Pelvic Floor Disorders in Women: Symptoms, Causes and Treatments (video/podcast)

Your pelvic floor is a group of muscles that supports internal organs including the bladder and bowels and, in women, the uterus. A strong pelvic floor holds these organs in place so they can function correctly. Weak or tight pelvic floor muscles can lead to problems with bladder or bowel control and other issues that can cause pain, frustration or embarrassment.

In this video, San Diego Health host Susan Taylor talks with Varuna Raizada, MD, an OB-GYN and urogynecologist at Scripps Clinic, about pelvic floor disorder causes, symptoms and treatments.

Disorders of the pelvic floor can affect anyone, but the risk is higher for women than men; 1 in 3 women will have pelvic floor issues at some point. Numerous factors may affect the muscles, including genetics, pregnancy, childbirth, age and menopausal changes.

Because the muscles can no longer properly support the organs, people may experience pelvic floor disorder symptoms, such as involuntary leakage of urine when they cough, sneeze or laugh. They may have frequent bladder infections, bladder pain or bowel leakage, or may suddenly need to use the restroom and not make it in time.

Prolapse, which happens when the vaginal walls are no longer supported by the surrounding connective tissue, may be another symptom for women.

“With prolapse, the walls of the vagina begin to invert. You may notice something protruding out of your vagina that you can touch and feel and is very uncomfortable,” explains Dr. Raizada. “It may be worrisome and some patients may even go to the emergency room thinking something is wrong.”

If you have symptoms, the first step is a thorough pelvic examination and medical history.

“Sometimes we may do other tests to help us come to a diagnosis, but the majority of the time a good pelvic examination is all that we need,” says Dr. Raizada. “These are very common issues and there are lots of treatments available.”

Treatments for pelvic floor disorders range from lifestyle changes and physical therapy to medication and surgery.

Lifestyle factors include maintaining a healthy weight, quitting smoking and controlling chronic conditions such as diabetes. Women may also benefit greatly from vaginal estrogen cream.

“Vaginal estrogen cream restores elasticity to the tissue. It also restores the normal bacterial floor of the vagina, reducing bladder infections and vaginal infections, and can have lots of benefits,” explains Dr. Raizada. “It’s a small thing to do but can have a big impact.”

Pelvic floor physical therapy is another nonsurgical treatment option. Scripps offers private, one-to-one pelvic floor rehab programs with physical therapists who specialize in these disorders. Your therapist will determine what you need to work on to resolve your symptoms, such as pelvic floor relaxation or core strength, and guide you through exercises to restore normal functioning.

If conservative treatment options are not effective, your doctor may recommend surgery.

Depending on your symptoms, surgical options may include vaginal wall reconstruction and procedures to restore proper bladder and bowel function. Most of these are minimally invasive outpatient surgeries; in some cases, an overnight hospital stay may be required.

If you have pelvic floor disorder symptoms, there are several important reason to see your doctor for several reasons. For example, bladder pain may indicate an infection that needs to be treated before it spreads to the kidneys.

“Another reason to bring it up to your physician is because, at some point, it begins to affect your quality of life. You begin to retract from social engagements and go out less, which is not great for your well-being,” Dr. Raizada says. “You may start pulling back from physical activities, which has its own detriment.”

She adds that the earlier you seek medical advice, the better, as conservative treatments may be more successful. Moreover, the longer you wait, the more your symptoms may affect your quality of life. Start with your primary care doctor, who can direct you to the right specialists if necessary.

“We understand that this is something very embarrassing, be it women or men, but you are not alone and you don’t have to live like this,” says Dr. Raizada.

“At Scripps, we have people who focus their practices on these issues, so they have a wealth of knowledge and expertise and will not dismiss your concerns. Together, we can make a decision that works best for you.”

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