Pelvic Floor Conditions
Pelvic Floor Conditions:
- Diastasis Recti
- Urinary/ Fecal Incontinence
- Pelvic Pain
- Prolapse
- Vulvodynia
- Vaginismus
- Dyspareunia
- Interstitial Cystitis
- Prenatal And Post-partum Exercise Coaching
Diastasis Recti
Symptoms of Diastasis Recti:
- A loose-looking bulge or wrinkled-like skin in the middle or lower portion of the belly
- Constipation
- Bloating
- Lower back pain
Urinary/ Fecal Incontinence
Urinary incontinence is the uncontrolled loss of urine. Under normal conditions, the bladder stores urine until it is voluntarily released. This involves a complex interaction between the brain, spinal cord, bladder and support structures in the pelvis. Anything that interferes with this interaction or causes damage to the support tissues can result in a person developing urinary incontinence.
This condition is much more common than most people think, occurring in greater than 40% of American women. The condition should not be considered a normal part of the aging process and occurs in all age groups. In fact, recent studies show that urinary incontinence is becoming quite prevalent among younger women.
If you suffer from bladder control issues the following sections will help inform you on the different types of urinary incontinence. This information will allow you to better understand the type of urinary incontinence you suffer from. Being better informed will help guide you in deciding what type of treatment would be best for you. In the great majority of situation urinary incontinence can be corrected or significantly improved. Physicians that specialize in the diagnosis and treatment of urinary incontinence have the training and knowledge to help you with this condition.
Bowel incontinence, also known as fecal incontinence, is the inability to control bowel movements, which can include leaking stool or difficulty having bowel movements.
Pelvic Pain
Pelvic pain is defined as pain below the belly button within the pelvic region. While more prevalent in women, pelvic pain can also affect men. Pelvic pain can present as acute (a sudden, sharp pain due to an injury) or chronic (persistent or ongoing pain) and is difficult to properly diagnose, given the wide range of bodily systems present within the pelvic region.
Pelvic pain can be attributed to the digestive tract, reproductive organs or the urinary system. It requires thorough examination and testing by a specialist to diagnose the underlying issue causing the pain.
There is a wide range of potential causes for pelvic pain in both men and women. It may be related to an issue in the pelvic bone, an infection of the colon, bladder or other non-reproductive organs, or it may be due to inflamed ligaments, tissues or nerves within the pelvic area.
Chronic pelvic pain, in which pain lasts more than six months, can be mild or severe, intermittent or longer lasting and may eventually interfere with one’s daily activities. It’s estimated that approximately 15 percent of women are affected by chronic pelvic pain with 4 percent experiencing severe pain affecting their ability to work.
Cause Of Pelvic Pain In Women
- Endometriosis – a disease in which tissue (the endometrium) that normally lines the inside of the uterus grows outside the uterus. Many women with endometriosis have pelvic or abdominal pain, particularly during menstrual bleeding or sex. Endometriosis can make it difficult to become pregnant. In fact, 30 to 50 percent of infertile women have endometriosis. Due to the tissue being hard to see on an ultrasound, the only certain way to detect endometriosis is through a surgical procedure called laparoscopy.
- Ovarian Cysts – a fluid-filled sac that develops on an ovary and causes pelvic pain when it becomes twisted or bursts (it will probably need to be removed). In some cases the cyst can form from endometriosis (endometrioma) growing in an ovary, which can be seen on an ultrasound, unlike other forms of endometriosis.
- Ovarian Cancer
- Pelvic Inflammatory Disease – an infection of the female reproductive organs. It can lead to irreversible damage to the uterus, ovaries, fallopian tubes or other parts of the female reproductive system, and is the primary preventable cause of infertility in women. PID is one of the most serious side effects resulting from sexually transmitted diseases (STD), and 90 percent of the cases are a result of chlamydia and/or gonorrhea.
- Uterine Fibroids – growths on the uterine wall and while not considered a problem, they can be painful
Additional Causes Of Pelvic Pain In Both Men And Women Are:
- Diverticulitis – is the inflammation or infection of pouches (diverticula) that form in the wall of the colon. Diverticulitis can be very painful, and usually causes bloating, diarrhea, constipation, nausea or fever. Doctors aren’t sure of the exact causes for diverticula in the colon (diverticulosis), but they think that a low-fiber diet plays a role. Without fiber to add bulk to the stool, the colon has to work harder than normal to push the stool forward. The pressure from this may cause pouches to form in weak spots along the colon.
- Interstitial Cystitis (Painful Bladder Syndrome) – is a chronic condition that occurs when the bladder muscles and nerves that normally create the urge to urinate get mixed up, causing the need to urinate more often with smaller volumes. You may experience bladder pressure, bladder pain and sometimes pelvic pain, ranging from mild discomfort to severe pain.
- Kidney Stones – are a hard crystalline mineral material formed within the kidney or urinary tract. They generally form when there is a decrease in urine volume and/or an excess of stone-forming substances in the urine. Kidney stones can be very painful and often cause blood in the urine.
- Urinary Tract Infection (UTI) – is an infection in any part of the urinary tract. Most UTIs occur in the lower urinary tract, which includes the urethra and bladder. Women are more likely to have a UTI because their urethra is shorter, meaning bacteria doesn’t have to travel as far to reach the bladder. The spreading of infection to the kidneys can be a life-threatening condition. If you have more than two UTIs in a six-month period and/or three in one year, you likely have a pelvic floor disorder and if not treated you will continue to have UTIs.
