For many women, discussing issues related to their pelvic health is embarrassing and uncomfortable. But women should know they are not alone and that help is available. In fact, one in four women of 20 years and older suffer from one or more pelvic floor disorders.
What are pelvic floor disorders? Pelvic floor disorders are a result of weakened pelvic muscles or tears in the connective tissue of the pelvis. Over time, the pelvic floor is not able to support the organs as effectively, which can affect the function of the bowel, bladder, uterus, vagina, and rectum.
There are multiple symptoms of a pelvic floor disorder which can occur alone or in a combination of symptoms, such as frequent urination during the day or at night, or both; urine leakage with little or no warning, and sometimes not making it to the bathroom in time; the inability to completely empty the bladder; accidental urine leakage with physical activity when exercising, sneezing, or coughing; problems with bowel function – accidental loss or leakage of stool; or the feeling of a bulge protruding past the vaginal opening.
While excessive strain due to childbirth can lead to a pelvic floor disorder, there are many other potential factors such as repeated strenuous activity, menopause, pelvic surgery, repetitive heavy lifting, tobacco use, and genetics which may cause women to develop issues with their pelvic region.
Many women have heard about Kegel exercises to improve pelvic strength. Pelvic exercises can stop the progression of prolapse or incontinence, and sometimes reverse it. However, if performed incorrectly, they can not only be ineffective, but possibly make certain conditions worse. In order to identify exercises that are appropriate and effective in meeting your needs, it is recommended to work with a pelvic floor physical therapist, who is much like a personal coach for your pelvic floor.
While surgery is sometimes necessary due to the severity of a patient’s condition and overall health, there is a wide variety of nonsurgical treatment options available as well. Nonsurgical treatment options include medications, targeted physical therapy, behavioral and lifestyle modifications, noninvasive pelvic support devices, biofeedback, and nerve stimulation.
What’s important to remember is that the symptoms of a pelvic floor disorder are not likely to resolve on their own. Over time, they can lead to long-term issues like chronic pelvic pain and incomplete bladder emptying, which can ultimately cause damage to the kidneys. That is why it is important to discuss any issues with a physician.
Urogynecologists (more recently referred to as female pelvic medicine and reconstructive surgeons) are specially trained to diagnose and treat women with pelvic floor disorders. Urogynecologists complete medical school and a residency in obstetrics and gynecology or urology and then additional years of training and certification in female pelvic medicine and reconstructive surgery. These physicians can help develop an optimal treatment plan that addresses each woman’s unique issues.
Women do not have to live in fear and embarrassment. The first step is speaking up.
Lioudmila Lipetskaia, MD
Associate Program Director, Female Pelvic Medicine and Reconstructive Surgery
The Ripa Center for Women’s Health and Wellness at Cooper