Many take the pelvic floor for granted, though this crucial part of human anatomy quietly supports numerous functions that make you healthy and happy. In fact, this complex internal network maintains your core by providing support for your pelvic organs, ensuring urinary continence and promoting sexual well-being. So, while you might not notice this portion of your body when it functions properly, when its strength wanes, weak pelvic floor symptoms typically impact your daily life significantly.
The term weak pelvic floor means the muscles, connective tissues and ligaments in your pelvic region are losing or have lost their ability to adequately support vital organs, such as the uterus and bladder. Various weak pelvic floor symptoms arise when this area loses muscle tone, including issues with continence, core stability and sexual health. Let’s delve a bit more into what this system is and what it does and look at the causes, symptoms, and treatments of a weak pelvic floor.
Anatomy of the Pelvic Floor
A weak pelvic floor can interfere with your quality of life considerably, so understanding what this part of your anatomy is can help you find solutions. Essentially a supportive hammock for your pelvic organs, the pelvic floor comprises connective tissues, muscles and ligaments that help hold up the bladder, uterus, rectum and prostate, depending on your sex.
Levator Ani Muscles
These muscles are the major muscle group on the pelvic floor:
- Pubococcygeus muscle: Running from the front of the pubic bone to the tailbone, the PC muscle forms the front portion of the pelvic floor. This muscle helps control urine flow and supports the bladder and urethra in both men and women.
- Iliococcygeus muscle: This muscle resides in the pelvic floor’s middle. This muscle provides extra support to the PC muscle when it comes to cradling and protecting pelvic organs.
- Puborectalis muscle: This muscle has a sling-like shape that wraps around the rectum. As such, this muscle helps control how the anus opens and closes.
Coccygeus Muscle
Also known as the ischiococcygeus muscle, the coccygeus muscle sits behind the levator ani muscles, providing pelvic floor support and boosting its strength.
Perineum
Consisting of connective tissue, nerves and blood vessels, the perineum lies between the anus and external genitalia. This portion of the pelvic floor is important for sexual function, childbirth, and urinary and rectal continence.
Pelvic Diaphragm
This portion of the pelvic floor separates the pelvic cavity above from the perineum below. This gives the pelvic diaphragm a significant role in organ support and controlling urine and fecal release.
Supportive Ligaments
Various ligaments in the pelvic floor reinforce its supportive function and help anchor the pelvic organs in place. For example, the cardinal ligaments stabilize the cervix, while the uterosacral ligaments support the uterus.
Nerves and Blood Vessels
The pelvic floor boasts a rich supply of nerves and blood vessels that enhance the senses and motor functions of the area. They do this by providing an ample supply of blood flow to the pelvis to help ensure responsiveness and good pelvic health.
The Pelvic Floor's Role
These muscles of the pelvic floor provide support for the pelvic organs, preventing them from descending into the vaginal and rectal regions and prolapsing. They’re crucial to maintaining continence, and they assist you in holding bodily fluids in until you’re ready to use the restroom. These muscles also contribute significantly to sexual health, aiding men in maintaining their erections and influencing sexual sensation in women. Lastly, a strong pelvic floor keeps core muscles in the spine and pelvis stable to support good posture and decrease the chance of lower back injuries.
Causes of Weak Pelvic Floor
Numerous causes exist for a weak pelvic floor, such as aging when you naturally lose some of your strength and muscle tone and hormonal changes such as those that occur in women during menopause. Pregnancy and childbirth can also weaken the pelvic floor via stress and trauma, and obesity may also play a role by putting excess weight on the area that can, over time, weaken muscles.
Pregnancy and Childbirth
Because the process of pregnancy and childbirth exerts a substantial amount of stress on the pelvis, it can result in weak pelvic floor muscles after the fact. This is due to hormonal changes during pregnancy and the weight of the fetus pressing down on the pelvic floor. Vaginal childbirth also puts extreme pressure on the pelvic floor, often leading to stretching and tears. Likewise, future pregnancies and deliveries may increase the weakness.
Aging
The natural process of aging results in gradual weakness in all muscle groups, including the pelvic floor. Known as muscle atrophy, this loss of muscle tone often results in a weak pelvic floor, with a decrease in integrity and strength in the area.
Obesity
Just like the weight of a growing baby can weaken the pelvic floor with increased pressure, so can obesity. Excess weight in the abdomen pushes down on the pelvic floor, straining and weakening muscles. Obesity also means higher urinary incontinence risks and an increased chance of prolapse in the pelvic organs.
Chronic Coughing and Constipation
A cough related to smoking or certain conditions that cause chronic coughing may increase intra-abdominal pressure, creating strain on the pelvic floor. Chronic constipation has a similar effect when you strain too hard during bowel movements.
High-Impact Exercises
Running, jumping and heavy weight lifting may cause weak pelvic floor symptoms. Without proper support for your muscles, these high-impact exercises can put undue stress on your pelvic floor, potentially leading to damage, strain, and weakness.
Genetics
Some people have a genetic predisposition to a weak pelvic floor. This is often due to genes influencing muscle tone, connective tissue and other elements that may make you more susceptible to pelvic floor weakness.
