Many of us have heard the term pelvic floor before but few of us really know where it is and how important it is to our sexual and urological health. I have met numerous patients who have experienced a level of pelvic floor dysfunction and many of these patients endure this condition for many years. It has become so commonplace to them that they do not realise that there are effective treatment options available so that they do not have to put up with the embarrassing and/or painful symptoms any longer. The statistics are astounding when you look at how many of us experience the symptoms of pelvic floor dysfunction.
What is the Pelvic Floor?
The pelvic floor is a layer of muscles that support the pelvic organs and spans the bottom of the pelvis. The pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women.
The pelvic floor muscles stretch from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick. Imagine the pelvic floor muscles as a round mini-trampoline made of firm muscle. Just like a trampoline, the pelvic floor is able to move down and up. The bladder, uterus (for women) and bowel lie on the pelvic floor muscle layer.
The pelvic floor muscle layer has hole for passages to pass through. There are two passages in men (the urethra and anus) and three passages in women (the urethra, vagina and anus). The pelvic floor muscles normally wrap quite firmly around these holes to help keep the passages shut except when in use. There is also an extra, circular muscle around the anus (the anal sphincter) and around the urethra (the urethral sphincter).
What do Pelvic Floor Muscles Do?
Pelvic floor muscles provide support to the organs that lie on it. The sphincters give us conscious control over the bladder and bowel so that we can control the release of urine, faeces and wind, and allow us to delay emptying until it is convenient. When the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine, wind and faeces.
Pelvic floor muscles are also important for sexual function in both men and women. In men, it is important for erectile function and ejaculation. In women, voluntary contractions (squeezing) of the pelvic floor contribute to sexual sensation and arousal.
The pelvic floor muscles in women also provide support for the baby during pregnancy and assist in the birthing process.
The muscles of the pelvic floor work with the abdominal and back muscles to stabilise and support the spine (more on this in the next chapter).
Signs that You May Have a Pelvic Floor Problem
Common signs that can indicate a pelvic floor problem include:
- Accidentally leaking urine when you exercise, laugh, cough or sneeze
- Needing to get to the toilet in a hurry or not making it there in time
- Constantly needing to go to the toilet
- Finding it difficult to empty your bladder or bowel
- Accidentally losing control of your bladder or bowel
- Accidentally passing wind
- A prolapse – in women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping. In men this may be felt as a bulge in the rectum or a feeling of needing to use their bowels but not actually needing to go
- Pain in your pelvic area, or
- Painful sex.
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Dr Cris Beer
Holistic Medical Doctor