Pelvic Floor Dysfunction: 6 Myths Busted!

Pelvic Floor Dysfunction (PFD) is a highly personal topic, so it is rarely discussed among family, friends, and sometimes even doctors, leaving many individuals to suffer in silence. Consequently, there are common misconceptions surrounding the condition – which we’re here to “bust!”

MYTH 1: PFD cannot be treated.

FACT: PFD most definitely CAN be treated. The muscles of the pelvic floor are just that — muscles. As with any muscle, there are strengthening exercises and ways to reeducate the muscles so that that they regain strength and functionality. In some cases surgery is necessary, but usually, there are non-invasive treatments that can help you reclaim control of your bodily functions and your life. Treatments include a combination of physical therapy, relaxation techniques, and sometimes hormones.

Note: For physical therapy, you’ll want to work with a pelvic rehabilitation specialist. Pelvic rehab specialists are highly trained and equipped to evaluate problems related to urination, defecation, sexual dysfunction, pelvic pain and prenatal/postpartum issues and can provide you with a wide range of tools to find long term success.

MYTH 2: Pelvic floor dysfunction is always associated with pelvic pain.

FACT: Pelvic Floor Dysfunction (PFD) is an umbrella term, encompassing problems with pelvic floor muscles, ligaments, and connective tissue that support the pelvic organs. Sometimes, but not always, PFD is associated with pelvic pain. The pelvic organs include the rectum and bladder, and in women, the uterus and vagina. With PFD, the pelvic muscles may be tight, damaged or weak, which can lead to a lack of bladder and bowel control (urinary or fecal incontinence). In women, “pelvic-organ prolapse” can occur, a condition where the pelvic organs drop, causing a bulge in the vaginal canal, which can lead to incontinence or pain during intercourse.

MYTH 3 – Incontinence, a typical symptom of Pelvic Floor Dysfunction (PFD), is rare.

FACT: These disorders are actually quite common. In fact, according to a 2021 study published in the Journal of Urology, which analyzed data from 15,003 women over the age of 20 and who participated in the 2005–2016 National Health and Nutrition Examination Survey, found that the prevalence of any type of urinary incontinence was 53%!

• Within the 53%: 16% of women had mixed urinary incontinence, 26% had stress only, and 10% had urgency only
• Urgency urinary incontinence and mixed urinary incontinence were highest among women aged ≥60 years
• Stress urinary incontinence was highest among women aged 40–59 years

Another study published in 2022 in Female Pelvic Medicine & Reconstructive Surgery, looked at the data of 5,006 women and found that approximately 60% had urinary incontinence (31.3% mixed UI, 37.5% stress UI, and 22% urgency UI, and 9.2% unspecified) and 32.4% experiencing symptoms at least monthly.

There are few studies that have investigated pelvic floor dysfunction in men, however, according to the National Library of Medicine (NLM), urinary incontinence affects between 11% to 34% of older men.

Unfortunately, women and men both suffer from incontinence for years before finally seeking treatment. Obviously, many people are living with chronic symptoms that undermine their day-to-day quality of life — a fact made more tragic because help is readily available.

MYTH 4: Incontinence is a normal part of aging.

FACT: Although age is a contributing factor in pelvic floor dysfunction, the truth is that incontinence is NOT a normal OR an inevitable part of growing older. In fact, there are many factors that can contribute to the onset of incontinence, including a poor diet, years of being sedentary, hormonal changes, and being overweight. In women, pregnancy and childbirth also can increase the risk.

MYTH 5: PFD is strictly a woman’s disorder.

FACT: Although it is true that women are more often diagnosed with pelvic floor dysfunction, it does occur in men too. Men can experience urinary or fecal incontinence due to weak pelvic floor muscles, just as women do. And like women, men also can exhibit coccydynia — pain in the tailbone — if their pelvic floor muscles are too tight.

MYTH 6: Your medical provider will be embarrassed if you bring up any issues you be experiencing with incontinence, pelvic pain, or sexual dysfunction.

FACT: This is the silliest myth of all!! Your physicians and physical therapists have heard and seen it all. They deal with these issues often. Your provider will ask questions to help you describe your symptoms and will be happy to answer any questions you may about the issues that may be contributing to your particular set of symptoms.

Remember, your medical providers are there to help you. If you are experiencing urinary or fecal incontinence, pelvic or tailbone pain/pressure, we urge you to talk to your physician. At the Kaplan Center, we assess possible musculoskeletal and postural problems, as well as hormonal or dietary issues that may be contributing to symptoms. When appropriate, we also use biofeedback to help assess the health of the pelvic floor muscles. A typical course of treatment is likely to include physical therapy and may include modification to posture, diet, and physical exercise routines.

Now that we’ve busted the myths about pelvic floor dysfunction, it’s up to you. Talk with your medical provider, and get on the path toward resolution.

Part I: Understanding the Urogenital System, Bladder Control: Urinary Urgency & Frequency

Physical therapist and pelvic rehab specialist, Jeanne Scheele, explained the urological system (UG system) and the factors that influence bladder urgency & frequency, stress incontinence, and normal/abnormal behaviors of the UG system. Jeanne also discussed several ways to manage symptoms in order to regain control and lessen the stress and anxiety that incontinence issues cause for so many women.

This article was originally published in June 2016. It was reviewed and updated in October 2023.