Pelvic Floor Dysfunction: What Is It and How to Treat

Table of ContentsView AllTable of ContentsSymptomsCauses in FemalesCauses in MalesTreatmentDiagnosisInterdisciplinary TreatmentPhysical TherapyWhen on Outings

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes in Females

Causes in Males

Treatment

Diagnosis

Interdisciplinary Treatment

Physical Therapy

When on Outings

Pelvic floor dysfunction (PFD) occurs when the muscles and nerves in the pelvis don’t work as they should. The pelvis is the area between your hips, and the pelvic floor is a group of muscles that support organs like the bladder and intestines. These muscles help control urination (peeing), bowel movements (pooping), and aspects of sexual health.

In both females and males, these muscles can become weak or tight, causing urinary or bowel leakage, pelvic pain, or painful sex.Treatments like exercises, physical therapy, and medications can significantly improve symptoms.

Pelvic Floor Dysfunction Symptoms

Hypotonic (Weak) Symptoms

Symptoms of a hypotonic or weak pelvic floor include:

Hypertonic (Tight) Symptoms

Hypertonic PFD can cause chronic pain or pressure that often worsens with specific activities or over the course of the day. Pain may occur in the lower back,pelvis,penis, tailbone,vagina, orvulva(external female genitalia).

Other symptoms may include:

Risk factors include:

Causes of PFD in males include:

Does Treatment Improve Dysfunction?

Treatment can help reduce PFD symptoms and may involve lifestyle changes,physical therapy, medications, or surgery. The primary treatment is pelvic floor physical therapy (PFPT) to relax or strengthen the pelvic muscles.The best approach depends on whether the PFD is due to muscle weakness or tightness.

Symptom Triggers

PFD symptom triggers may involve:

Diagnosis and Associated Providers

Diagnoses involve a history and a physical exam, including arectalexam and, for females, avaginalexam.Providers may also order urine or blood tests to rule out infection or pregnancy. They may also recommend an ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) to view internal organs.

Your care team may include providers who work in:

The above specialists may perform diagnostic procedures such as:

An interdisciplinary approach to PFD treatment may involve physicians, therapists, nurses, and their assistants. They offer physical therapy, medications, talk therapy, and injections.

Pelvic floor physical therapyis the primary treatment for PFD. For hypotonic PFD, the goal is to strengthen pelvic muscles with interventions such as:

In some cases, you may need surgery to secure the vagina, bladder, or urethra (the tube that carries urine out of the body).

For hypertonic PFD, the focus is on muscle relaxation, with treatments like:

You may also need oral muscle relaxants like Lioresal (baclofen) and vaginal or rectal suppositories like Valium (diazepam). Additional treatment might involve:

Physical Therapy and Exercises at Home

Your physical therapist may perform dry needling, biofeedback, andtrigger point release(releasing “knots”) in the clinic. They’ll also teach you deep breathing techniques orexercisesto practice at home.

For hypotonic PFD, yoga exercises may include:

For hypertonic PFD, relaxation exercises might involve certain yoga poses and other techniques, including:

Kegels or Reverse Kegels?

How to Make Outings More Comfortable

Outings can be challenging with PFD. You may feel uncomfortable after sitting for a while or experience bladder irritation, similar to a urinary tract infection. Pelvic pain, frequent restroom urges, or anxiety about needing to go quickly can also be issues. Here are a few tips to help you stay comfortable during outings:

For pain relief, consider natural options likearnicatea, pellets, or cream to relieve muscle soreness and inflammation.Over-the-counter options like Tylenol (acetaminophen) or Advil or Motrin (ibuprofen) can help with general pain. Topical (on the skin) pain relief orlidocaine patchescan offer targeted relief for the lower back.Heating patches for your pelvis or lower back may help—just remember to check your skin to prevent overheating.

For urinary discomfort, consider AZO (phenazopyridine). Make sure it is the pain relief option rather than the cranberry option, which is a preventive. Keep in mind that AZO may temporarily turn yoururine orange.

Summary

Pelvic floor dysfunction happens when muscles and nerves in the pelvic area do not work correctly. The pelvic floor, made of muscles, ligaments, and nerves, supports organs like the bladder, uterus, and intestines and controls urination, bowel movements, and sexual health.

PFD can cause weak (hypotonic) or tight (hypertonic) muscles, leading to symptoms such as urinary or bowel leakage, pelvic pain, constipation, and sexual discomfort. Treatment options, including physical therapy, home exercises, and medications, can significantly improve symptoms for many people.

