Is Your Lower Abdominal Pain Due to Pelvic Floor Dysfunction?

Any treatment for male pelvic floor issues should begin with a prostate exam to rule out other issues like prostate cancer, Pagliano adds.

2. Pain during intercourse is a common symptom

While pelvic floor dysfunction can cause an array of symptoms, “the biggest tip-off for me, is [women having] pain with intercourse,” Mahajan says. Other typical symptoms include a feeling of pelvic pain or pressure, pain as urination finishes or pain with a pelvic exam, she adds.

Constipation can also be misdiagnosed. “I see patients all the time going, ‘Obviously, I have irritable bowel syndrome, and I’m not responding to any other therapies,’ ” Brenner says. “And I say, ‘Maybe it isn’t just irritable bowel syndrome. Maybe the muscles in your pelvic floor don’t work.’ ”

Incontinence — peeing when you laugh or sneeze, or having to race to the bathroom so you don’t leak in your underwear — can be another sign of pelvic floor issues, said Erin T. Carey, M.D., a gynecologist who specializes in pelvic floor disorders at the University of North Carolina School of Medicine.

Many physicians, though, are not used to checking pelvic floor muscles during a pelvic exam, so they will miss the reason for the pain or discomfort. “They’ll just think that [patients are] being overly reactionary,” Mahajan says.

If you ask your physician to do a pelvic floor muscle exam, they should be able to assess your muscle tone by pushing with their fingers on the muscles of the vagina, Carey says. For men, the exam would involve the rectum. “Even a good amount of pressure should not be painful,” Carey says.

3. Treating yourself could make things worse

Do not try to treat pelvic floor dysfunction yourself, says Jeffrey-Thomas. You could, for example, end up strengthening muscles that are already tight by trying to treat incontinence with Kegel exercises.

“For some people, Kegel exercises can be helpful in terms of building coordination and awareness and strength, but in some people that can make the problem worse,” she says.

Also, don’t buy a vaginal wand or other type of over-the-counter object without direction from a physical therapist, Carey says. It could potentially exacerbate your problem.

Your best bet is to find a physical therapist who specializes in pelvic health. The American Physical Therapy Association has an online locator where you can find someone near you. Even if you can only afford one or two appointments, it’s worth it, Carey says. “You want to make sure you’re doing the exercises correctly,” she adds.

Other treatments include meditation, yoga, “any kind of relaxation where [patients are] unclenching their pelvic floor muscles,” Mahajan says. Some of her patients do acupuncture for their pelvic floor; some are given muscle relaxants. For extreme cases, there are Botox injections, she says.

4. Pelvic floor dysfunction is often a result of trauma

Wondering how you ended up with this condition? Pelvic floor dysfunction is often the result of trauma — physical trauma to the muscles, or emotional trauma, often from childhood.

It’s not uncommon for women to develop pelvic floor dysfunction following childbirth, Carey says. Other physical causes include pelvic floor surgery, chronic constipation (constant pushing can create pelvic floor issues, which can then make the constipation worse), injuries to the pelvic floor area (such as from a car accident), obesity and aging. The condition can also be hereditary.

Brenner, the gastroenterologist, said when a patient comes in complaining of constipation and he suspects pelvic floor dysfunction, he asks about trauma. If pelvic floor muscles are clenching due to subconscious, emotional reactions, patients also need to do specialized clinical therapy, he says. “If you have a history of trauma or abuse and you don’t address that trauma or abuse, the pelvic floor physical therapy is invariably ineffective,” he explains.

Pelvic Floor Disorder vs. Dysfunction

Both conditions are common, both affect the pelvic area, and both have similar symptoms and causes. But pelvic floor disorders are different from pelvic floor dysfunction. A pelvic floor disorder, like pelvic organ prolapse, occurs when the muscles or connective tissues of the pelvic area weaken or are injured. Pelvic floor dysfunction is a result of tight muscles that won’t relax. The good news: Both can be treated once diagnosed.