Pelvic Floor Dysfunction
Pelvic Floor Dysfunction encompasses a range of issues related to a "dysfunctional" pelvic floor. This can manifest as a pelvic floor that is too weak, slow, or loose (hypotonic). Conversely, it may also occur when the pelvic floor is "hypertonic," characterised by excessive strength, tension, or tightness. It can also refer to pelvic floor dyssynergia, which involves poor coordination of pelvic floor muscles.
The hypotonic and hypotonic pelvic floor can both present with symptoms such as bladder leakage or bladder urgency. However, weakness and hypertonicity do have some variations to their symptoms.
The hypertonic pelvic floor often co-exists with “persistent pelvic pain“
You can also simultaneously be tight AND weak.
Hypotonic "weak" Pelvic Floor
- Weak or loose pelvic floor
- Co-exists with bladder or bowel dysfunction, pain, or prolapse.
- Pain, if present, is often lower back or pelvic musculoskeletal pain, or poor postural control
- Often there a history of chronic straining, persistent coughing, regular repetitive heavy lifting, being overweight, difficult childbirth, or multiple pregnancies
Hypertonic 'tight" Pelvic Floor
- Tight, tense, or spasmed pelvic floor
- Co-exists with bladder or bowel dysfunction, pain, or prolapse.
- Pain is often lower abdominal, perineal, or pain with penetration (dyspareunia or vaginismus)
- Often there is a history of long term or repeating abdominal pain (e.g. painful periods, IBS), trauma (emotional, sexual, or physical), generalised body tightness, or overtraining
Treating Pelvic Floor Dysfunction
Effective treatment starts with a comprehensive assessment. This process includes a discussion of your medical history, covering areas such as bladder and bowel function, menstrual cycles, sexual health, obstetric history, gynaecological issues, and overall medical background. With your permission, a pelvic examination will include an assessment of the external vaginal area as well as an internal examination. For the internal assessment, a finger exam will be performed to evaluate the pelvic floor muscles, the position of the cervix, and to assess your pelvic floor strength and coordination. In some cases, I may request your additional consent to use a speculum to examine the internal vaginal walls.
Treatment will tailored to your specific needs, typically involving pelvic floor muscle training. This may consist of strengthening exercises, relaxation techniques, or coordination training. Additionally, a home exercise program may be recommended, incorporating specific exercises or stretches to support your progress.
NO REFERRAL REQUIRED