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Pelvic Floor Dysfunction: 6 Myths Busted!

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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.

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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.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

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.

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Physical Therapy: The Right Touch For Your Musculoskeletal Pain

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Pain can come in many forms; it can be the result of an injury, surgery, or an illness; it can be intense pain or a subtle ache; it may be acute or longstanding, localized or widespread. However it manifests, the bottom line for anyone in pain is: the sooner the recovery, the better the quality of life.

Pain is often an indicator of an imbalance somewhere in the musculoskeletal system. Our body’s magnificent framework is made up of bones, muscles, joints, tendons, and ligaments that work together to provide stability, put us in motion, and support the proper functioning of all our vital organs and their systems. When there is an imbalance the body overcompensates, eventually causing fatigue, inflammation, and dysfunction in the area.

Physical therapy offers undeniable value when treating musculoskeletal pain. With extensive training in manual skills and a comprehensive understanding of body mechanics, physical therapists can treat a wide range of musculoskeletal pain problems. For example, there are physical therapists who help patients recover from sports injuries or strokes, others who work primarily with patients suffering from pelvic floor dysfunction, and those who specialize in Craniosacral Therapy, which may provide symptomatic relief from chronic neck and back pain, migraine headaches, fibromyalgia, temporomandibular joint syndrome (TMJS), and traumatic brain injuries, among many other conditions. While some physical therapists specialize in working with children and infants, others work primarily with adult or geriatric patients.

“Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function.” – American Physical Therapy Association (APTA)

Fundamental benefits of PT

Encourages physical activity

PT requires movement! The inclination may be to take time off from exercise when in pain. However, physical therapists are able to “prescribe” exercise programs appropriate for a patient’s specific medical condition. With the right program and under the right guidance, the body continues to move, which promotes heart health, bone health, mental health, and more. In other words, staying active is critical for healing and for lowering the risk of other illnesses in the future.

Promotes natural healing

PT, like other alternative therapies, promotes the body’s natural healing process and does not come with the cost and risky side effects of powerful pain medications and invasive measures like surgery and injections. Because of the massive opioid crisis, in 2016 and again in 2022, the Centers for Disease Control changed its clinician guidelines to recommend physical therapy and other nonpharmacological therapies as a first line of treatment for chronic, non-cancerous pain conditions. While there is an appropriate time to consider opioids for acute pain management, physical therapy should be the first line of treatment for musculoskeletal pain, and, depending on your condition, may very well be the only treatment you need.

Restores function

PT teaches individuals about body mechanics for sitting, standing, and lifting. Patients are educated about their body’s limitations and given an individualized program that will gradually improve their range of motion, muscle strength, and stability for a faster and more complete recovery so they can reengage in life.

Teamwork makes the dream work!

Teamwork is defined as “the combined actions of a group of people working together effectively to achieve a goal.” Working with a physical therapist will provide instruction, encouragement, and consistency in your healing process.

In sum

Fundamental health relies on a healthy musculoskeletal system so that other critical systems, like the neurological, circulatory, and hormonal systems, can function properly too. Physical therapists are expertly trained to locate and rehabilitate deficiencies in the musculoskeletal system for a more complete recovery.

If you have a pain problem, your physician should take a thorough medical history, including asking questions about the special characteristics of your pain, including its duration and the particular sensations you are experiencing. This will not only help to accurately identify the cause or causes of your pain problem but will also eliminate other possibilities. If physical therapy is in order, your doctor can help you find a physical therapist with the right set of skills to meet your medical needs.

To schedule an appointment with a Kaplan Center physician to see if physical therapy is appropriate for you, please call 703-532-4892. Physical Therapy orders from non-Kaplan physicians can be used for treatment here.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published in October 2018. It was reviewed and updated in October 2023.

Q&A: Do women who have never had children experience incontinence with or after menopause?

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Q: Do women who have never had children experience incontinence with or after menopause? There are estrogen receptors on muscles, including the bladder, so if a woman never had a child – and therefore never stretched out her pelvic floor – would she still have incontinence because she has so little estrogen?

A: Thank you for your great question. Women who never have given birth, can and do experience urinary incontinence peri or post-menopause. It is true that over time, our bodies become depleted of estrogen. However, low estrogen is not the only factor contributing to incontinence.

Good hormonal health is a balance of estrogen, progesterone, and testosterone. The onset of urinary incontinence can be attributed to an accumulation of many issues: A history of urinary tract infections, obesity, constipation, hormonal imbalance, high-stress lifestyle, overactive abdominals, sedentary lifestyle, abdominal, pelvic, low back, hip surgical procedures, certain medications, gradual pelvic floor weakness. This list is not complete, but you get the picture. The reasons for incontinence are multiple; a “stretched-out” pelvic floor or not, is only one consideration.

Thanks!

Jeanne Scheele, PT, PRPC

Related:

 

Jeanne Scheele PT

Provider Spotlight: Jeanne Scheele, PT

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“Provider Spotlight” is a series that highlights the wonderful team of healthcare providers and specialists here at the Kaplan Center for Integrative Medicine.

Jeanne SpotlightJeanne Scheele has practiced physical therapy in Northern Virginia for 40 years and serves as the Kaplan Center’s Physical Therapy Director. Over the last several years, Jeanne has focused her continuing-education efforts on pain management, and in particular, on the use of physical therapy to decrease women’s pelvic pain and to manage incontinence.

Why did you choose your specialty?

I have been focused on women’s health and pelvic floor problems for about 16 years. I became interested long ago because I had patients who had orthopedic problems and confided in me that they were also “leaking.” At the time, I did not have an answer so I investigated. I am still learning.

What is the biggest challenge in your practice and how do you overcome it?

The biggest challenge in my practice, because each woman is unique with special needs, is how to do an evaluation and produce a plan of care for that individual. It cannot be a cookie cutter approach.

What’s the one piece of advice that you give to all of your patients?

One piece of advice? Think positive. Find a way to be quiet within yourself and de-stress.

What are some of your interests and/or pastimes outside of work?

Outside of work, I love to travel with my husband, experiment with gourmet meals, read historical novels, make greeting cards, exercise and meditate, see my children and grandchildren.

If you could choose another career, what would it be?

I honestly do not know of another career. I chose physical therapy at the age of 16 and never looked back!