Other Causes Of Pelvic Pain For Both Men And Women Include:
- Fibromyalgia
- Chronic constipation
- Crohn’s Disease
- Irritable Bowel Syndrome
- Inguinal hernia
- Intestinal Obstruction
- Appendicitis
- Ulcerative Colitis
Prolapse
Pelvic Organ Prolapse (POP) is a downward descent of the female pelvic organs, including the bladder, rectum, uterus if present, upper part of the vagina if the uterus is absent or small bowel resulting in a bulge pressing into or out of the vagina.
Prolapse development can be attributed to the damage, stretching and weakening of the support muscles and ligaments in the female pelvis. These support structures keep the bladder, rectum, small bowel and uterus oriented in the appropriate position. Any event that results in damage to these structures can result in POP.
Factors contributing to pelvic organ prolapse include:
- Child birth
- Hysterectomy
- Pelvic trauma
- Aging
- Straining (heavy lifting, defecation, chronic coughing)
- Prior surgery for POP
Symptoms Of Pelvic Organ Prolapse
- Bulge in the vagina or protruding out of the vagina
- Pelvic pressure
- Low back pain
- Urinary problems (slow stream, urinary incontinence, urinary frequency)
- Bowel problems (constipation, fecal incontinence)
- Painful intercourse
Types Of Pelvic Organ Prolapse Our Specialists Treat
- Vaginal—When the top of the vagina weakens and collapses into the vaginal canal.
- Uterine—When the pelvic muscle, tissue and ligaments weaken, causing the uterus can drop down into the vaginal canal.
- Enterocele—When the small intestine pushes into the top of the vagina, creating a bulge.
- Rectocele—When the wall between the rectum and vagina weakens, causing the rectum to sag and bulge into the vagina.
- Cystocele—When the wall between the bladder and vagina weakens, causing the bladder to drop or sag into the vagina.
- Incontinence—The inability to control the passage of urine, ranging from an occasional leakage to a complete inability to hold any urine
Vulvodynia
A chronic vulvar pain without an identifiable cause, and the location, frequency and severity differs among patients. The most common symptom reported from patients suffering from this condition is a burning sensation.
For women with generalized vulvodynia (GV), pain occurs spontaneously and is relatively constant, but there can be some periods of symptom relief.
Activities that apply pressure to the vulva, such as prolonged sitting or sexual intercourse, typically exacerbate symptoms.
The majority of women with localized vulvodynia have Provoked Vestibulodynia (PVD), in which pain occurs during or after pressure is applied to the vestibule, e.g., with:
- Sexual intercourse,
- Tampon insertion,
- A gynecologic examination,
- Prolonged sitting, and/or
- Wearing fitted pants.
Vaginismus
Vaginismus is a type of sexual dysfunction, an involuntary tightness of the pelvic floor muscles
It occurs when the vaginal muscles involuntarily or persistently contract. While it doesn’t interfere with sexual arousal, it can cause pain during sexual intercourse, making penetration difficult. The vaginal muscles involuntarily or persistently contract when they attempt vaginal penetration.
Vaginismus is classified into two types:
- Primary vaginismus: when vaginal penetration has never been achieved
- Secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible, potentially due to factors such as gynecologic surgery, trauma, or radiation
Some women develop vaginismus after menopause. When estrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful, stressful, or impossible. This can lead to vaginismus in some women.
The condition has been linked to:
- Past painful intercourse
- Emotional factors
- Past sexual abuse or trauma
Dyspareunia
- Cysts
- Pelvic inflammatory disease
- Vaginal atrophy
Entry dyspareunia may result from a variety of conditions affecting the labia or vestibule. A history of pain with entry is most commonly associated with vaginismus and inadequate lubrication from incomplete arousal. Entry pain is also suggestive of atrophy, vulvodynia and transient causes such as fungal or bacterial vaginitis and vulvar dystrophies. Atrophic changes from inadequate estrogen levels may also cause entry dyspareunia, although the pain typically extends into the vaginal area as well.
Atrophic changes and inadequate lubrication cause problems with dryness or friction with penile movement. The vaginal barrel may not distend and elongate in response to the arousal phase, and this may cause discomfort, particularly in certain positions or with penile impact on the cervix.
The pain associated with deep thrusting is often described as “something being bumped into.” Etiologies include endometriosis, pelvic adhesions and pelvic congestion. Other pathology, endometritis and scarring from pelvic inflammatory disease are less frequent causes of dyspareunia. A minority of women with uterine retroversion and pelvic relaxation have pain.
Interstitial Cystitis
Interstitial cystitis (IC)/bladder pain syndrome (BPS) is a chronic painful bladder health issue. Interstitial Cystitis is an issue of long-term bladder pain. It may feel like a bladder or urinary tract infection, but it’s not. It is a feeling of discomfort and pressure in the bladder area that lasts for six weeks or more with no infection or other clear cause. There may also be lower urinary tract symptoms like a regular, urgent need to pass urine. If you or a loved one has IC/BPS, it is of great value to learn how to control symptoms and relieve pain.
Symptoms range from mild to severe. For some patients the symptoms may come and go, and for others they don’t go away. IC/BPS is not an infection, but it may feel like a bladder infection. Women with IC/BPS may feel pain when having sex. The more severe cases of IC/BPS can affect your life and your loved ones. Some people with IC/BPS have other health issues such as irritable bowel syndrome, fibromyalgia, and other pain syndromes.
Symptoms
Pain
Pain (often with pressure) may be constant or may come and go. The pain can get worse as the bladder fills. Some patients feel discomfort in other areas as well, such as the urethra, lower abdomen or lower back. Women may feel pain in the vulva or vagina. Men may feel pain in the scrotum, testicle, penis or rectal area. Both women and men with IC/BPS can have sexual problems as a result. Sex for women is painful because the bladder is right in front of the vagina. A man may have pain a day after having an orgasm.
Frequency
both day and night.
