Addressing pelvic health disorders

Nearly 1 in 3 women experience some form of pelvic health dysfunction. The pelvic organs include the uterus, bladder, large intestine and rectum. Pelvic floor issues are more common in women but also can affect men.

Common symptoms of pelvic health disorders include incontinence, frequency and urgency of urination, pelvic pressure or bulging, pelvic pain and sexual problems. Symptoms may cause some people to fear social settings outside their homes, feel isolated or experience sexual problems. These unseen issues can have an adverse effect on daily activities, work and relationships.

Factors that can contribute to pelvic health disorders include:

• Age
• Constipation
• Family history of pelvic health conditions, such as prolapse
• Genetic factors
• Menopause
• Occupational risks, such as heavy lifting
• Pregnancy
• Smoking

Take these steps to address pelvic health disorders:

1. Start the discussion.

Your primary care provider is a trusted partner in your overall health and well-being. Many people delay speaking with their health care team due to lack of information about pelvic floor disorders. Talking about your symptoms may be uncomfortable and seem minor to you compared to other conditions. But don't hesitate to talk about your pelvic health symptoms during an appointment or ask to be referred to a specialist.

2. Find reputable resources.

Learning about pelvic health disorders, risk factors and treatments can help you feel more comfortable speaking with your health care team. Look for information from trustworthy sources, such as Mayo Clinic, to get accurate and up-to-date resources about your symptoms.

3. Seek expert care.

Your primary care provider can refer you to a specialist who will evaluate your risk factors and symptoms. Your care team can provide options for the best combination of treatments ranging from lifestyle changes and physical therapy to medication or surgical options. No single treatment is appropriate for every pelvic health condition, so discuss your options with an expert for an individualized treatment plan.

Pelvic floor disorder treatments

Effectively treating pelvic health disorders takes a team approach. In addition to your primary care provider, your care team may include an OB-GYN, urologist, urogynecologist, and pelvic floor physical therapist.

Nonsurgical treatments

You may benefit from simple lifestyle modifications and exercises. As with other areas in the body, muscles and tissues lose strength and elasticity with age. Exercises like Kegels can build pelvic floor muscle strength and lessen your symptoms. Pelvic floor physical therapy also can address muscle weakness or tension that could be causing your symptoms.

Other nonsurgical options include medications and Botox injections into the bladder muscle to reduce the frequency of bladder contractions.

Many women find these nonsurgical treatment alternatives helpful in easing symptoms and improving quality of life.

Surgical treatments

Simple lifestyle changes, physical therapy or medications sometimes aren't enough to treat pelvic floor conditions, and surgery may be needed. The care team will work to understand your needs and determine goals to develop custom treatment plans.

Many surgeries are minimally invasive and often can be performed as outpatient procedures, meaning most patients can go home the same day.

Surgical treatment options include:

• Vaginal, laparoscopic or robotic surgery for pelvic organ prolapse.
• Mid-urethral sling or urethral bulking procedures for urinary incontinence.
• Sacral neuromodulation therapy for urge incontinence or fecal incontinence.

Many pelvic floor procedures are done vaginally, with no external incisions. This approach may help shorten recovery time and decrease restrictions following the procedure.

In the short term, most people will have minor restrictions for up to six weeks or less and can return to normal activities within a few weeks. Talk with your health care team about your healing time, including sexual activity.

For long-term success managing pelvic health, consider lifestyle changes to maintain a healthy weight and activity level.

Next steps:

• Watch a video about pelvic organ prolapse.
• Read about pregnancy and pelvic health.
• Learn how strengthening pelvic floor muscles can help prevent bladder leakage.
• Find pelvic health services and treatments near you.