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Pelvic Floor Disorder Symptoms — from Itchy Vulva & Weak Orgasm to Low Back Pain

Have you ever had a dull ache or burning sensation in your vulva? Maybe you've noticed the occasional bladder leak when you laugh or cough? Or perhaps you've found sex to be a little (or very) painful at times? It may not be something you feel comfortable talking about, but it definitely has you curious — and possibly a little worried.

We're so glad you're paying attention to this too-often-ignored part of your body. When something is off with your vulva, vagina, bladder, bowels, or the muscles and joints of your midsection, it can be due to pelvic floor dysfunction (PFD).

PFD is extraordinarily common. Every year 40 million people born with vaginal anatomy experience pelvic floor dysfunction. The good news is pelvic floor physical therapy is highly effective at preventing or treating PDF.

Let's take a deep dive into your amazing pelvic floor and the top symptoms of PFD that you should be aware of.

What is pelvic floor dysfunction?

First of all, allow us to introduce you to your pelvic floor muscles. These are a multitasking group of muscles that sit at the bottom of your pelvis and are critical to healthy bowel, bladder, and sexual function.

a diagram of the pelvic floor

The pelvic floor muscles work in tandem with your abdominals, diaphragm, back, and hip muscles and are responsible for the following functions:

  • Provide stability to your low back and pelvis to facilitate powerful, pain-free movement
  • Lift and support your pelvic organs (bladder, bowel, uterus)
  • Improve blood flow and circulation in pelvic area
  • Help to prevent bladder and bowel leaks (incontinence)
  • Support your uterus during pregnancy and assist in childbirth
  • Help bowel and bladder function by preventing leakage and allowing for easy and pain-free emptying
  • Enhance sexual pleasure and allow for pain-free intercourse

A healthy pelvic floor is strong, flexible, coordinated and works without you really having to think about it — that is until it become weakened or injured. Known as pelvic floor muscle dysfunction, weak and/or injured pelvic floor muscles can't function properly, which can lead to a host of symptoms.

Bladder symptoms that can signal a pelvic floor disorder

The pelvic floor muscles are integral in supporting the bladder and urethra, and facilitating normal bladder function. Your pelvic floor muscles should also be strong and agile enough to support your bladder as it fills, and hold in pee no matter how much you run, laugh, or dance around. At the same time, your pelvic floor should allow you to easily and fully empty your bladder at the right time and place.

Alas, when pelvic floor muscle dysfunction is at play, bladder symptoms can pop up. If you notice any of the following symptoms, you may have PFD:

  • Bladder leakage when you run, laugh, sneeze, or do any activity that causes pressure on your bladder.
  • You have to pee a lot. More specifically, you find yourself running to the bathroom more than once every two hours.
  • Alternatively, you can hold your bladder all day, or pee less frequently than once every 5 hours.
  • It feels difficult to start your urinary flow, your urinary flow starts and stops or feels weak, or you feel like you cannot fully empty your bladder.
  • You have pain or discomfort when you pee — but your physician assures you that you don’t have a UTI or STD.
  • When you have to pee it feels urgent, like you’re not going to make it to the bathroom on time. The feeling of urgency may even lead to leakage.
  • No matter how many kegels you do, bladder leakage continues — or is worse.
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Bowel symptoms that can signal a pelvic floor disorder

Similar to supporting your bladder function, your pelvic floor muscles help to prevent leakage of gas or feces during the time in between trips to the bathroom, and then help you easily empty your stool by lengthening and opening.

Whether your muscles are weak and underactive, or tight and inflexible, your bowel function is often impacted by muscle dysfunction. Check out the following bowel symptoms that may indicate pelvic floor dysfunction:

  • It’s difficult to poop, and you have to strain to empty.
  • On the regular, you have fewer than 3 bowel movements a week.
  • It’s painful when you have a bowel movement.
  • You can’t seem to avoid leaking stool and/or gas.
  • It takes forever to clean up after a bowel movement — The Tushy is your new bathroom must-have.
  • Every time you have to poop, it is urgent — it feels like you will have an accident if you don’t rush to the bathroom immediately.

Sex symptoms that can signal a pelvic floor disorder

Your pelvic floor muscles have so much to do with your sexual function. They help pump blood flow to your genitals during arousal, they help increase sensation during penetration, and they contract during orgasm to enhance pleasure. But pelvic floor muscle dysfunction can also cause a lot of trouble, leaving a wake of symptoms to keep an eye out for:

  • Whether it is solo sex, partnered sex, penetrative sex, or outercourse, sex hurts.
  • Orgasms are painful, or you feel lingering cramps even after the orgasm is gone.
  • Since having a baby, sex just feels different. It’s not painful, you just feel “less” during penetration, or stimulation of any kind.
  • It’s difficult to have an orgasm, or it takes an extraordinary amount of time to O.
  • It’s painful or impossible to insert a finger or tampon. Don’t even think about a penis or dildo.

More pelvic floor disorder symptoms to watch for

Beyond sex, your bowel, and your bladder, there are a few other symptoms to keep an eye out for:

  • It feels like something is falling out of your vagina — kind of like that feeling you get when it’s time to change your tampon.
  • Your pelvic floor just feels heavy, especially after a long and busy day.
  • You see, or feel some sort of skin dropping out of your vagina.
  • Your vulva burns, or itches constantly — the thought of yoga pants, or thong panties feels like torture — but your physician isn’t able to find any infection or skin condition.
  • Your pelvis, hips, or low back are hurting.
  • Your tailbone aches.
  • You always have to reach for the gel cushion in spin class to avoid burning, numbness, tingling or pain. 60 minutes on that bike seat is impossible otherwise.
  • You clench your jaw, grind your teeth, or have TMJ pain.
  • You have plantar fasciitis.

We've got you!

If any of these symptoms resonate, you may want to consider your pelvic floor, and reach out to one of our pelvic physical therapists. They will help you understand if the symptoms you are experiencing are related to pelvic floor muscle dysfunction, and work with you to find a treatment plan to help you improve your symptoms. Still unsure? Take this quick quiz to learn more.

Ashley Rawlins Headshot
Dr. Ashley Rawlins, PT, DPT

Dr. Rawlins is a physical therapist at Origin who specializes in the treatment of pelvic floor muscle dysfunctions including pelvic pain, sexual dysfunction, pregnancy related pain, postpartum recovery, and bowel and bladder dysfunction. In addition to being a practicing clinician, she is a passionate educator and author.

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