When damage to the pelvic floor occurs, the muscles become weak or the ligaments and tissues are stretched or damaged. This can lead to a pelvic floor disorder. The five main categories of pelvic floor disorders include: bladder dysfunction, bowel dysfunction, pelvic organ prolapse (when the organs of the pelvis fall out of place), pelvic pain and female sexual dysfunction. Learn more about these disorders below.
Most adults should urinate approximately eight times in a 24-hour period and are able to sense fullness and comfortably make it to the bathroom and go without difficulty. Not being able to make it to the bathroom or having frequent accidents is a cause for concern. The most common types of bladder disorders include:
Stress urinary incontinence: This is a bladder control problem that occurs when urine leaks during physical activities. When stress is placed on the bladder during laughter or physical activity, pressure in the abdomen rises, often resulting in leakage in the form of spurts of urine. (Printer-Friendly guide at bottom of this page.)
Urge incontinence or overactive bladder: This occurs when a woman has a sudden and strong urge to urinate and leaks on herself before she can get to the toilet.
Recurrent urinary tract infections (UTIs): Some women are prone to developing recurrent bladder infections (having more than three infections per year). Many women with pelvic floor disorders suffer from recurrent UTIs. (Printer-Friendly guide on our resources page.)
Interstitial cystitis: This is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms vary from case to case. Women may experience pressure, tendernes or intense pain in the bladder and pelvic area. Symptoms usually include very frequent urination, urgency or bladder irritation, as well as pain during intercourse. (Printer-Friendly guide on our resources page.)
Most adults should have regular bowel movements anywhere from three times a week to two times per day. Chronic constipation, or an inability to control gas or stool can be symptoms of an abnormal pelvic floor. This inability to control bowel function is often related to weakening or stretching of the muscles, prior surgery for hemorrhoids and other anal disorders, chronic diarrhea, colonic inflammation, physical disabilities, or problems with the structure of the posterior pelvic floor muscles.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs when the organs of the pelvis fall out of place because supporting tissue is weakened. Often, a woman has more than one type. In all types, the most common symptom is a feeling of heaviness, pressure or bulging in the area of the vagina, and in more severe cases, tissue may protrude outside of the vaginal opening. (Printer-Friendly guide on our resources page.)
Types of pelvic organ prolapse include:
Cystocele: the bladder protrudes through the vagina
Enterocele: the small intestine protrudes through the upper vaginal supports (especially in women who have had a hysterectomy)
Rectal prolapse: the lining and/or muscles of the rectum protrude out of the anus, typically during attempts at bowel movements
Rectocele: the rectum protrudes through the back wall of the vagina
Sigmoidocele: the sigmoid colon (the part of the large intestine that is closest to the rectum and anus) slips into the rectovaginal space
Vaginal vault prolapse or uterine prolapse: the entire vagina or uterus sag through the vaginal opening
It’s important to understand that pain in the pelvic area (the bladder, uterus, vagina, vulva or rectum) is not normal. Significant vaginal pain or pressure, particularly during or after menopause, is related to a lack of estrogen in the vaginal area. During menopause, a woman’s ovaries stop functioning and quit producing estrogen, which can create a condition called urogenital atrophy. This is when the vaginal skin becomes very thin and sensitive. Some women also suffer from vulvodynia, chronic vulvar pain (the vulvar is the external female genital organs, such as the labia, clitoris and vaginal opening). Women with chronic pelvic pain can significantly benefit from a full evaluation of the entire pelvic floor.
Female Sexual Dysfunction
Sexual problems like pain during intercourse and vaginal dryness are often related to pelvic floor disorders. Pelvic organ prolapse, menopause-related hormonal changes and a disorder of the pelvic floor muscles (the levator-ani) are some common causes. Women who are sexually active should enjoy normal sexual desire, normal arousal and normal orgasmic function.
The specialists at Division of Female Pelvic Medicine and Reconstructive Surgery can help determine whether your symptoms are the cause of a pelvic floor disorder and offer a variety of treatment options. Learn more by visiting the diagnosis and treatment pages of our Web site or call 423.439.7272 to speak to a specialist.