Pelvic Health: What is the Pelvic Floor?

What is the pelvic floor?

The term “Pelvic Floor” refers to the muscles, ligaments and connective tissue spanning the space between a woman’s tail bone and pubic bone that support her pelvic organs (the bladder, vagina, womb and bowels). An intact pelvic floor is critical to maintaining normal bladder, bowel and sexual function.

If the supportive tissues of the pelvic floor weaken or are injured, a woman may begin to develop symptoms of a pelvic floor disorder (PFD). These include problems such as urinary or fecal incontinence, pelvic organ prolapse, overactive bladder and sexual dysfunction. The intimate nature of these conditions can make them feel off-limits for polite conversation, even for friends or close family members. This can lead women to suffer in silence.

Do pelvic floor disorders (PFD) affect a lot of women?

If you have a PFD and are wondering if you are alone, you are not. Because PFDs result from commonly occurring life events they are in fact quite common. Epidemiologic studies tell us that approximately 1 in 4 women will experience a PFD during their lifetime.

We do not have a complete understanding of all that contributes to the development of pelvic floor problems. But commonly associated risk factors include childbirth, aging, menopause, having had a hysterectomy, obesity, constipation, genetic makeup and smoking.

Are there doctors who treat these problems?

Yes! They are referred to as urogynecologists. A urogynecologist is a surgeon who has specialized in the care of women with pelvic floor disorders. These are physicians who have completed medical school and a residency in Obstetrics & Gynecology or Urology. These doctors become specialists with additional years of fellowship training and certification in Female Pelvic Medicine and Reconstructive Surgery.

If you are experiencing pelvic floor symptoms talk to your primary care physician or general Ob/Gyn. They will help you determine whether or not you should see a urogynecology specialist.

Can pelvic floor symptoms improve by strengthening pelvic floor muscles?

Again, I am happy to say yes! Pelvic floor muscle exercises, also referred to as Kegel exercises (named after American gynecologist, Arnold Kegel, MD), can improve PFD symptoms. A key first step is ensuring one is able to identify their pelvic floor muscles. For many patients this is a straight forward thing. But not for all.

The instruction I like to give is for a patient to imagine they are in a crowded elevator and have the sudden urge to pass gas. What muscles would they squeeze to keep from doing so? Once one is contracting the correct muscles, improved strength will come with time. Performing 10 squeezes for 10 seconds (beginners may have to start at 3 or 5 seconds) 2-3 times a day is a good habit to develop. For patients who are not able to identify their pelvic floor muscles, or for those whose symptoms do not improve with regular exercise, a consultation with a pelvic floor physical therapist is an option.

Is there an app for that?

There are a number of pelvic floor muscle training apps for iOS and Android devices available in their respective app stores. Using an app can be a nice way to help establish the habit of performing pelvic floor muscle exercise routinely. That said, the usability and quality of these programs have not been well studied. If you are using an app to do pelvic floor muscle exercises and are wondering about its quality, show it to your physician or pelvic floor physical therapist to get their professional opinion.

Does Catholic Health have specialists who treat PFDs?

Catholic Health's Center for Pelvic Health, with locations in Rockville Centre, NY and West Babylon, NY, provide comprehensive care for women with PFDs.

Our team of experienced doctors, nurses and support staff understand the sensitivity of PFDs—from diagnosis to treatment. Your treatment options are carefully explained so you understand your condition and can make the best decision for your health.

For more information or for an appointment, please call 631-376-3880.