Pelvic Floor Dysfunction (PFD)

PFD: What It Is, And How To Help - Pelvic Floor Dysfunction (PFD) is a term that describes a wide range of symptoms that can occur in the pelvic region. Many women experience PFD after giving birth, and the risk of PFD increases with age. Learn more about PFD and how to get help. | FemFusion Fitness

In January 2017 I announced a slight change in direction for my YouTube channel. Instead of shying away from issues related to pelvic health and pelvic floor dysfunction, I was ready to shine some light on these subjects.

This was a big step for me and something that I was a little nervous about. How would people respond? Would everyone UNSUBSCRIBE?

To my astonishment, the response was overwhelmingly positive. Over the last 8 months (since making the announcement) my subscriber count MORE THAN DOUBLED, and as of today, my channel has had more than 2,050,000 views. (WaHOOOOO!!!!! Thanks so much for joining me over on the ‘Tube!!!)

This rapid growth indicates that people are HUNGRY to learn more about “taboo” subjects such as painful sex, bladder leakage, pelvic organ prolapse, and more. People are opening up to pelvic health issues and are more willing to learn about them than ever before!

For this reason, I want to define and describe pelvic floor dysfunction (PFD).

PFD became a buzzword last Spring when Zosia Mamet (one of the stars of HBO’s Girls) publicly spoke about her experience with PFD, which caused her years of sexual difficulties, pain, and problems with urination. Mamet also described how she was misdiagnosed, was prescribed medication that made her gain weight and feel depressed, and ultimately, was told that her condition was all in her head.

Mamet’s story is not unique. Millions of women and men suffer from various forms of PFD and feel just as alone and “crazy” as Zosia describes. Why? Because despite the growing awareness about PFD, the pelvic floor remains shrouded in mystery and (sadly) shame. Furthermore, discrimination against—and apathy toward—people with PFD continues to be a problem, even amongst some healthcare providers.

PFD: What It Is, And How To Help

Pelvic Floor Dysfunction (PFD) is a term that describes a wide range of symptoms that can occur in the pelvic region. Many women experience PFD after giving birth, and the risk of PFD increases with age. Unfortunately, due to embarrassment, many women suffer in silence and know very little about what’s happening “down there.”

Let’s go back to the first part of the term, the “PF,” or the pelvic floor. The pelvic floor is a group of muscles situated at the base of the pelvis. The pelvic floor muscles are a support system for your abdominal and pelvic organs. They also help close off the orifices they surround, including the urethra, vagina, and anus in women, and the urethra and anus in men.

The female pelvic organs and pelvic floor | FemFusion Fitness

The “D” in the term PFD refers to a lack of—or a change in—function of the pelvic floor muscles. This usually presents as weakness or excessive tension in the pelvic floor.

What does this “D” look like? To keep things simple, let’s break it up into a few broad categories:

  • Dysfunction manifesting as a lack of support (causing issues such as pelvic organ prolapse or back pain).
  • Dysfunction manifesting as a lack of closure (causing issues such as bladder leakage, fecal incontinence, or unintentional “slips” of wind).
  • Dysfunction manifesting in too much closure, or an inability to relax the pelvic floor muscles. This can cause painful sex, difficulty initiating the stream of urine, and generalized pelvic pain that is often felt in the buttocks, tailbone, or groin.

Whether weakness or excessive tension is the primary dysfunction, a lack of coordination and control of the pelvic floor (and surrounding) muscles is usually the ultimate concern. Thankfully, there is help in the form of pelvic floor physical therapy. (Find a women’s health physical therapist here.)

Why aren’t more people getting help?

Despite rising awareness about PFD, many people are still embarrassed and ashamed to admit they have problems such as bladder leakage, sexual pain, and problems on the toilet. It can feel “weird” to talk about these issues with family and friends, and awkward to discuss them with a healthcare provider with whom you may only have a brief consultation. Many individuals would rather ignore their pelvic floor problems (or deal with them on their own) than discuss their “dirty little secrets” with a provider who is often a stranger—and a rushed stranger at that.

To make matters worse, since these problems are only just now starting to be openly discussed, some healthcare providers are not yet aware that there are conservative (non-invasive, non-pharmacological) treatment options such as pelvic floor physical therapy.

From not knowing where to send clients, to discouraging offhand comments, to frank belittlement, I’ve collected a range of stories from women who have described their providers’ lack of sympathy and lack of awareness about potential treatment options for PFD.

One of my readers was diagnosed with pelvic organ prolapse (a form of PFD) during a postpartum checkup. She was concerned, but her midwife commented, “prolapse is normal after childbirth, get used to it.” 

