The Pelvic Floor
Function and Dysfunction
Having worked in the sexual health education field for almost eight years, the pelvic floor is a topic that is often left out. Yet knowing this information is critical to understanding the important functions of the pelvic floor, what’s normal and what may require reaching out for professional support.
What is the Pelvic Floor?
Your pelvic floor is a group of muscles that sits like a bowl within your pelvis. The pelvic floor muscles have attachments to your pubic bone, tailbone and pelvis. They are working throughout your day in many ways you may not have ever realized…
5 Important Functions of the Pelvic Floor Muscles:
Sphincteric: The muscles of the pelvic floor wrap around and control the opening of your bladder and rectum. When there is an increase in abdominal pressure (for example when you cough, sneeze, laugh or jump), these muscles contract around your urethra and anus to prevent leakage. Equally as important, these muscles have to relax and lengthen to allow us to urinate or have bowel movements easily.
Support: The pelvic floor muscles act as a basket to support our pelvic organs (bladder, rectum and uterus) against gravity and increases in abdominal pressure. With excess strain on the pelvic floor (especially during pregnancy), or with weakening of the pelvic floor (with age or hormonal changes), the pelvic organs can start to protrude near the vaginal opening. This is referred to as prolapse.
Stability: Because of their attachments to the pelvis and hips, the pelvic floor muscles are an important part of the “core”. These muscles assist other abdominal, hip and back muscles to control movement of the sacroiliac and hip joints. If you are trying to strengthen your core — you pelvic floor should be a part of your training program!
Sexual: During intercourse, the pelvic floor muscles help to achieve and sustain an erection and allow for penetration. Sufficient strength of the pelvic floor muscles is necessary for orgasm, and excessive tension or sensitivity of the pelvic floor can also contribute to pain during or after intercourse.
Sump-pump: Just like the calf muscles in your leg act to pump blood and lymphatic fluid back up towards your heart, the pelvic floor muscles act as a blood/lymph pump for the pelvis. A loss of this “sump-pump” action can contribute to swelling or pelvic congestion.
What is Pelvic Floor Dysfunction?
There are a number of reasons why someone may experience pelvic floor dysfunction. These dysfunctions may be indicated by the following symptoms:
Pain during and/or after sex
Pain and/or difficulty with urinating and bowel movements
Pain while sitting
Postpartum pelvic pain
Chronic pelvic pain
Difficulty achieving arousal or over arousal
Pain with ejaculation
And many more…
What can you do?
There is an unnecessary amount of shame and taboo around pelvic floor dysfunction, given the lack of education in this area. Far too many people suffer through pain for many years in silence, either due to inaccurate advice from their primary care physicians; unawareness about professionals in the field of pelvic floor dysfunction; or not having the resources to seek support.
The following steps may help:
If your primary care physician has not been helpful (as many are not educated about pelvic pain and may even dismiss women’s pain), seek an evaluation from a trained and experienced pelvic floor physical therapist. Check out this link to find one in your area.
There are medical professionals who are trained in pelvic floor dysfunctions. I highly recommend Pelvic Rehabilitation Medicine. They have locations in Manhattan, NY and New Jersey.
Psychoeducation about pelvic health can be incredibly empowering before, during, and after the treatment process. Pelvic Pain Rehab is a nationally located practice (on the West and East coasts of the U.S.) with a wealth of information and resources on their website.