Half of all women don’t talk about it

You might hesitate to talk to your doctor or even your friends about it – and understandably so. But pelvic pain, pelvic prolapse or shifting of organs, incontinence issues, and sexual dysfunction are all real medical questions that have answers.

Many women suffer quietly thinking that the symptoms they feel are a normal part of aging. Actually, the symptoms can be traced back to a specific problem with specific treatment options. Talk to your doctor about how you feel.

Your pelvic floor muscles work like a sling to support your bladder, rectum, vagina and uterus. The urethra, vagina and anus pass through small openings in this muscle group. By contracting and relaxing these muscles, you control your bladder and bowel movements. Loss of muscle strength can happen for many reasons, including injury or surgery. You might not know there’s a problem until you experience pain, bladder dysfunction or bowel dysfunction.

Symptoms of pelvic floor dysfunction include:

  • Feeling that you need to have several bowel movements in a short time period
  • Feeling that you cannot complete a bowel movement
  • Constipation or straining pain during bowel movements
  • Frequent need to urinate
  • Stop and start during urination
  • Pain when you urinate
  • Unexplained pain in your lower back
  • Chronic pain in your pelvic area, genitals or rectum
  • Pain during intercourse

It’s important to find a specialist in pelvic floor dysfunction to help you identify the cause of the symptoms. Sometimes, the symptoms are caused by too much contraction of the pelvic floor muscles (non-relaxing pelvic floor dysfunction can cause vague pain and constipation). Other times, the symptoms are caused by muscles that are too relaxed (causing pelvic floor prolapse and urinary incontinence, for example).

The pelvic area is neurologically connected, meaning that the bowel, bladder and pelvic organs “talk” to each other. It’s not surprising that women might feel pain in the pelvic area, but cannot easily tell whether the pain merits a visit to the gynecologist or the urologist.

Your primary care doctor or your gynecologist can perform a pelvic exam to diagnose a problem and refer you to a specialist. There are specific tests to help rule out different problems and arrive at an accurate diagnosis and effective treatment:


  • Anal manometry. This test evaluates the strength of the anal sphincter muscles.
  • Cystoscopy. This test is used to look inside the bladder and urethra (the tube that carries urine from the bladder and discharges it outside the body) to look for problems, such as kidney stones, tumors, or inflammation.
  • Endoanal ultrasound. This test uses sound waves to form a picture of the anal sphincter muscles for evaluation.
  • Urodynamics. To evaluate how well the bladder and urethra are working. It can help identify bladder control problems.

Pelvic floor exercises, or Kegel exercises, will not reverse pelvic floor prolapse, but can prevent or at least slow down the progression of prolapsed muscles. Read on for more specifics on what you can do to improve your life by improving the health of your pelvic floor muscles.

The most important thing to remember is that your symptoms are real and deserve a conversation with your doctor. You might find out that your problem has a simple solution, and you’ll be able to resume activities you enjoy without worrying about accidents, discomfort or pain.

Other pelvic health topics:
Urinary incontinence | Painful intercourse

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