In our culture, the pelvic floor is treated like a black box: (some) people know it exists, but they often do not know much about how it works, problems that may arise due to pelvic floor dysfunction, or how to help.

The pelvic floor is rapidly gaining notoriety in the pregnant and postpartum world, as it rightfully should. Growing a child requires some odd changes from the body, and researchers have shown that delivery can have big implications on the pelvic floor. 

However, pregnancy is by no means the sole determinant of pelvic floor dysfunction. The pelvic floor is a group of muscles, sometimes likened to a hammock, that covers the floor of the pelvis. Within these muscles are openings for the rectum, urethra, and vagina. This means that the pelvic floor influences bowel, bladder, and sexual function, playing a role in going to the bathroom and during intercourse. This is true for everyone, not just women who are pregnant or postpartum.

Our bodies are good and essential to our personhood, and it is important for our bodies to function as they were designed. This includes the pelvic floor. However, issues that lead women to seek pelvic floor physical therapy are extremely personal and are less likely to be discussed casually, which may contribute to a lack of public awareness of the pelvic floor.

Here are some common, but important, activities that the pelvic floor impacts:

Feeling like you can go for a run without peeing your pants.

The pelvic floor muscles are almost always active. The pelvis (and the pelvic floor) transmits and absorbs forces coming from the legs, torso, and even the upper body. Think about running or jumping: there is significant pressure transmitted during landing, which is then attenuated through the pelvic floor. These muscles also counter downward pressure through the torso and must be strong enough and have enough endurance for lifting or carrying heavier objects. Weakness, decreased endurance, and decreased activation of the pelvic floor can contribute to increased urgency or incontinence, or pelvic organ prolapse.

Going to the bathroom.

Though the pelvic floor muscles are frequently active, they must also be able to relax. Their ability to relax allows you to go to the bathroom. If your pelvic floor isn’t working correctly, it can result in constipation and/or incomplete bladder emptying.

Intimacy.

Pelvic floor muscles can also impair normal sexual function. This can be due to pain or increased muscle tightness or tension, which can lead to a variety of issues including painful intercourse and an inability to orgasm. Like using the restroom, pelvic floor muscles must be able to relax in order to orgasm during intercourse.

Tampon use and OBGYN exams.

Pain does not only impact intimacy. Tension or increased sensitivity decrease tolerance to tampon insertion and gynecological exams. Many women dread speculum exams because they are painful. In truth, they are not supposed to be painful.

Causes of these symptoms are variable and individual.

Stress can contribute to pelvic floor issues, as the pelvic floor is one of the first parts of the body that responds to stress by tightening. Infections can also lead to similar symptoms due to muscle guarding, where the muscles contract in an effort to protect and prevent anything from entering the vagina.

However, it is also not always just about the pelvic floor. Muscle imbalances and decreased strength in other parts of the body, such as the hips, can increase demand on the pelvic floor.

If you are experiencing any of these issues, the good news is that there are solutions. Pelvic floor physical therapy is highly effective. It is not a cure-all, but pelvic floor therapists are skilled at assessing symptoms and determining when to see additional medical providers.

With increased education and awareness, the pelvic floor does not have to be a black box!