disorders are also beneficial. Urinary incontinence may improve with a pessary, a device that physically supports the pelvic organs. In some cases, biofeedback may be advisable to facilitate the proper performance of pelvic floor exercises.