While most people have heard the term pelvic floor, many don’t realize what the pelvic floor does on a daily basis. Your pelvic floor is working 24/7, supporting your bladder, colon, rectum and sexual organs. This versatile set of muscles performs many important functions. Pelvic floor muscles help your bladder and rectum relax and contract on demand when you need them, and they’re the muscles that contract during sex.

When pelvic muscles are too loose or too tight, problems can occur. Weak or damaged pelvic floor muscles can lead to urinary leakage, accidental bowel leakage and pelvic organ prolapse, a condition in which the uterus, bladder and bowel may drop causing sense of pressure and fullness. If these muscles are too tight, it can be hard to relax, causing difficult bowel movements, incomplete bladder emptying, burning during urination, weak urinary stream, constipation or pain when having sex.

“Anything that puts pressure on the pelvis, including pregnancy and childbirth, chronic cough, chronic constipation, constant straining while toileting or nerve damage from surgery or disease, can lead to a pelvic floor disorder,” said Dr. Brooke Gurland, MD, a colorectal surgeon at the Stanford Health Care Pelvic Health Center. Almost one-quarter of women face pelvic floor disorders, and the incidence of these issues increases as they age.

“Although it is rarely discussed, men also suffer from pelvic floor disorders,” said Dr. Ekene Enemchukwu, MD, MPH, an urologist who specializes in pelvic reconstruction surgery at the Stanford Health Care Pelvic Health Center. Men can develop pelvic floor disorders as a result of trauma, neurologic diseases, enlarged prostates, pelvic surgery, infections and even radiation treatments for conditions such as prostate cancer.  

Pelvic health issues should not be accepted as a normal or acceptable part of aging, said Dr. Gurland. “They are actually very common medical problems that can be treated successfully.”

Tips for pelvic health at every age
In both men and women, stress and lifestyle can both aggravate and exacerbate pelvic floor spasm and pain.

Just as people exercise and eat well to help prevent heart disease, obesity and diabetes, they can also work to improve their pelvic health throughout their lives. The goal is to maintain a strong pelvic floor to avoid chronic issues such as bladder and bowel control.

• Strengthen your pelvic floor. If loose muscles are the issue, Kegel exercises should be a daily routine.
• Meditation and guided relaxation can help loosen overly tight pelvic muscles.
• Avoid constipation by consuming ample fluids and fiber and exercising regularly.
• Dietary changes can improve stool consistency, which can help with bowel leakages or painful constipation.
• Avoid prolonged toileting.
• Avoid straining or pushing during bowel movements and when urinating.
• Decrease intake of caffeine, alcohol and artificial sweeteners.
• Learn how to relax the muscles in the pelvic floor area. For example, take warm baths and practice yoga.
• Maintain a healthy weight.
• Avoid heavy lifting, which can lead to organ prolapse.
• Don’t smoke.

When to Seek Treatment
Millions of people have pelvic health issues, but few seek treatment, compromising their quality of life. Some people are at higher risk for pelvic floor disorders, such as those with connective tissue disorders, steroid dependency, multiple births, a history of pelvic radiation and pelvic surgery. Higher risk patients should undergo evaluation early to maintain good pelvic floor health.

“I find that in my practice, both men and women delay seeking care from their health care providers,” said Dr. Enemchukwu. “Women often delay care due to embarrassment, prioritization of family, while others suffer in silence because they believe their symptoms are simply part of the normal aging process. Many men often delay care due to fear or concern that something serious may be wrong.”

“Many people don’t feel comfortable seeking medical help for pelvic floor disorders and symptoms such as incontinence. These are things that people don’t want to discuss, they’re embarrassing,” said Dr. Gurland. “But the pelvic floor is really crucial to how we function everyday. If you have a pelvic health issue, you should know that there is help. Don’t hesitate to learn more about your treatment options.”

The Stanford Pelvic Health Center delivers comprehensive and compassionate care to treat all pelvic disorders. Patients have access to a broad range of pelvic health specialists in one location.

• Urologists who specialize in the treatment of urinary disorders in women and men
• Colorectal surgeons who provide surgical treatment of the digestive system
• Gastroenterologists who treat the digestive system
• Urogynecologists who specialize in the care of women with pelvic floor disorders
• Physical therapists who use targeted exercise and biofeedback to help patients learn how to relax and coordinate the movement of their pelvic floor muscles
• Pain management specialists

Our team uses advanced diagnostic testing to pinpoint the cause of your condition to guide treatment options. Most pelvic health problems can be treated without surgery. Many patients benefit from working with a physical therapist specially trained in strengthening and coordinating the muscles of the pelvic floor. Other treatments include medications, minimally invasive devices and surgery.