Symptoms of Weak Pelvic Floor
Recognizing the symptoms of a weak pelvic floor helps you get the support you need to treat and manage your health and, in many cases, prevent further problems from arising. When you know what’s going on with your body and the underlying factors contributing to your weak pelvic floor symptoms, you can better regain control, reduce pain and bolster your sexual health.
One of the main pelvic floor weakness symptoms you're likely to encounter is urinary incontinence. This unintentional urinary leakage may hinder your day-to-day activities, while its fecal counterpart may lead to extreme discomfort and even isolation when it makes you uncomfortable leaving your home. Both chronic and intermittent pelvic pain may also indicate a weak pelvic floor, and this may lead to sexual dysfunction in both men and women. In extreme cases, prolapse of internal pelvic organs may occur when your pelvic floor is weak. This bulging sensation may cause profound discomfort and urinary and fecal incontinence.
Pelvic Floor Diagnosis
If you’re experiencing weak pelvic floor symptoms, consult with your health care provider. An accurate diagnosis helps ensure you get the correct type of management and treatment for his condition, and it usually comes after a comprehensive evaluation from professionals well-versed in the problems. Your doctor can aid you in identifying underlying causes and guide you toward the care you need.
When you speak to your health care professional, discuss the weak pelvic floor symptoms you’re experiencing openly and honestly. For example, if you’re having pelvic pain and sexual dysfunction, this may point to a specific issue with a proven solution. To really know what’s going on in your pelvic area, your doctor needs to perform a physical examination. For women, this means a comprehensive exam that checks the walls of the vagina, the uterus, and all surrounding structures. Women and men both, however, often undergo a rectal exam that assesses muscle tone and strength.
If problems are found during the physical exam that need further exploration, health care professionals often perform additional testing and imaging.
- Urodynamic testing: Tests bladder function by assessing how the organ stores and releases urine
- Cystoscopy: Tests for internal issues such as interstitial cystitis via insertion of a thin, flexible camera tube for easier inspection
- MRI and CT scans: Provide detailed pelvic area imaging for better identification of complex issues with the pelvic floor
- Pelvic ultrasound: Looks for abnormalities in the pelvic floor structure and identifies prolapse via internal imaging techniques
How to Prevent a Weak Pelvic Floor
Weak pelvic floor symptoms may hinder your ability to go about your everyday routine, making prevention preferable to treatment down the road. Whether you’re looking to ward off future issues, noticing little problems, and want to repair them before bigger issues arise, or already experiencing more serious weak pelvic floor symptoms, these techniques may help.
Kegel Exercises
A simple, effective way to target your pelvic floor muscles and strengthen them, Kegel exercises can improve muscle tone and bowel and bladder control. To perform these exercises, locate the muscles you use to stop the flow of urine, contract them for a few seconds, and release them. Kegel exercises often work best when you perform them on a daily basis. However, make sure you talk to your doctor before starting Kegels or another exercise for your pelvic floor health, as these exercises are not appropriate for everyone.
A Healthy Weight
Excess weight in the abdominal area may put too much pressure on the muscles in your pelvic floor, causing weakness and strain. A balanced diet and regular exercise can help you lose weight and thus reduce the pressure causing weak pelvic floor symptoms by relieving the extra stress on your organs.
Proper Weightlifting Techniques
Strength training exercises help you stay healthy and active by boosting the integrity of your core. When you don’t use the proper weightlifting techniques, however, you may acquire pelvic floor damage. This means using techniques and equipment that adequately support your core and pelvic floor muscles to reduce strain. Techniques include bracing your core, using proper form, and not holding your breath while lifting weights.
Hydration and Diet
Getting ample hydration and eating a balanced diet can help you avoid chronic constipation that may cause a weak pelvic floor. When your body has ample moisture within it, you tend to strain less during bowel movements. Also, drinking enough fluids can prevent urinary tract infections, which have the potential to aggravate existing pelvic floor issues.
Pelvic Floor Treatment Options
If you’re experiencing pelvic floor weakness, there are a range of treatment options available to improve your quality of life. These treatment options range from noninvasive options such as physical therapy, medications, and lifestyle modifications to more serious surgical interventions.
Physical Therapy
One of the most-used tools in treating pelvic floor weakness, physical therapy for this condition is often called pelvic floor rehabilitation. Physical therapists experienced with pelvic floor issues work closely with you to create a personalized exercise routine that strengthens and rehabilitates your pelvic floor muscles. This type of treatment generally works best for those with incontinence, pelvic pain, and sexual dysfunction.
Medications
Sometimes, medications are used to manage specific weak pelvic floor symptoms. For instance, anticholinergic medications may help with overactive bladder issues, while topical creams may soothe symptoms of pelvic irritation or pain.
Lifestyle Modifications
No matter the type of weak pelvic floor therapy you choose, you’re likely to require lifestyle modifications in addition to the treatment. This means maintaining a healthy weight, getting enough hydration, and keeping fiber levels high in your diet. Also, your doctor may suggest incorporating exercises such as Kegels into your daily routine to improve pelvic floor function.
Surgical Interventions
Noninvasive treatments for weak pelvic floor symptoms don’t work for everyone, and in those cases, surgical intervention may be necessary. For instance, pelvic organ prolapse may require surgery, including using meshes that support the pelvic floor. These interventions, however, nearly always deliver long-term relief from weak pelvic floor symptoms.