Be Well: Why Pelvic Floor Disorders Often Go Untreated
From Mpls.St.Paul Magazine’s Be Well
Deep within your abdomen lives a network of muscles that mostly go unnoticed. When problems arise, however, the pain and discomfort can be gripping. A lower back pain that takes your breath away. An inability to control your bladder or your bowels. A pain during sex that becomes an obstacle in your relationship. Seemingly unrelated, all of these problems could be symptoms of an often-overlooked disorder, one that most people have no idea exists.
A silent epidemic, pelvic floor disorders will affect one in four women at one point in their lifetime. And, the problem isn’t exclusive to women. Men experience symptoms of pelvic floor disorder, too. Unfortunately, most people assume that their symptoms are simply a part of life. Whether they chalk it up to growing old or think it’s the price to pay for having a baby, they often suffer alone.
So, why aren’t we talking about a disorder that affects so many people?
“In the United States, providers can’t turn to a standard of care for treating patients with pelvic floor disorder because there is no such standard,” says Jessica Frier, D.A.O.M, dean of the College of Acupuncture and Chinese Medicine at Northwestern Health Sciences University (NWHSU) in Bloomington. “Symptoms are so wide-ranging that medical professionals have struggled to create a protocol.” As a result, Frier says, doctors don’t regularly discuss pelvic floor health with their patients and significant issues remain untreated. When not addressed, pelvic floor disorders can sometimes lead to unnecessary pain, depression, and in some cases, to a decreased quality of life.
Your Best Supporter
The pelvic floor, a network of lower abdominal muscles, supports some of the body’s most important organs—like the bladder, bowel, uterus, and rectum—and keep them in their proper place. The hammock-like structure also plays a vital role in bowel, bladder, and sexual function.
Pelvic floor disorder is an umbrella term for an array of lower body pain and dysfunction that can range from urinary incontinence and constipation to organ prolapse (dropping) and chronic back pain. Contrary to popular belief, pelvic floor disorders are common among all ages and are not a normal part of the aging process. Usually caused by a life event, like childbirth, or a lifestyle factor, such as obesity, the shifting of the pelvic floor can result in pain, discomfort, and even, embarrassment. “A weak or imbalanced pelvic floor can lead to women avoiding activities they previously enjoyed,” says Dr. Andrea Wilde, D.C., assistant faculty at NWHSU’s Colleges of Chiropractic, Acupuncture and Chinese Medicine and manager of Integrative Clinic of Minnesota. “The pelvic floor is also essential to a patient’s sex life and maintaining a healthy relationship with their partner.”
Oh, the Joys of Motherhood
For nine months, moms-to-be receive detailed information about the stages of their baby’s development, get prenatal care to ensure a healthy pregnancy, and gain an understanding of how to properly care for their child. But, once that little bundle of joy makes its appearance, the focus shifts to the baby’s health. As far as postpartum maternal care? Oftentimes, Mom gets a six-week check-up and a green light to have sex again.
It’s not surprising that pelvic floor disorders fall through the cracks. With the lack of comprehensive postpartum care and patient information, pelvic floor disorders can move right in and take hold. If new moms knew what to watch for, they could seek proper treatment. Instead, women learn to deal with the pain and discomfort, and the long-term implication is unnecessary suffering of a largely treatable problem.
Unfortunately, doctor-patient discussions about pelvic floor issues, like incontinence, sexual dysfunction, and constipation, are few and far between. “These topics are often brushed under the rug and patients think that it’s just the way it is after pregnancy,” says Wilde. “Once healthcare providers start asking more in-depth and focused questions and have a network of providers in which to refer patients, you will start to see a standard of care for pelvic floor dysfunction.”
The term pelvic floor conjures up imagery of women doing postpartum Kegel exercises. To the surprise of many, men also have pelvic floors with an intricate weave of muscles. When unbalanced, these muscles cause pelvic floor disorders to arise. Often caused by an injury or an unintended outcome of surgery, male pelvic floor disorder can present as prostatitis (an inflamed prostate), erectile dysfunction, urinary incontinence, or testicular pain. While other health problems can lead to these symptoms, pelvic floor disorders are often to blame.
Where East Meets West
Like with many diseases, Western medicine treats the symptoms of pelvic floor disorder while Eastern medicine addresses the structural and systemic issues. Combining Eastern practices, such as acupuncture, with Western disciplines, like physical therapy, providers can maximize results. Treating a pelvic floor disorder is not a one-size-fits-all endeavor. “When most people think about muscles, they picture them connecting to bones horizontally or vertically,” said Frier. “The pelvic floor has a complex, nonlinear shape—think of it like a bowl in the lower abdomen. That’s why a holistic treatment approach is essential.”
Acupuncture addresses the body as a whole, which is why the modality is an effective treatment. A practitioner can relax or engage muscles, alleviate acute and chronic symptoms, and calm the central nervous system to promote an overall sense of wellness. Acupuncture also heals scar tissue and resolves pelvic nerve pain.
Chiropractic adjustments address spinal dysfunction, which can affect the nerves that lead to the pelvic floor muscles. By manipulating and applying force to the spinal joints, chiropractors can improve muscle and joint function, helping to stabilize the pelvic floor. As with other treatments, integration of chiropractic treatments with other care providers is essential.
Pelvic floor physical therapy focuses on retraining the pelvic floor muscles with internal and external massage, trigger point therapy, and joint mobilization. Depending on the type of disorder, the goal is to manipulate the muscles and relax or strengthen them. Simple physical therapy exercises can also go a long way in improving bothersome symptoms.
Biofeedback guides patients in loosening or strengthening their pelvic floor. By inserting a probe or applying electrodes to the affected area, a patient can better understand just how tense or relaxed their muscles are and perform simple exercises to help balance them.
An Ounce of Prevention…
Of course, the best way to avoid more severe complications is to address issues as early as possible, when they first arise. “Prevention is all about being aware of what is going on in your pelvic floor and being mindful about addressing it,” says Frier. Knowledge is power, as they say, so tune into your body. And, the next time seemingly mysterious issues arise down under, consider that your pelvic floor might be screaming for attention.