Understanding Pelvic Floor Dysfunction: Symptoms You Shouldn't Ignore

Common signs of pelvic floor dysfunction, it’s causes, and the importance of seeking help from a pelvic floor physical therapist

Pelvic floor dysfunction is common, but many people aren't sure what it actually means—or whether the symptoms they're experiencing are related to their pelvic floor.

Your pelvic floor is a group of muscles, connective tissues, and other structures at the bottom of your pelvis. These muscles play an important role in bladder and bowel control, sexual function, pelvic organ support, breathing, pressure management, and movement.

When the pelvic floor muscles are weak, overly tense, poorly coordinated, or unable to relax appropriately, they can contribute to a wide range of symptoms.

Signs of Possible Pelvic Floor Dysfunction

Pelvic floor dysfunction doesn't look the same for everyone. Some people experience pain, while others have difficulty with bladder or bowel control. Some people have symptoms during exercise or sex, while others notice changes after pregnancy, surgery, or an injury.

Possible symptoms include:

• Pelvic, genital, vaginal, rectal, or tailbone pain

• Difficulty starting or fully emptying your bladder

• Straining or pushing to urinate or have a bowel movement

• Urinary urgency or frequent trips to the bathroom

• Difficulty holding back urine or stool

• Urinary leakage

• Fecal leakage or difficulty controlling bowel movements

• Constipation

• Pain or burning with urination

• Persistent low back, hip, groin, abdominal, or pelvic pain

• Pain with sex

• Difficulty with sexual function or orgasm

• Erectile difficulties

• Testicular or pelvic pain

• A feeling of pelvic pressure, heaviness, or bulging

• Difficulty inserting a tampon

• Symptoms that occur with running, jumping, lifting, or other physical activity

You don't need to have several of these symptoms to benefit from an evaluation. Even one persistent or bothersome symptom can be worth discussing with a pelvic health physical therapist or another appropriate healthcare provider.

What Causes Pelvic Floor Dysfunction?

There isn't always one clear cause. Pelvic floor symptoms can develop for many different reasons, and sometimes several factors contribute at the same time.

Some potential contributors include:

Pregnancy and childbirth

Pregnancy places significant physical demands on the pelvic floor, abdominal wall, hips, and spine. Vaginal delivery can also affect the pelvic floor muscles and connective tissues, but pelvic floor symptoms can occur after pregnancy regardless of how you give birth.

Surgery

Abdominal, pelvic, and prostate surgeries can affect muscles, connective tissue, nerves, and movement patterns. Examples include hysterectomy, prostate surgery, hernia repair, and other pelvic procedures.

Injury or trauma

A fall onto the tailbone, motor vehicle accident, sports injury, or other trauma can affect the pelvis and the muscles and nerves surrounding it.

Changes in activity

Increasing your running, weightlifting, jumping, or high-intensity exercise can sometimes bring pelvic floor symptoms to the surface.

This doesn't mean that exercise is harmful or that you should stop doing the activities you enjoy. Instead, symptoms can be a sign that your body needs a different approach to strength, coordination, breathing, pressure management, or training load.

Bowel and bladder habits

Repeatedly straining to have a bowel movement, routinely holding your urine or stool, or developing habits that interfere with normal bladder and bowel function can contribute to pelvic floor problems.

Hormonal changes and aging

Changes in hormones, including those that occur during perimenopause and menopause, can affect pelvic tissues and contribute to urinary, sexual, and other pelvic health symptoms.

Stress and the nervous system

Your pelvic floor is closely connected to your nervous system. Stress, anxiety, pain, and other factors that affect the nervous system can influence muscle tension, breathing, bladder and bowel function, and how your body experiences pain.

Other musculoskeletal problems

Your pelvic floor doesn't work in isolation.

Changes in your hips, spine, abdomen, feet, breathing mechanics, or overall movement patterns can influence how your pelvic floor functions. This is one reason pelvic floor physical therapy often looks beyond the pelvic floor itself.

Will My Pelvic Floor Symptoms Go Away on Their Own?

Sometimes symptoms improve on their own, particularly when they're related to a temporary change or recent event. But persistent symptoms shouldn't be something you simply learn to live with.

If your symptoms are interfering with exercise, sleep, work, sex, bowel or bladder function, or your daily life, an evaluation can help you understand what's contributing to the problem and what you can do about it.

And you don't have to wait until your symptoms become severe before seeking help.

Should I Be Embarrassed to Talk About Pelvic Floor Symptoms?

Absolutely not.

Talking about urinary leakage, constipation, pelvic pain, painful sex, bowel changes, or sexual symptoms can feel uncomfortable. But these are common healthcare concerns, and pelvic health physical therapists are specifically trained to have these conversations in a professional, respectful, and judgment-free environment.

You should never feel embarrassed about asking questions about your body.

During an evaluation, I take the time to understand what you're experiencing, what matters most to you, and how your symptoms are affecting your life.

Who Can Help With Pelvic Floor Dysfunction?

A pelvic health physical therapist can evaluate many types of pelvic floor symptoms and help determine whether physical therapy is appropriate.

Depending on your symptoms, care may also involve collaboration with other healthcare professionals, including:

• OB/GYNs

• Urologists

• Gastroenterologists

• Primary care providers

• Other medical specialists

Pelvic health physical therapy doesn't replace medical care when you need it. Instead, it can be an important part of a collaborative approach to your care.

Your Pelvic Floor Is Part of Your Whole Body

At AnewU Physical Therapy, I don't look at the pelvic floor in isolation.

Your pelvic floor works together with your diaphragm, abdominal muscles, hips, spine, and other muscles throughout your body. For example, if you experience urinary leakage while running or exercising, we may look at your breathing, strength, running mechanics, hip and trunk control, and how you manage pressure during movement—not simply prescribe more Kegels.

Your treatment should be based on why you're having symptoms, not simply on the symptom itself.

My goal is to help you understand what's happening in your body and develop an individualized plan that helps you return to the activities and life you enjoy.

You Don't Have to Live With Pelvic Floor Symptoms

Pelvic floor symptoms are common, but that doesn't mean you have to accept them as your normal.

Whether you're experiencing urinary leakage after having a baby, pelvic pain, constipation, painful sex, symptoms with exercise, or something that simply doesn't feel right, there are options for care.

If you're wondering whether pelvic floor physical therapy could help, I offer a free discovery call where we can talk about your symptoms and determine whether an evaluation is the right next step.

Schedule a Discovery Call

You can also schedule a pelvic floor physical therapy evaluation directly.

Written and reviewed by Dr. Amanda Gotschall, PT, DPT