17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM.Pelvic floor dysfunction: Prevalence and associated factors.BMC Public Health. 2023;23(1):2005. doi:10.1186/s12889-023-16901-3.Notenboom-Nas FJM, Knol-de Vries GE, Beijer L, et al.Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: a population-based study.Neurourol Urodyn. 2022;41:1739- 1748. doi:10.1002/nau.24996Wallace S, Miller L, Mishra, K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics and Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584American Society of Colon & Rectal Surgeons (ASCRS).Pelvic floor dysfunction.Louis-Charles K, Biggie K, Wolfinbarger A, Wilcox B, Kienstra C.Pelvic floor dysfunction in the female athlete.Current Sports Medicine Reports.2019;18(2):p 49-52. doi:10.1249/JSR.0000000000000563Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).What causes pelvic floor disorders (PFDs)?van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, Pelger RCM, Hagenaars-van Miert CHAC, Laan ETM.Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy.Sex Med Rev. 2022;10(2):209-230. doi:10.1016/j.sxmr.2021.03.002Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).Pelvic floor disorders: Surgical treatment.Torosis M, Carey E, Christensen K, et al.A treatment algorithm for high-tone pelvic floor dysfunction.Obstet Gynecol. 2024;143(4):595-602. doi:10.1097/AOG.0000000000005536Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Prosko S.Optimizing pelvic floor health through yoga therapy.Yoga Therapy Today. 2016:32-35.National Association for Continence.How to relax your pelvic floor.MedlinePlus.Pelvic floor muscle training exercises.Smith AG, Miles VN, Holmes DT, Chen X, Lei W.Clinical trials, potential mechanisms, and adverse effects of arnica as an adjunct medication for pain management.Medicines (Basel). 2021;8(10):58. doi:10.3390/medicines8100058Derry S, Wiffen PJ, Kalso EA, Bell RF, Aldington D, Phillips T, Gaskell H, Moore RA.Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;5(5):CD008609. doi:10.1002/14651858.CD008609.pub2MedlinePlus.Phenazopyriine.

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM.Pelvic floor dysfunction: Prevalence and associated factors.BMC Public Health. 2023;23(1):2005. doi:10.1186/s12889-023-16901-3.Notenboom-Nas FJM, Knol-de Vries GE, Beijer L, et al.Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: a population-based study.Neurourol Urodyn. 2022;41:1739- 1748. doi:10.1002/nau.24996Wallace S, Miller L, Mishra, K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics and Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584American Society of Colon & Rectal Surgeons (ASCRS).Pelvic floor dysfunction.Louis-Charles K, Biggie K, Wolfinbarger A, Wilcox B, Kienstra C.Pelvic floor dysfunction in the female athlete.Current Sports Medicine Reports.2019;18(2):p 49-52. doi:10.1249/JSR.0000000000000563Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).What causes pelvic floor disorders (PFDs)?van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, Pelger RCM, Hagenaars-van Miert CHAC, Laan ETM.Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy.Sex Med Rev. 2022;10(2):209-230. doi:10.1016/j.sxmr.2021.03.002Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).Pelvic floor disorders: Surgical treatment.Torosis M, Carey E, Christensen K, et al.A treatment algorithm for high-tone pelvic floor dysfunction.Obstet Gynecol. 2024;143(4):595-602. doi:10.1097/AOG.0000000000005536Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Prosko S.Optimizing pelvic floor health through yoga therapy.Yoga Therapy Today. 2016:32-35.National Association for Continence.How to relax your pelvic floor.MedlinePlus.Pelvic floor muscle training exercises.Smith AG, Miles VN, Holmes DT, Chen X, Lei W.Clinical trials, potential mechanisms, and adverse effects of arnica as an adjunct medication for pain management.Medicines (Basel). 2021;8(10):58. doi:10.3390/medicines8100058Derry S, Wiffen PJ, Kalso EA, Bell RF, Aldington D, Phillips T, Gaskell H, Moore RA.Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;5(5):CD008609. doi:10.1002/14651858.CD008609.pub2MedlinePlus.Phenazopyriine.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM.Pelvic floor dysfunction: Prevalence and associated factors.BMC Public Health. 2023;23(1):2005. doi:10.1186/s12889-023-16901-3.Notenboom-Nas FJM, Knol-de Vries GE, Beijer L, et al.Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: a population-based study.Neurourol Urodyn. 2022;41:1739- 1748. doi:10.1002/nau.24996Wallace S, Miller L, Mishra, K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics and Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584American Society of Colon & Rectal Surgeons (ASCRS).Pelvic floor dysfunction.Louis-Charles K, Biggie K, Wolfinbarger A, Wilcox B, Kienstra C.Pelvic floor dysfunction in the female athlete.Current Sports Medicine Reports.2019;18(2):p 49-52. doi:10.1249/JSR.0000000000000563Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).What causes pelvic floor disorders (PFDs)?van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, Pelger RCM, Hagenaars-van Miert CHAC, Laan ETM.Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy.Sex Med Rev. 2022;10(2):209-230. doi:10.1016/j.sxmr.2021.03.002Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).Pelvic floor disorders: Surgical treatment.Torosis M, Carey E, Christensen K, et al.A treatment algorithm for high-tone pelvic floor dysfunction.Obstet Gynecol. 2024;143(4):595-602. doi:10.1097/AOG.0000000000005536Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018Prosko S.Optimizing pelvic floor health through yoga therapy.Yoga Therapy Today. 2016:32-35.National Association for Continence.How to relax your pelvic floor.MedlinePlus.Pelvic floor muscle training exercises.Smith AG, Miles VN, Holmes DT, Chen X, Lei W.Clinical trials, potential mechanisms, and adverse effects of arnica as an adjunct medication for pain management.Medicines (Basel). 2021;8(10):58. doi:10.3390/medicines8100058Derry S, Wiffen PJ, Kalso EA, Bell RF, Aldington D, Phillips T, Gaskell H, Moore RA.Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;5(5):CD008609. doi:10.1002/14651858.CD008609.pub2MedlinePlus.Phenazopyriine.

Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM.Pelvic floor dysfunction: Prevalence and associated factors.BMC Public Health. 2023;23(1):2005. doi:10.1186/s12889-023-16901-3.

Notenboom-Nas FJM, Knol-de Vries GE, Beijer L, et al.Exploring pelvic floor muscle function in men with and without pelvic floor symptoms: a population-based study.Neurourol Urodyn. 2022;41:1739- 1748. doi:10.1002/nau.24996

Wallace S, Miller L, Mishra, K.Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women.Current Opinion in Obstetrics and Gynecology. 2019;31(6):485-493. doi:10.1097/GCO.0000000000000584

American Society of Colon & Rectal Surgeons (ASCRS).Pelvic floor dysfunction.

Louis-Charles K, Biggie K, Wolfinbarger A, Wilcox B, Kienstra C.Pelvic floor dysfunction in the female athlete.Current Sports Medicine Reports.2019;18(2):p 49-52. doi:10.1249/JSR.0000000000000563

Hill DA, Taylor CA.Dyspareunia in women.Am Fam Physician. 2021;103(10):597-604. PMID:33983001.

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).What causes pelvic floor disorders (PFDs)?

van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, Pelger RCM, Hagenaars-van Miert CHAC, Laan ETM.Pelvic floor physical therapy for pelvic floor hypertonicity: a systematic review of treatment efficacy.Sex Med Rev. 2022;10(2):209-230. doi:10.1016/j.sxmr.2021.03.002

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH).Pelvic floor disorders: Surgical treatment.

Torosis M, Carey E, Christensen K, et al.A treatment algorithm for high-tone pelvic floor dysfunction.Obstet Gynecol. 2024;143(4):595-602. doi:10.1097/AOG.0000000000005536

Anğın AD, Gün İ, Sakin Ö, Çıkman MS, Eserdağ S, Anğın P.Effects of predisposing factors on the success and treatment period in vaginismus.JBRA Assist Reprod. 2020;24(2):180-188. doi:10.5935/1518-0557.20200018

Prosko S.Optimizing pelvic floor health through yoga therapy.Yoga Therapy Today. 2016:32-35.

National Association for Continence.How to relax your pelvic floor.

MedlinePlus.Pelvic floor muscle training exercises.

Smith AG, Miles VN, Holmes DT, Chen X, Lei W.Clinical trials, potential mechanisms, and adverse effects of arnica as an adjunct medication for pain management.Medicines (Basel). 2021;8(10):58. doi:10.3390/medicines8100058

Derry S, Wiffen PJ, Kalso EA, Bell RF, Aldington D, Phillips T, Gaskell H, Moore RA.Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews.Cochrane Database Syst Rev. 2017;5(5):CD008609. doi:10.1002/14651858.CD008609.pub2

MedlinePlus.Phenazopyriine.

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