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Pelvic Floor Disorders (PFDs) Overview
What Are Female Pelvic Floor Disorders (PFDs)?
The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the
pelvis that provides support for a woman’s internal organs, including the bowel, bladder, uterus,
vagina and rectum. A PFD occurs when women have weakened pelvic muscles or tears in the
connective tissue, which may cause:
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Bladder Control Problems: Inability to hold urine long enough to reach the restroom
(urge incontinence), frequent urination during the day and night (urge frequency), and
urine leakage caused by increased abdominal pressure (stress incontinence). Urgency
frequency and urge incontinence are also defined as overactive bladder.

Bowel Control Problems: Loss of normal control of the bowels that leads to leakage of
solid or liquid stool or gas.

Pelvic Organ Prolapse: Dropping of the bladder, uterus and rectum caused by the loss
of normal support of the vagina. In severe cases, women may feel bulging tissue
protruding through the opening of the vagina.
PFDs Impact 1 in 3 Women.
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One in three women will experience a pelvic floor disorder in their lifetime.

PFDs are not a normal part of aging and can be treated successfully.
What are the Symptoms Associated with PFD?
The symptoms generally begin gradually and the natural history is for the symptoms to progress
with time. Symptoms may vary among women; however they can include:


Symptoms of Bladder Control Problems:
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Urine leakage
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Overactive bladder
o
Difficulty emptying the bladder
Symptoms of Bowel Control Problems:
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Infrequent bowel movement
o
Constipation or diarrhea
o
Hard bowel movements
o
Abnormal stool consistency
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
Symptoms of Pelvic Organ Prolapse:
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A bulging, pressure or heavy sensation in the vagina that worsens by the end of
the day or during bowel movements
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Difficulty starting to urinate or a weak or spraying stream of urine
o
Urine leakage with intercourse
What are the Risk Factors?
Risk factors may vary among women; however they can include:
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Age/Ethnicity:
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Age: The strength of the pelvic floor deteriorates as women age, which can lead
to the development of pelvic organ prolapse.
o
Race: The strength of a woman’s bones, muscles and connective tissue are
influenced by genes and race. Women born with weaker tissues are at a greater
risk for developing pelvic organ prolapse. Caucasian women are more likely than
African American or Asian women to develop prolapse. African American women
are more likely to have urinary leakage related to urgency while Caucasian
women are more likely to have leakage related to coughing and sneezing.
Woman’s Life Stage:
o
Pregnancy/Childbirth: Childbirth can contribute to the development of PFDs.
Vaginal births double the rate of pelvic floor disorders compared to Cesarean
deliveries or women who never gave birth.
o
Menopause: The pelvic floor muscles often weaken during menopause, which
can lead to the development of pelvic organ prolapse.
Lifestyle/Behaviors:
o
Obesity: Overweight or obese women have increased pressure on the bladder
and often lack strength in their pelvic muscles, and they are at an increased risk
of developing pelvic organ prolapse and urinary incontinence.
o
Diet: When there is not enough fiber or water in a woman’s diet, bowel
movements are more likely to be hard or irregular. Processed foods can lead to
constipation. Certain foods also can irritate the bladder, making women feel like
they have to urinate. Bladder irritants include caffeine and alcohol.
o
Smoking: Women who smoke increase their risk of developing urinary
incontinence and pelvic organ prolapse.
o
Heavy Lifting: Certain occupations, usually those that involve heavy lifting or
exertion can increase the risk of developing PFDs.
o
Sexual dysfunction: Pelvic floor symptoms are significantly associated with
reduced sexual arousal, infrequent orgasm, and painful intercourse (known in
medical terms as dyspareunia).
Health Conditions/Medical History:
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Constipation/Chronic Straining: Conditions that promote prolapse include
constipation and chronic straining. Straining with constipation puts significant
pressure on the weak vaginal wall and can further thin it out.
o
Pelvic Injury/Surgery: Loss of pelvic support can occur when the pelvic floor is
injured from falls, car accidents or surgery. Hysterectomy and other procedures
that treat pelvic organ prolapse can sometimes cause further prolapse.
o
Lung Conditions/Chronic Coughing: Chronic respiratory disorders can cause
increased pressure in the abdomen and pelvis, which increases the risk of pelvic
organ prolapse.
Seeing a Specialist to Break Free From PFDs.
Urogynecologists are physicians who complete a residency in Obstetrics and Gynecology or
Urology and then become specialists with additional training in treating PFDs. A
Urogynecologist may recommend the following non-surgical or surgical treatment options
depending on the type of PFD being treated.
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Non-surgical Treatment Options:
o
Lifestyle changes such as performing pelvic floor muscle exercises, like Kegels,
or losing weight, can help control and strengthen the pelvic floor muscles. In fact,
overweight or obese women who lose weight have shown to decrease weekly
incontinence episodes by more than half.
o
Dietary changes like drinking fewer alcoholic beverages and avoiding caffeine
can help control urinary and bowel incontinence.
o
Other treatment options include using medication or a pessary (a device
designed to lift the bladder), physical therapy, electrical nerve stimulation to
stimulate the nerves that control bladder or bowel functions, and biofeedback to
improve sensation and muscle strength in the pelvic floor.
Surgical Treatment Options:
o
Pelvic surgeries can help restore the normal pelvic floor anatomy or repair
damaged muscles or tissue.
o
Many procedures to correct pelvic organ prolapse can be performed through
small incisions in the vagina or abdomen, which may reduce scarring and
complications and may shorten recovery time.
How to “Break Free from PFDs” and For More Information:
1. Visit voicesforpfd.org to learn more about PFDs, use interactive tools to help better
understand your symptoms, and download a fact sheet to help discuss PFDs with a
physician.
2. Talk to your Primary Care physician and ask him/her to refer you to a Urogynecologist if
necessary. Anyone experiencing symptoms should have a thorough examination, be
informed of the many non-surgical and surgical treatment options available and referred to a
trained specialist.
3. Remember PFDs are not something you need to live with. Talk to your doctor and “Break
Free from PFDs” today.
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