Located at the base of the pelvis, the pelvic floor consists of a group of muscles that provide support for internal organs, including the bladder, rectum, uterus and prostate. The muscles are also involved in posture, urination, bowel movements and sex.
Anecdotally, some pelvic floor experts say they have seen an influx of patients during the pandemic with new or worsening pelvic floor problems related to working from home and heightened levels of stress and anxiety. “The combination of stress and then just sitting and not getting up to go to do those different activities throughout your workday definitely seem to have contributed to people’s symptoms,” said Alicia Jeffrey-Thomas, a pelvic floor physical therapist at Greater Boston Urology.
Pelvic floor dysfunction is “a broad term for anything that’s happening with the pelvic floor that is not a normal state,”
said Heather Jeffcoat, president-elect of the Academy of Pelvic Health Physical Therapy, and typically occurs when the muscles are either overactive or underactive. Symptoms include pain in the pelvic area or during sex, as well as difficulties with urination and bowel movements, experts said. In some people, problems can lead to pelvic organ prolapse, which is when your organs drop out of their normal position because the pelvic floor can no longer support them.
The most widely known cause of pelvic floor dysfunction is pregnancy and delivery, Austin said, noting that both vaginal and Caesarean delivery can result in muscle trauma. Other factors that can increase your chances of developing problems are aging; trauma to the pelvic area, including sexual abuse; surgeries, such as prostatectomies or gender-affirming procedures; and overusing the pelvic muscles by, for example, going to the bathroom too often or straining too hard, which can lead to poor muscle coordination, according to the Cleveland Clinic.
Overactive muscles are often responsible for pain symptoms and can also complicate urination and make it harder to have a bowel movement. Although people often associate underactive — longer and overstretched — muscles with urinary incontinence, experts emphasized that the overactive muscles, which are also weak and not coordinated, could be to blame.
Although pelvic floor problems are common, Jeffcoat urged people not to dismiss their symptoms as “normal.”
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