Pelvic Floor Dysfunction

Pelvic floor dysfunction occurs when the muscles in the pelvic floor are unable to relax or contract properly, causing pelvic pain, constipation, and urinary or fecal incontinence.
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The basics

Pelvic floor dysfunction (PFD) is a condition that affects the muscles, ligaments, and connective tissues in the pelvic floor, which support the bladder, uterus, and rectum. The pelvic floor muscles can become weakened or tight, causing a range of symptoms, including urinary or fecal incontinence, chronic pelvic pain, painful intercourse, and difficulty emptying the bladder or bowels.

PFD can affect both men and women, but is more common in women, particularly those who have given birth vaginally or undergone pelvic surgery. The causes of PFD can be varied, including pregnancy and childbirth, trauma, chronic constipation or straining during bowel movements, and chronic coughing. Treatment options for PFD may include physical therapy, biofeedback, medications, or surgery, depending on the underlying cause and severity of symptoms. It's important for anyone experiencing symptoms of PFD to seek medical attention, as early diagnosis and treatment can improve outcomes and quality of life.

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Symptoms

The presentation of Pelvic Floor Dysfunction can vary depending on the individual, but common symptoms associated with the condition include:

  • Urinary or fecal incontinence
  • Difficulty or pain with bowel movements
  • Pain during intercourse
  • Pelvic pain or pressure
  • Frequent urination
  • Urgency to urinate
  • Painful urination
  • Constipation
  • Lower back pain

These symptoms may be mild or severe and can have a significant impact on a person's quality of life. It is important to note that not all individuals with Pelvic Floor Dysfunction will experience all of these symptoms, and some may have additional symptoms not listed above.

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Therapies & treatments

Pelvic Floor Muscle Training

Pelvic floor muscle training is a form of physical therapy that involves exercises designed to strengthen the pelvic floor muscles, which can help alleviate pelvic floor dysfunction symptoms such as incontinence and pelvic pain. A physiotherapist will develop an individualized treatment plan that includes exercises to improve pelvic muscle strength and coordination, as well as education on proper bladder and bowel habits.

Biofeedback Therapy

Biofeedback therapy involves the use of electronic sensors to provide real-time feedback about muscle tension in the pelvic floor muscles. This can help patients learn to control and relax their pelvic floor muscles, improving muscle coordination and reducing pelvic floor dysfunction symptoms.

Bladder and Bowel Training

Bladder and bowel training involves developing a regular schedule for voiding and defecating to help reduce symptoms of urinary and fecal incontinence associated with pelvic floor dysfunction. A physiotherapist can assist patients in developing an individualized bladder and bowel training plan.

Relaxation Techniques

Relaxation techniques such as deep breathing, meditation, and progressive muscle relaxation can help reduce stress and muscle tension in the pelvic floor muscles, improving pelvic floor dysfunction symptoms.

Electrical Stimulation

Electrical stimulation involves the use of small electrical currents to stimulate the pelvic floor muscles, helping to improve muscle strength and coordination. This can be done in a clinical setting with a physical therapist or with an at-home device.

Vaginal Dilators

Vaginal dilators are used to help stretch and strengthen the pelvic floor muscles in individuals with pelvic pain or dyspareunia. A physiotherapist can guide patients in using vaginal dilators safely and effectively.

Myofascial Release

Myofascial release is a form of manual therapy that involves gentle, sustained pressure on the connective tissue surrounding the pelvic floor muscles. This can help reduce muscle tension and improve muscle function in individuals with pelvic floor dysfunction.

Trigger Point Release

Trigger point release involves the application of pressure to specific points in the pelvic floor muscles to release muscle tension and alleviate pain associated with pelvic floor dysfunction. A physiotherapist can identify and treat trigger points using manual therapy techniques.

Education and Lifestyle Modifications

Education on pelvic floor anatomy and function, as well as lifestyle modifications such as diet and exercise, can help individuals with pelvic floor dysfunction manage their symptoms and improve their overall pelvic health.

Surgical Interventions

In severe cases of pelvic floor dysfunction, surgical interventions such as pelvic floor reconstruction or nerve stimulation may be necessary. These procedures are typically reserved for individuals who have not responded to other treatment options.

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Self-care strategies

Pelvic Floor Exercises

Pelvic floor exercises or Kegel exercises can help strengthen the pelvic floor muscles and improve bladder and bowel control.

Healthy Diet

A healthy and balanced diet that includes fiber-rich foods can help prevent constipation and improve bowel movements, reducing the risk of pelvic floor dysfunction.

Good Posture

Maintaining good posture while sitting or standing can help reduce pressure on the pelvic floor muscles and prevent them from weakening.

Regular Exercise

Engaging in regular physical activity can help maintain overall health and prevent weight gain, which can put additional pressure on the pelvic floor muscles.

Stress Management

Stress can exacerbate pelvic floor dysfunction symptoms, so learning stress management techniques such as meditation, deep breathing, or progressive muscle relaxation can be an effective way to manage symptoms.

Avoiding Certain Activities

Avoiding activities that put stress on the pelvic floor muscles, such as heavy lifting, prolonged sitting, or high-impact exercises, can help prevent pelvic floor dysfunction.

Weight Management

Maintaining a healthy weight can help reduce pressure on the pelvic floor muscles and prevent the development of pelvic floor dysfunction.

Bladder and Bowel Habits

Establishing regular bladder and bowel habits, such as going to the bathroom at the same time every day, can help prevent constipation and reduce the risk of pelvic floor dysfunction.

Good Hygiene

Maintaining good hygiene can help prevent infections that can contribute to pelvic floor dysfunction, such as urinary tract infections.

Communication

Effective communication with healthcare providers and loved ones can be an important aspect of self-care for individuals with pelvic floor dysfunction. It is important to be clear and assertive when discussing symptoms and treatment preferences, and to seek support from others when needed.

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