The midwife did not provide any suggestions for prolapse treatment; she did not offer any “next steps,” or precautions to prevent progression of the condition. Ultimately, the client left feeling like there was no hope.

Bringing PFD Into the Light

Thankfully, the story above will not be everybody’s experience. Many healthcare providers are fully aware of PFD signs and symptoms and are supportive and knowledgeable about conservative treatment options such as women’s health physical therapy (also called pelvic floor physical therapy).

If you have any of PFD symptoms, from painful sex to bladder leakage to the heaviness and discomfort of pelvic organ prolapse, please know that there is hope and there is help.

These under-discussed problems are MORE COMMON than you might think, and if you need help with something, speak up! Talk to your healthcare provider. If he or she doesn’t take you seriously or listen with compassion to your concerns, then talk to someone else. You know your body best… Heed its warnings if it tells you that something is “off.”

PFD Self-Help

For stories of real women who are dealing with PFD, watch this video:

To determine whether you might be dealing with an overactive or underactive pelvic floor, join my email list HERE. Fill in the blanks and check the box under “Pelvic Health Self-Help.” You will receive a quiz that’s a great starting place to determine your specific needs.

The following video is ideal for anyone with excessive pelvic tension (great for those with pelvic pain and/or a hyperactive pelvic floor):

Understand your body! Learn more about your pelvic floor and the common “kegel” exercise:

Prevent PFD! Try these “Toilet Tips for Pelvic Health:”

And finally… If you’re ready to start STRENGTHENING your core and pelvic floor, check out Ab Camp! You can find the downloadable, ad-free edition in the FemFusion Wellness Shop.

Thanks for being with me, and AS ALWAYS remember… Eat clean, move every day, and you WILL shine brighter.

With love,

Dr. Bri, PT, DPT


  • September 9, 2017

    Gail Longo

    Thank you for your work. I probably have the 4th stage of uterine prolapse. I had two children,and began kundalini Yoga soon after having ny firstborn in 1975. Oops!

    I am 74 this year. I never heard a thing about prolapse until the Doctor told me I had a cystocele.
    What was that? (Too bad I hadn’t seen your You Tube site.)

    I have always lifted heavy objects and moved furniture never knowing the importance of core strength or even what core strength meant. I heard that Isadora Duncan referred to that part of her body as the solar plexis,but didn’t look for the meaning behind it .

    I looked to find information about strengthening my core,because the medical physicians only offered the advice of kegel exercises,and nothing more..

    I am not an athelete but I walk as often as I can.

    So rather than having surgery and risking a blood clot,I decided to be fitted for a pessary. After that, everything was fine for awhile,then worsened. First off, The pessary they gave me was a huge donut which was painful to insert and felt impossible to remove. It was replaced with a more delicate example,and all went well for awhile.

    In addition, I chose to work out with a trainer but he knew nothing about my situation for strengthening the core appropriately, when I was suffering with this form of a hernia and I felt embarrased to explain my situation..

    I went along every day remaining ignorant of my body, accepting my situation and disappointed with the Doctors and support staff at the Clinic. I felt there was noone to help me learn more about the situation,and kegels were the only option.

    I remained busy being an early childhood educator and now I’m a grandmother.
    I remained happily occupied with my work and ignored my problem as best as I could.

    Recently I found your You tube excercises. I became very interested in talking with you or the Irish woman who chose to demonstrate how prolapse looks by using fabric models to show the 4 stages of prolapse .She held up the model of the vagina and cystocele, rectocele, uterus and bladder.

    I feel young women in high school need complete information about their bodies. They could begin learning about themselves in the Department of Family and Consumer Sciences in our public school classrooms . When they study the human lifespan they can begin to study changes in the body/brain of humans from birth to death. And even before high school ,teachers and parents can help children grow in awareness by exercising in ways that focus on all muscles to build core strength.

    I live in Seattle,and will be referring your site to educators who teach in the field of Health and Human Services. It’s about time that human models in schools show a more complete anatomy. I think it’s time to recognize how humans are beautifully wonderfully made, and as we understand more about our bodies, we can be free to make better choices to help ourselves.

    Thank you again for your attention to this subject.


    • September 10, 2017


      Gail, THANK YOU for your comment and for your support of bringing this information to MORE WOMEN (particularly young women and girls). Yes, it’s a shame that it’s not more widely discussed or understood. I feel strongly that things are changing in the RIGHT direction although we still have a long way to go. I’m glad you found this information now; even if it’s too late to reverse your prolapse you can still help manage it (prevent progression and keep your core muscles healthy and strong) AND you can help spread the word about the importance of understanding this region of the body. Sending love and light!