Pelvic floor dysfunction can be caused by:
- Diminished muscle integrity due to weakness, tearing or cutting
- Abnormal nerve function
- Torn or avulsed fascia, which leaves an otherwise functional muscle unattached to the anchoring structures
The most common causes of injury to the pelvic floor muscles, nerves and fascia are pregnancy and childbirth. During pregnancy the growing baby puts extra pressure on the mother's pelvic floor, especially if she is expecting twins, triplets or other multiples. In preparation for delivery, the mother’s body produces hormones which soften the ligaments and muscles to allow for the pelvic joints and soft tissue to widen, allowing the baby to descend through the birth canal.
Vaginal delivery can stretch and compress the pelvic floor structures. Other events that can increase the risk of pelvic injury include large babies, fast labor or pushing for more than 1.5 hours. However, simply being pregnant increases the risk of pelvic floor dysfunction, as women who have caesarean sections may also have pelvic floor problems.
Other factors that can contribute to pelvic floor dysfunction or make symptoms more apparent are:
- Obesity
- Chronic constipation
- Straining during urination or bowel movements
- Coughing associated with chronic bronchitis, asthma, other lungs disorders and smoking
- Heavy lifting
- Nerve or internal sphincter damage caused by prostate surgery
- Low estrogen due to hysterectomy or menopause
Since pelvic heaviness, bloating and urinary or bowel elimination changes may be a sign of other more serious health conditions, such as urogynecologic or prostate cancer, always consult your primary health care provider if you experience any of these symptoms.
Since you can't see your pelvic floor structures, you might not even realize that they have become stretched, weakened or injured until you notice other changes in your body or health. There are four categories of pelvic floor issues that may develop, which are outlined below. Please note that although treatment options are discussed in this article, your physiotherapist at In Balance Physiotherapy will work with you in a supportive and caring way to address your questions, concerns, and treatment options.
