7 Pelvic Floor Dysfunction Myths, Debunked

Pelvic floor dysfunction is much more common than you may think. And unfortunately, there’s many misconceptions and myths floating around about this topic.

Without a comprehensive guide, or individualised support from a pelvic health physio, it can be challenging to distinguish fact from fiction.

Here are the most common pelvic floor dysfunction myths you need to know. 

What is the pelvic floor?

The pelvic floor is comprised of muscles and fascia that form a sling or hammock across the bottom of the pelvis, to support the pelvic organs. In women (or people AFAB) the pelvic organs are the bladder, uterus and rectum. The pelvic floor infrastructure plays a crucial role in many bodily functions including sexual function, bladder and bowel control. 

What is pelvic floor dysfunction (PFD)?

Widely speaking, PFD is an alteration of normal pelvic floor muscle function. In particular, if this alteration results in any degree of bother to the individual, and, there are associated signs/symptoms/findings which correlate with the bother. Essentially, PFD is an umbrella term to describe improper functioning of the pelvic floor.

(Frawley H et. al ICS Report on Terminology for Pelvic Floor Muscle Assessment, Neurourol Urodyn. 2021)

Pelvic floor myths

Myth 1: Only women experience PFD

All of us have a pelvic floor, and therefore we can all experience PFD. It can affect all genders, across all age groups. In women, things like pregnancy, childbirth and menopause can predispose someone to PFD. In men, things like prostate surgery can predispose someone to PFD. In all genders, things like chronic constipation, obesity and ageing can also be risk factors. 

In all genders, PFD may manifest as urinary incontinence, difficulty with bowel movements, pelvic pain, and pain with intercourse.

Myth 2: PFD is a natural part of ageing

While age can definitely play a role in our health, PFD is not simply an inevitable consequence of getting older. Lifestyle choices, hormonal changes, and comorbidities can impact the pelvic floor muscles and their function over time. 

In women, the strain of pregnancy (particularly if multiple) and vaginal deliveries can weaken the pelvic floor. Without appropriate guidance and management this may lead to symptoms including urinary incontinence and pelvic organ prolapse. 

Proactive measures including pelvic floor muscle strengthening, maintaining a healthy weight, and practicing good bladder and bowel habits, can help to reduce the likelihood of negative symptoms developing. Early intervention, including pelvic floor physiotherapy, can play a crucial role in preventing and managing PFD.

Myth 3: Surgery is the only treatment for PFD

Surgery is definitely not the only treatment option or cure for PFD. There’s a wide range of non-surgical treatments that can be appropriate (or even preferred) for individuals based on their assessment findings, symptoms, and degree of bother. For example, pelvic floor physiotherapy focuses on strengthening and coordinating the muscles through targeted exercises and techniques such as biofeedback. 

Following an individual assessment, supervised pelvic floor muscle training can improve some symptoms of PFD - such as pelvic organ prolapse, stress and mixed urinary incontinence, and faecal incontinence. Lifestyle modifications such as maintaining a healthy weight, practicing good bladder and bowel habits, and practicing breathing and relaxation techniques can further support pelvic floor health. 

These non-surgical approaches can not only address symptoms but also address underlying issues contributing to PFD, offering individuals a holistic approach to managing PFD without resorting to surgery unless completely necessary.

Myth 4: Pelvic floor muscle exercises are the cure-all for PFD

Pelvic floor muscles typically involve contracting and relaxing the pelvic floor muscles to improve coordination, strength and endurance. While these can be beneficial when done correctly, performing them without a personalised plan may do more harm than good. They also may not address or fix other contributing factors such as lifestyle factors. 

An effective approach involves individualised assessment and treatment, considering individual needs and circumstances. At Papaya Clinic we work with women to develop customised treatment plans to ensure comprehensive care to manage and improve pelvic floor function. 

Myth 5: PFD is just incontinence

As discussed above, PFD encompasses a wide spectrum of conditions and symptoms, not just urinary incontinence or leakage. Urinary and faecal incontinence can be common signs of PFD, but pelvic pain or pain with intercourse also fall under the PFD umbrella. 

For some, PFD will be just one or two isolated issues, while for others it may be multiple symptoms simultaneously. Therefore, it’s important for people to get a personalised assessment and diagnosis to ensure appropriate and effective treatment. 

Myth 6: You should avoid exercise if you have PFD

In fact it’s usually the opposite! Appropriate physical activity can be really beneficial for pelvic floor health. Exercise can help to maintain overall fitness, good circulation, and appropriate weight management - these all can contribute positively to pelvic floor function. 

Low-impact activities such as walking, swimming and cycling are generally well tolerated and can support pelvic floor stability. Supervised pelvic floor muscle training will also be important to help strengthen and support the pelvic floor.

Myth 7: PFD will resolve on its own

It can be tempting to hope that your PFD will spontaneously resolve on its own, especially if your symptoms are mild or intermittent. However, waiting for symptoms to worsen before seeking help may lead to more serious complications or delayed recovery. Early intervention and treatment are crucial in managing PFD effectively. 

What can be mistaken for PFD?

Several conditions may share some symptoms with PFD, leading to either misdiagnosis or improper management. 

1. Urinary tract infections (UTIs)

2. Irritable bowel syndrome (IBS)

3. Endometriosis 

4. Interstitial cystitis (IC)

5. Pelvic inflammatory disease (PID)

6. Musculoskeletal issues 

7. Psychological factors

What can worsen PFD?

1. Chronic constipation 

2. Frequent heavy lifting (without proper technique) 

3. High-impact exercises (without proper support or pelvic floor muscle strength)

4. Poor posture 

5. Obesity 

6. Chronic coughing or sneezing 

7. Hormonal changes 

8. Ignoring symptoms and delaying treatment 

9. Poor fluid intake or diet 

10. Repeated vaginal deliveries

The wrap up

It’s important to have a good understanding of your own body, and work with trusted professionals to ensure appropriate management and support of any symptoms or conditions. 

At Papaya Clinic we take an integrated approach to women’s healthcare. If you’re ready to empower yourself with accurate knowledge and professional support to support your pelvic health journey, take the next step and book an appointment with one of our pelvic health physios.