Hello friends! Pelvic floor muscle dysfunction is more common than you might think. In fact, one in every four women in the U.S. experiences symptoms (Wu, 2014). But does that mean it's normal and nothing to worry about? The short answer is no. Symptoms of pelvic floor muscle dysfunction indicate that things aren’t working the way they were designed to. Just because your mom, grandma, sister, or best friend pees when they sneeze doesn’t mean there isn’t treatment available.
We often say in pelvic health: these may be common, but they are not normal!
This week, we’ll go over several common symptoms that are actually signs that the pelvic floor muscles aren’t functioning properly. Note: Just because you're getting older or have had children doesn't mean you should just “deal with it.” Help is available to get your muscles working their best again so that you can live a happy, healthy life doing all the things you love!
Vaginal Pressure/Heaviness/Bulging
These are all common signs of pelvic organ prolapse. Pelvic organ prolapse occurs when the bladder, cervix, or rectum descend into the vaginal canal due to insufficient support. The pelvic floor muscles are crucial in providing support to these organs and preventing prolapse. When these muscles are not functioning well—whether due to weakness or tightness—these organs can begin to descend, and in some cases, can even protrude outside the vaginal opening. Many people with prolapse describe the sensation of a ball sitting inside or at the opening of the vagina. While prolapse often doesn't cause pain, it can lead to discomfort and irritation. To learn more about prolapse in detail, click here to see how to check for a vaginal bulge.
Peeing More Than Every 2 Hours
Another common, but not normal, symptom is frequent urination. The average person should urinate once every two to four hours. This is because it typically takes that long for the kidneys to produce enough urine to fill the bladder.
The normal bladder can hold about 400-600 cc (1.69-2.5 cups) of urine. The kidneys produce anywhere from 1-14 mL of urine per minute, which equals about 0.25 cups to 3.5 cups of pee per hour (Haylen, 2010). Several factors can affect the rate at which your kidneys produce urine, including your fluid intake, body weight, environmental conditions, activity level, certain medical conditions like diabetes, and medications such as water pills.
If you find yourself running to the bathroom multiple times within an hour, you may have a condition called overactive bladder (OAB). You can learn more about OAB here.
Urgency to Pee or Poop
When we first feel the urge to pee or poop, it shouldn't send us into a panic to find a bathroom. Our bodies are designed to give us enough time to get to a bathroom without rushing.
Leaking Gas, Poop, or Pee
The pelvic floor muscles wrap around the openings of the urethra and anus. When these muscles are functioning properly, they stay engaged to keep these openings closed, preventing leakage of gas, poop, or pee when we’re not ready to go. If leakage occurs, it could be due to a problem with muscle strength, coordination, or sometimes both.
Pain
Pain in the pelvic region is not normal, except during childbirth. While many factors can cause pelvic pain, symptoms like pain from sitting for long periods, pain during vaginal or rectal penetration (e.g., intercourse, pelvic exams, or inserting/removing menstrual products), or pain during activity/exercise could indicate an issue with pelvic floor muscle function. Often, pelvic pain is linked to muscles that are too tight or have difficulty relaxing.
If you experience any of these symptoms, talk to your healthcare provider about possible treatment options. Many of these symptoms can be improved with pelvic floor therapy. You can find a therapist near you at www.mypfm.com/find-a-pt. There is hope for a healthy life, free from pain, leakage, or living in constant fear of the bathroom!
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Pelvic Physical Therapy
Learn more about your pelvic floor on our Instagram
Visit our Amazon store for our favorite pelvic health products
Sign up for our email newsletter
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources.
Written by Emily Reul, PT, DPT
References
Fowler CJ, Griffiths D, de Groat WC. The neural control of micturition. Nat Rev Neurosci.2008;9(6):453-466.
Haylen BT et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4-20.
Wu JM, et al. Prevalence and treads of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014. PMID: 24463674.
Zondervan KT et al. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001;(51):541-547.