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What causes PFD?

In general, a pelvic floor disorder is due to weakened pelvic muscles or tears in the connective tissue. A damaged pelvic floor cannot continue to provide the support that your organs need to work effectively. As this structure weakens, normal functioning of the bowel, bladder, uterus, vagina, and rectum can be affected 

Symptoms of PFD include:

  • Urinary urgency, frequency, hesitancy, stopping and starting of urine stream, painful urination, or incomplete emptying

  • Constipation, straining, pain with bowel movements

  • Unexplained pain in the low back, pelvic region, genital area, or rectum

  • Pain during or after intercourse, orgasm, or sexual stimulation

  • Uncoordinated muscle contractions causing the pelvic floor muscles to spasm



Sometimes simple changes and interventions significantly affect daily quality of life. Urogynecologists provide a variety of treatment options, depending the severity of the condition, one’s general health, and preferences. Often doctors recommend a combination of therapies. PFD treatments include lifestyle and behavioral changes or procedures and surgery.

Lifestyle & Behavior:

  • Diet and Fitness

  • Pelvic Floor Muscle Exercises (Kegels)

  • Bladder Retraining

  • Pantiliners, Pads, Briefs, and Diapers

  • Physical Therapy, for the pelvic floor.

  • Vaginal Devices (Pessary)Medicines

Procedures & Surgery:

  • Nerve stimulation

  • Bulking agents

  • Surgery


What are the risk factors?

One out of four women (25%) 20 years or older suffer with PFDs. Most struggle with one or more PFDs—POPurinary incontinence (UI), and fecal incontinence (FI—also called anal incontinence or accidental bowel leakage).

Life Stage

  • Pregnancy/Childbirth: Childbirth can contribute to the development of PFDs, because it can put excessive strain on the pelvic floor during delivery. Vaginal births double the rate of pelvic floor disorders compared to Cesarean deliveries or women who never gave birth.

  • MenopauseThe pelvic floor muscles often weaken during menopause, which can lead to the development of pelvic organ prolapse (POP).

  • SeniorThe strength of the pelvic floor deteriorates as women age, which can also lead to the development of POP.

Race and Ethnicity

  • Genetic: Some women are born with weaker pelvic floor muscles. This puts them at a greater risk for PFDs. If your mother or sister have a PFD, you are at higher risk of developing one.

  • Race: Caucasian women are more likely to develop prolapse and to have urine leakage related to coughing, sneezing and activities. African American women are more likely to have urinary leakage related to urgency.

  • Ethnicity: Mexican American women are more likely to struggle with urinary incontinence than other Hispanic/Latino women. However, this difference may reflect a reluctance to seek medical care and/or language barrier.


  • Obesity: Overweight or obese women have increased pressure on the bladder and often lack strength in their pelvic muscles. They are at an increased risk of developing POP and urinary incontinence (UI).

  • Diet: When there is not enough fiber or water in a woman’s diet, bowel movements are more likely to be hard or irregular. Processed foods can lead to constipation. Certain foods also can irritate the bladder, making women feel like they have to urinate. Bladder irritants include caffeine and alcohol.

  • Smoking: Women who smoke increase their risk of developing POP and UI. If you smoke, quit now. Smoking is generally not good for bladder health. It also can damage connective tissue in your body, including the tissue in your pelvic area.

  • Heavy Lifting / Exertion: Certain occupations, usually those that involve heavy lifting or exertion can increase the risk of developing PFDs. Repetitive strenuous activity is also a risk. For some women, stair climbing can cause leakage.

Health Problems/Medical History

  • Constipation/Chronic Straining: Straining with constipation puts significant pressure on the weak vaginal wall and can further thin it out. This increases the risk for prolapse.

  • Pelvic Injury/Surgery: Loss of pelvic support can occur when the pelvic floor is injured from falls, car accidents or surgery. Hysterectomy and other procedures that treat pelvic organ prolapse can sometimes cause further prolapse.

  • Lung Conditions/Chronic Coughing: Chronic respiratory disorders can cause increased pressure in the abdomen and pelvis, which increases the risk of POP.

  • Sexual Dysfunction: Pelvic floor symptoms are significantly associated with reduced sexual arousal, infrequent orgasm, and painful intercourse (known in medical terms as dyspareunia).

  • Health Conditions or Injuries That Affect the Nerves: For example, diabetes, Parkinson’s disease, stroke, back surgery, spinal stenosis, or childbirth can weaken the pelvic floor muscles.

  • Emotional Stress: Emotional stress can make you feel anxious and that you need to go. For some, it can also result in loose stools.

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