Why You Should Talk to a Doctor About Pelvic Floor Dysfunction

By Bryan Roth
January 04, 2021
A provider speaks with a patient

Pelvic floor dysfunction, which includes conditions such as urinary incontinence, fecal incontinence, and pelvic organ prolapse, affects nearly one quarter of all women. Almost half of these women will experience uncomfortable symptoms by the time they reach their 60s. While pelvic floor dysfunction is common, no one should consider it a normal part of aging you should just deal with, said Katelyn Smith, MSN, FNP-C, a nurse practitioner at Duke Women’s Health Navaho in Raleigh.

“Being ‘common’ and being ‘normal’ are two very different things because you should never suffer through anything that’s treatable,” said Smith, who specializes in pelvic floor health in women. “We’re here to help get you back to a better place.”

Here, Smith and Dr. J. Eric Jelovsek, MD, a Duke urogynecologist who specializes in pelvic floor dysfunction, answer some common questions about pelvic floor dysfunction. Learn about conditions related to pelvic floor dysfunction, when you should see your doctor, and how to find relief.

What is the pelvic floor?

The pelvic floor is a collection of muscles that support your vagina, uterus, bladder, colon, and rectum. Pelvic floor muscles play a role in your sexual health and ability to enjoy sex. Childbirth and age-related hormonal changes can weaken your pelvic muscles. Problems including urinary or fecal leakage can occur when the pelvic muscles and tissue weaken and no longer provide enough support and control. Prolapse occurs when the vagina and organs in the pelvis drop into, and even outside of the vaginal opening.

What are the symptoms of pelvic floor dysfunction?

Urinary and fecal incontinence, feeling a vaginal bulge, and difficulty emptying your bowels during a bowel movement are common symptoms of pelvic floor dysfunction.  Feeling as though something is falling out of your vagina can be a sign of prolapse.

If you suffer from these symptoms, it’s important to seek medical care. “The time to share any problems with your doctor is when they become bothersome and before they begin to interfere with your quality of life,” Dr. Jelovsek said.

What happens if symptoms are left untreated?

Leakage or incontinence are not life-threatening, but they can gradually worsen over time. “Chronic conditions aren’t going to resolve themselves,” Smith said. Avoiding treatment can result in more discomfort and possibly cause additional damage that could make it harder for you to enjoy your daily activities without medication or complex care.

Should I see a specialist?

Talk to your primary care doctor or gynecologist if you notice changes in bathroom use or start experiencing bothersome symptoms in your pelvis. This is especially important if you’re an older woman and more susceptible to these disorders.

As a specialist in treating pelvic floor dysfunction and its symptoms, a urogynecologist can conduct precise tests to accurately diagnose your condition. Because they focus their practice on treating women with these conditions, they can recommend the most effective treatment.

How are pelvic floor disorders treated?

The right treatment depends on your condition. We offer a variety of treatment options that range from simple, non-surgical approaches like at-home Kegel exercises and physical therapy to injections and nerve stimulation. More serious conditions may be corrected or repaired with surgery.

Will I need surgery to fix pelvic floor dysfunction?

That will depend on the severity of your condition. In some cases, a urogynecologist may recommend a procedure to correct prolapse or provide support to prevent incontinence. Some can be performed vaginally and require no external incisions.

Is pelvic floor surgery covered by insurance?

Pelvic floor dysfunction is a medical condition, and surgical procedures are covered by insurance, said Dr. Jelovsek. “There’s often a perception that surgery is a cosmetic procedure because it’s not a life-threatening condition, but this is about improving your quality of life,” he said. “We never want anyone to suffer simply because they think that these types of treatments are not covered by Medicare and insurance companies.”