Ask the doctors: Pelvic floor dysfunction has several treatments

Dear Doctors: The yoga teacher at our local Y is always talking about the pelvic floor and how keeping it strong is important for staying healthy. Is that the same as your core? What would be the symptoms if it was weak?

Dear Reader: When someone talks about the pelvic floor, they are referring to the muscles and connective tissues that form a kind of hammock at the base of the abdomen. They form a strong yet flexible framework that keeps the organs and tissues located in the pelvis in their proper place. This includes the large intestine, also known as the colon, the bladder and the rectum. In women, the pelvic floor helps support the uterus and vagina. It aids in urination, urinary control and bowel movements. It is also important to sexual function. During pregnancy, the pelvic floor supports the growing baby.

Although it is not part of the abdominal muscles known as the core, the pelvic floor does contribute to core strength. It plays a role in supporting the spine as someone sits, stands and bends, and it helps ease and distribute the pressure caused by lifting, certain types of exercise and even coughing and laughing. As you can tell from the crucial functions it carries out, your yoga instructor is correct that maintaining a strong pelvic floor is important to good health and well-being.

Over time, the pelvic floor can begin to weaken. Aging, inactivity, hormonal changes, illness and being overweight or obese can weaken the muscles. Pregnancy and vaginal delivery also take a toll on the framework. When the muscles of the pelvic floor are no longer performing as they should, it is a condition known as pelvic floor muscle dysfunction. One of the most common symptoms is loss of urinary control. This often begins with leaks that occur during a cough, sneeze or laugh, or while exercising or lifting. With a weakened pelvic floor, it can be a race to reach the toilet in time. It can also become difficult to either control or complete bowel movements.

In women, a weakened pelvic floor can lead to passing wind through the vagina, a loss of a sensation in the vagina, a feeling of persistent heaviness in the vagina and an increase in the frequency of urinary tract infections. A more serious problem is something known as pelvic organ prolapse. That is when a portion of the uterus, bladder or bowel drops below the base of the pelvis and protrudes into the vagina. This requires an immediate medical evaluation.

Anyone who experiences symptoms of pelvic floor dysfunction should check with their health care provider. These are common enough to be caused by several different conditions. If you are diagnosed with a weakened pelvic floor, be sure to follow through with the treatment plan you are given. This may include losing weight, changing your diet to prevent constipation and facilitate easier bowel movements, medications to address bowel movement issues and a variety of specific exercises. Sometimes, surgery is the best option. The good news is, when addressed early, pelvic floor dysfunction is a treatable condition.

Send your questions to askthedoctors@mednet.ucla.edu.