The Functions of the Pelvic Floor

So you were recently diagnosed with pelvic floor dysfunction, but what does that mean? Let’s talk about what the pelvic floor is, what it does, and what happens when it is not working correctly. 

What does your pelvic floor do? 

Your pelvic floor is a group of muscles that runs from your pubic bone to your tailbone and acts as a muscular sling. It is responsible for the 3 S’s: Support, Sphincter, and Sexual Function. The pelvic floor acts as support because it works in conjunction with your abdominal muscles and diaphragm to provide stability to your pelvis and support your internal organs. Your pelvic floor also surrounds your urethra and anus and is responsible for sphincter function. Lastly, your pelvic floor plays an intimate role in your ability to have pleasurable intercourse, reach orgasm, and, for men, maintain an erection.  

What is pelvic floor dysfunction? 

Pelvic floor dysfunction is an umbrella term for any issue that may cause the pelvic floor to not function properly. Usually, pelvic floor dysfunction falls into two categories: tension or weakness. 

What happens if your pelvic floor is too tight? 

Tension occurs when the pelvic floor muscles and surrounding musculature are too tight and have trouble relaxing. Risk factors include frequent yeast and urinary tract infections, endometriosis, interstitial cystitis, nerve entrapments, constipation, urge urinary incontinence, abdominal surgeries, and fibromyalgia. Symptoms can include pain around your abdomen, vaginal opening, inner thighs, rectum, back, and buttocks. You may notice that it is uncomfortable to urinate, insert a tampon, have intercourse, or have a gynecological exam.  Orgasms can be painful because your muscles are tight and stay contracted after climax. 

Pelvic floor tension can also cause urinary and bowel issues. Muscular tension around your anus can cause constipation because it is hard for stool to pass through the sphincter. Similarly, if the muscles that surround your urethra are tight, you may experience urinary hesitancy and have difficulty starting the flow of urine. Another common urinary symptom of pelvic floor tension is frequency. You may find that you have the sensation to urinate every 30 minutes to an hour or wake up multiple times a night to pee.   

What happens if your pelvic floor is too weak? 

Pelvic floor weakness occurs when your pelvic floor lacks the strength and endurance to perform its regular function. Risk factors include older age, pregnancy and childbirth, abdominal surgery, obesity, and activities that involve high impact or heavy lifting.  

Like pelvic floor tension, pelvic floor weakness can also cause urinary and bowel issues. Because the muscles that hold back urine are weak, you may have stress incontinence and notice leaking during activities such as lifting, jumping, or sneezing. After you urinate, you may also notice slight dribbling because your pelvic floor muscles that surround your urethra do not close it completely.  

A weak pelvic floor can also cause issues with support of your pelvis and torso. You may experience a sensation of heaviness or falling out around your vaginal opening that can be a symptom of pelvic organ prolapse. Additionally, pelvic floor weakness can also contribute to a separation of your abdominal muscles called diastasis recti.  

What can you do if you think you have pelvic floor dysfunction? 

See a women’s health physical therapist! An evaluation with a trained women’s health physical therapist can help you determine the type of pelvic floor dysfunction you have and begin to work towards correcting those issues.  

– Dr. Fei Zang, PT, DPT


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