Wednesday, April 20, 2016

Pelvic Floor Dysfunction - Do I have it?

by Dr. Urszula May, MHSc, ND

Have you suffered with stress incontinence, urinary urgency/frequency, painful bladder syndrome or painful intercourse?  What about pelvic organ prolapse, prostatitis, heaviness in the vaginal or rectal area, constipation, fecal or gas incontinence?  These are a few of the conditions that are related to pelvic floor dysfunction and that can be addressed through pelvic floor treatment.  

What is the Pelvic Floor?

The pelvic floor is a sling-like structure that sits between the hips and has several important functions.  It's made up of muscle and connective tissue that:
  • support internal organs 
  • allow sexual functions
  • relax during urination, defication and birth
  • act like a pump moving blood and lymph from our lower body back to our heart
  • and provide stability for the body as a whole. 

What Causes Pelvic Floor Concerns?

The pelvic floor is a crucial component of your anatomy and can be damaged in a number of ways.  Falls, traumas, infections, childbirth and surgeries are some of the most common reasons patients end up with pelvic floor dysfunctions.

When damaged, the muscles, tissues and joints of the pelvis can become too tight or too loose, or both.  Tissues that are too tight can pull on the structures in their neighbourhood, like the bladder for example, leading to urge incontinence or painful intercourse.  When these tissues are too loose, pelvic organ prolapse or stress incontinence can result.

Many pelvic floor issues arise slowly over time. Also, they can wrongly be associated with aging in general and misdiagnosed as hip and / or low back pain.  Pelvic floor dysfunctions can tremendously impact a person's quality of life. They often result in people spending more time at home and avoiding social outings due to concern with bladder control or pain management. Painful intercourse can also dramatically affect a person's relationship with their sexual partner. 

How is Pelvic Floor Dysfunction Diagnosed?

Pelvic floor dysfunction is diagnosed using hand-on assessment of both internal and external structures.  An initial visit includes an examination of:
  • posture 
  • gait
  • flexibility
  • skin
  • muscle tone and trigger points

Often stress, anxiety and perceptions of pain are related to incontinence and pelvic pain, and those, too, are discussed and evaluated.  An internal examination (rectal for men, vaginal and rectal for women) can be differed depending on patient comfort level and body need.  When the external structures are significantly tight, it's important to relax them prior to moving deeper into the body. 

What's the Treatment?

Pelvic floor treatment is a combination of in-office visits and self-care exercises. Self-care is the most important aspect of any pelvic floor treatment plan. Stretching, massage, deep breathing and bathing become part of a daily routine that maintains the progress made during office visits.  

What's exciting about this type of therapy is how well it works for people who thought they were stuck living with their symptoms for the rest of their lives. With the proper instruction and guidance, the results of pelvic floor therapy are life-long. 
Dr. May is one of the few naturopathic doctors in Canada with special training in Pelvic Floor diagnosis and treatment. If you feel you may benefit from a pelvic floor assessment, or would like more information to see if pelvic floor therapy is right for you, please feel free to contact Dr. May.