The Pelvic Floor: How These Muscles Affect Your Everyday Life

Your pelvic floor muscles are some of the most important muscles in your body. But many people haven’t heard of them.

These MVPs give you control over your bladder and bowels. They’re also the muscle group that helps you have sex. When your pelvic muscles aren’t working properly, you can develop trouble holding in your urine and stool, pain during sex, and erectile dysfunction. 

So how can you keep your pelvic floor healthy? Here’s everything you need to know about your pelvic floor and how to make sure it stays strong. 

Which muscles make up the pelvic floor, and what do they do?

The pelvic floor is made up of two major muscle groups — the levator ani muscle and coccygeus muscle. These muscles hold the organs that sit in the pelvis in place, including the:

• Bladder and urethra

• Anus and rectum

• Uterus and vagina

• Prostate

Your pelvic floor muscles help control the openings (sphincters) where your urine and stool come out. 

They’re also part of your “core muscles,” so they stabilize your lower back and pelvis and let you keep your posture.

And they also play a role in sexual function and allow people to have an orgasm.  

What are the symptoms of pelvic floor dysfunction?

Pelvic floor dysfunction is a medical condition where the pelvic floor muscles aren’t working properly. You can develop pelvic floor dysfunction if your pelvic floor muscles are weak or if the muscles are too rigid. 

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In both cases, the pelvic floor muscles can’t contract the way they’re supposed to. And this causes symptoms like:

• Trouble holding in your urine (urinary incontinence)

• Feeling like you have to pee more often

• Dribbling urine when you cough or sneeze

• Trouble starting your urine stream

• Trouble holding in stool or gas

• Constipation

• Erectile dysfunction

• Trouble having an orgasm

• Pain with sex

• Lower back pain

What is pelvic organ prolapse?

People who have pelvic floor dysfunction can also develop pelvic organ prolapse. This is when the organs in the pelvic bulge into the vagina, rectum, or urethra. 

Pelvic organ prolapse can be difficult to treat and lead to all of the symptoms of pelvic floor dysfunction. 

Who develops pelvic floor dysfunction? 

Anyone can develop pelvic floor dysfunction. But certain things increase the risk of developing pelvic floor dysfunction, like:

• Pregnancy and childbirth: Pregnancy puts extra strain on the pelvic floor muscles. These muscles have to hold up the extra weight of a baby during pregnancy. They also get stretched during labor. The more times you undergo pregnancy and childbirth, the more likely you are to develop pelvic floor dysfunction.

• Aging: Muscles naturally get weaker with age. Pelvic floor muscles are no exception. Hormonal changes during menopause can also weaken the pelvic floor.

• Trauma: Trauma to the pelvic floor can lead to pelvic floor dysfunction. This includes injuries as well as surgeries, like hysterectomy (uterus removal) and prostatectomy (prostate removal).

• Muscle strain: Anything that puts extra stress on the pelvic floor muscles can lead to pelvic floor dysfunction. This includes frequent straining from constipation and sports that stress the pelvic floor muscles, like gymnastics, jumping, and running. Excess weight also increases the stress on the pelvic floor muscles and can lead to pelvic floor dysfunction. 

• Medications: Certain medications can weaken pelvic muscles, including some blood pressure medications, muscle relaxers, and certain pain medications

What’s the treatment for pelvic floor dysfunction?

There are many treatment options for pelvic floor dysfunction. The right one for you depends on your symptoms. Some options include:

• Strengthening exercises: If your pelvic floor muscles are weak, pelvic floor exercises can help. Kegel exercises are the most popular type of pelvic floor strengthening exercises. Doing these exercises correctly can be tricky, so you may want to work with your provider or a physical therapist to make sure you have the right technique. Your physical therapist may even use biofeedback to help you perfect your technique. 

• Relaxation exercises: If your pelvic muscles are too rigid, you may need to practice pelvic floor relaxation exercises. Pelvic floor physical therapy teaches you these exercises along with massage therapy you can do at home. 

• Diet changes: Increasing your fiber intake can help lessen constipation. And avoiding certain diet triggers — like caffeine, alcohol, sweet foods, and spicy foods — can help lessen urinary incontinence.

• Medications: If you have urinary incontinence because of pelvic floor dysfunction, medications like tolterodine or mirabegron can help. Topical estrogens can also help if you’re going through menopause or having pain with intercourse. 

• Procedures and medical devices: For some people, nerve stimulation can help relieve incontinence. If you have vaginal prolapse, a pessary can help. A pessary is a plastic or silicone device that can be inserted into the vagina to stop organ prolapse.

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Written by:

Jennifer Clements, MD, MSEd, NBHWC

Jennifer Clements, MD, MSEd, NBHWC, is a board-certified physician and health coach who believes in achieving optimal health through healthy lifestyles. She’s a diplomate of the American Board of Obesity Medicine.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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