PELVIC FLOOR HEALTH is a crucial yet often overlooked component of women's health. The pelvic floor comprises muscles and connective tissues forming a platform at the pelvis's base. This platform supports pelvic organs such as the bladder, uterus and rectum, playing a significant role in core stability, continence and sexual function.
Despite its importance, many women find the topic embarrassing due to the nature of the symptoms and are reluctant to seek help, leading to a potentially diminished quality of life. “Leaking urine can be a source of embarrassment and may cause women to avoid going out, being social, or having intimate relations,” says Angie Stoehr, MD, a gynecology pelvic pain specialist on the medical staff at Baylor Scott & White Medical Center - Centennial.
Fortunately, there are solutions available to address the potential problems caused by pelvic floor health issues.
HOW CAN THE PELVIC FLOOR IMPACT WOMEN’S HEALTH?
"When the pelvic floor becomes weakened or damaged, the structures can shift from their normal location and cause functional problems with the elimination of urine or stool, leakage and problems with intimacy," says Timothy L. Sandmann, MD, medical director of advanced gynecological services at Baylor Scott & White Medical Center - McKinney.
The pelvic floor can change significantly throughout a woman's life, becoming more pliable. According to Dr. Sandmann, "Pelvic floor health and support can change from many causes, including physical activity, childbirth, chronic conditions such as constipation and hormonal changes that occur with menopause."
WHAT ARE THE SYMPTOMS?
Recognizing the signs and symptoms of pelvic floor dysfunction is the first step toward seeking help. Symptoms can range from urinary incontinence, which includes leakage during activities like coughing or exercising, to a feeling of pressure or heaviness in the pelvic area, often linked to pelvic organ prolapse. Persistent pelvic pain and difficulties with bowel and bladder functions are also common indicators.
"When a woman has questions regarding her pelvic floor health, she should consult her primary care provider or OBGYN," says Dr. Sandmann. "If symptoms are new or bothersome, an appointment should be made to directly address these issues. Early treatment can provide solutions such as topical estrogen therapy and pelvic floor muscle therapy to ameliorate symptoms and stabilize changes."
HOW COMMON IS PELVIC FLOOR DYSFUNCTION?
"Pelvic health issues are very common and nothing to feel ashamed about," says Lorien Hathaway, PT, DPT, Program Director at Baylor Scott & White Institute for Rehabilitation and provider on the allied health professional staff at Baylor Scott & White Medical Center - Plano. It is important to address these concerns: 14% of women deal with pelvic pain, and 50% of women over 50 suffer from urinary incontinence. According to Dr. Stoehr, “Most of these symptoms are common and can be managed and treated. It's worth your quality of life to get things checked out."
THERE ARE TREATMENT OPTIONS
Treatment for pelvic floor dysfunction varies depending on the severity and type of symptoms. "Depending on the symptoms, a patient might need to see a gynecologist, a pelvic pain specialist, a urogynecologist or a pelvic floor physical therapist," said Dr. Stoehr. “Sometimes, a relationship therapist or gastroenterologist might also be involved in the treatment process.”
Pelvic floor physical therapy is a highly effective treatment option. It can help manage or prevent pelvic floor issues and is beneficial at any stage of life. "A pelvic health therapist works with other healthcare providers to provide comprehensive care and management of pelvic health conditions,” says Hathaway. “Therapy can address abdominal muscle separation, incontinence, pelvic and abdominal pain, discomfort during intercourse and pain during pregnancy and postpartum."
A comprehensive patient evaluation assesses posture, strength and alignment, including internal pelvic muscle function. A personalized treatment plan is created, often involving exercises to strengthen or relax the pelvic muscles, manual therapy for tension relief and education on proper habits. Treatment may also include biofeedback or electrical stimulation to help better control pelvic floor muscles. Additionally, lifestyle modifications and techniques, such as bladder or bowel retraining, are crucial therapy components.
“I frequently encourage patients to understand their options, as many pelvic health solutions do not involve surgery,” says Dr. Sandmann. “However, surgery does often help to improve quality of life and it’s important for patients to understand their options and evaluate their lifestyle to determine the best fit for their needs.”
For more information about pelvic health or to find a provider, visit bswhealth.com/specialties/womens-health/pelvic-health.
Physicians provide clinical services as members of the medical staff at one of Baylor Scott & White Health's subsidiary, community, or affiliated medical centers and do not provide clinical services as employees or agents of those medical centers or Baylor Scott & White Health.
