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What Is a Pelvic Floor Disorder?

A woman with urinary incontinence covers her pelvic region with her hands

It’s a medical condition that millions of American women have but people rarely talk about.

You may not be familiar with its name, what its symptoms are or how it’s treated. It’s a pelvic floor disorder, and chances are, someone you know has one.

What exactly is a pelvic floor disorder?

Pelvic floor disorders occur when ligaments, connective tissue and muscles in the pelvis are stretched, damaged or weakened so that they shift away from their natural alignment. Pelvic floor disorders can affect the vagina, uterus, bladder, intestines or rectum.

Are they common? Who’s at risk?

About one in three women in the United States have a pelvic floor disorder, and almost one in four have one or more. Vaginal birth, hysterectomy or injury to the pelvic region are common causes of pelvic floor disorders, but aging, obesity and activities that strain the abdomen, such as heavy lifting or excessive pushing during bowel movements, are also factors.

What are the symptoms?

Pelvic floor disorders have different kinds of symptoms, ranging from lower back discomfort and a feeling of heaviness in the pelvic area to urinary incontinence and constipation.

“Often, symptoms are associated with shame and embarrassment,” says Christine Hsieh, MD colon and rectal surgeon at Keck Medicine of USC and assistant professor of clinical surgery at the Keck School of Medicine of USC. “Women may minimize symptoms or brush them off as unimportant — but they are important.”

Vaginal and uterine symptoms can include:

  • A bulge inside your vagina, either visible or invisible
  • An aching, fullness or sagging feeling that worsens throughout the day
  • Difficulty urinating or frequent urination
  • Painful intercourse
  • Trouble with bowel movements
  • Bleeding from the skin in the vaginal area that is not related to your period

Bladder symptoms can include:

Intestinal and rectal symptoms can include:

  • Leaky stool
  • Inability to control gas
  • Constipation
  • Not getting to the bathroom in time when you have to go
  • Frequent feelings like you have to go

“I typically recommend that my patients with bothersome constipation or incontinence symptoms keep a GI diary — these days it’s fairly easy to do on a smartphone,” Dr. Hsieh says. “What we’re looking for are patterns, triggers and frequency of symptoms or events, and this helps to determine the treatment plan.”

How are pelvic floor disorders treated?

Treatment options can vary from lifestyle adjustments and exercises to surgery.

“Noninvasive therapies for prolapse and urinary symptoms include behavioral and pelvic floor physical therapy, oral medications, Botox injections to the bladder and neuromodulation, which is a minimally invasive technique that stimulates nerves related to bladder function,” says David Ginsberg, MD a urologist who specializes in female pelvic medicine at Keck Medicine of USC and a professor of clinical urology at the Keck School of Medicine of USC. “There are also surgical options to correct both stress urinary incontinence and prolapse, which often can be done on an outpatient basis.”

Even though a pelvic floor disorder can be embarrassing to discuss, it’s important to open up to your doctor so you can get proper medical care.

“I hope women realize that open dialogue about these issues with their doctor can go a long way to helping to improve or eliminate them,” Dr. Hsieh says.

Specialists within this field are here to help diagnose and treat this condition and to help improve your quality of life, Dr. Ginsberg adds.

by Heidi Tyline King

The USC Institute of Urology, colorectal surgery program and USC Women’s Health at Keck Medicine of USC can help you or a loved one diagnose and treat a pelvic floor disorder. If you are in the Los Angeles area, schedule an appointment or call (800) USC-CARE (800-872-2273).

Keck Medicine of USC is the University of Southern California’s medical enterprise, one of only two university-owned academic medical centers in the Los Angeles area.