The trouble happens when women reach a certain age and the rigors of childbirth, sometimes long-term constipation, or perhaps an injury or just the passing of time cause the muscles in the pelvic floor to weaken. The term pelvic floor refers to the group of muscles that form a sling or hammock across the opening of a woman’s pelvis. Together, these muscles and their surrounding tissue keep the pelvic organs in place so they can function properly. Loss of pelvic support can occur when any part of the pelvic floor is injured during vaginal delivery, surgery, pelvic radiation or by accidental back or pelvic fractures. Hysterectomy and other pelvic surgery can weaken pelvic support, as can constipation, smoking, chronic coughing and heavy lifting. Women who are obese have a 40 to 75 percent higher risk of pelvic organ prolapse. Aging, menopause and degenerative nerve and muscle diseases also can contribute to the deterioration of pelvic floor strength.
The most common problems include:
- Pelvic organ prolapse – When the pelvic muscles and tissues become weak and can no longer hold the organs in place. In uterine prolapse, the uterus can press down on the vagina, causing it to invert or even come out through the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop through the vaginal opening. If you feel a heaviness or fullness like something is falling out of the vagina, it might be prolapse.
- Urinary incontinence – Occurs when the bladder drops down into the vagina. A key symptom is urine leaking. Other symptoms might include urgency to urinate, frequent urination or painful urination.
- Overactive bladder - Is characterized by a frequent need to urinate. You may feel bladder pressure, urgency to urinate or dificulty holding back a full bladder.
- Pelvic or bladder pain - Discomfort, burning or other uncomfortable pelvic symptoms, including bladder or urethral pain.
- Rectal prolapse – This can occur when the rectum bulges into or out of the anus, making it difficult to control the bowels. It can also occur when there is damage to the anal sphincter, the ring of muscles that keep the anus closed.
Read more about pelvic floor disorders in the Winter 2011 edition of BestCare Magazine
Sources: National Institutes of Health Eunice Kennedy Shriver National Institute of Child Health & Human Development, Intuitive Surgical; American Urogynecologic Society