Weak Pelvic Floor

What is the Pelvic Floor?

The pelvic floor is a combination of muscles and connective tissue that span the area underneath the pelvis. This area of muscles protects and provides stability for vital organs such as the bladder, intestines, and uterus. This is also known as the pubococcygeal muscle or the PC muscle.

If pelvic floor muscles are weak, its side effects can include, but are not limited to, urinary incontinence, fecal incontinence, pelvic organ prolapse, vaginal atrophy, and decreased sexual pleasure in the genitals.

Regular exercise of the pelvic floor muscles can aid in recovery from unwanted issues and speed tissue recovery after a childbirth or surgery. A strong pelvic floor may also increase sensitivity and responsiveness to pleasure nerve endings in and around the genitals. Toned pelvic muscles are an important part of healthy daily living and a quality intimate life.

See figure below for general illustration of the pelvic floor.

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What causes a Weak Pelvic Floor?

  • Childbirth, pregnancy, and labor (especially a vaginal delivery)
  • Menopause and aging
  • Family history of weakened pelvic floor
  • Obesity or sedentary lifestyle
  • Constipation and excessive pushing to have a bowel movement
  • Repeated and frequent lifting of heavy objects increasing pressure in the abdomen
  • Having a hysterectomy or other pelvic surgery

Treatments for Weak Pelvic Floor

  • Perform daily kegel exercises to strengthen the pelvic floor muscles.
  • Gentle electrical stimulation: Electrodes are temporarily inserted into your vagina to stimulate and strengthen pelvic floor muscles. Gentle electrical stimulation can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months.
  • Give yourself, or have your partner give you a vulvar massage to increase healthy blood flow to the vulva.
  • Use kegel exercise devices to help strengthen the pelvic floor.
  • Make healthy lifestyle changes such as a diet and exercise.
  • Talk to your doctor about hormone replacement therapy.
  • Talk with your doctor about various medical and surgical treatments:
    • Vaginal surgery
    • Transvaginal mesh
    • Abdominal surgery
    • Vaginal pessary: this is a removable donut-like device placed into the vagina that holds everything in place. It is used to help with urinary incontinence and prolapse.

Pelvic Organ Prolapse

Pelvic organ prolapse is when the muscles and ligaments supporting the internal pelvic organs (bladder, rectum, small bowel, and uterus) weaken and can no longer provide support. The organs will lose support and begin to fall out of place, which can lead to health complications and pain.

There are several different types of pelvic organ prolapse:

  • Anterior prolapse (cystocele) – When the wall of the bladder bulges into the vagina.
  • Posterior prolapse (rectocele) – When the front wall of the rectum bulges into the vagina.
  • Small bowel prolapse (enterocele) – when the small intestine creates a bulge that pushes in the upper part of the vagina.
  • Uterine prolapse – When the uterus slips down or out of the vagina. See illustration below:

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The most common causes for pelvic organ prolapse are childbirth, menopause, and having a hysterectomy. Kegel exercises and kegel assistant devices designed to help you strengthen the pelvic floor can be beneficial in reducing risk of pelvic organ prolapse. It is important to talk with your doctor about necessary treatments to maintain your pelvic health. If you believe you may have pelvic organ prolapse please seek immediate treatment from a primary medical provider.