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

To determine whether you might be dealing with an overactive or underactive pelvic floor, join my email list HERE. You will receive a quiz that’s a great starting place to help determine your specific pelvic floor needs.

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

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