QUICKLINKS
What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction is an umbrella term intended to encompass pelvic pain regardless of the source. The pain might originate from the vagina, the bladder, the rectum, the pelvic floor muscles, or a combination of all four.
There are many different factors that can lead to an overactive pelvic floor, including:
- An injury that may cause the pelvic floor muscles to tighten as compensation.
- Trauma such as a fall onto the tailbone which causes the pelvic floor muscles to tighten protectively.
- Inflammation or an infection such as chronic urinary tract infections.
- Pelvic surgery that can cause scar tissue which irritates the pelvic structures.
- Stress, which can be stored in the pelvic floor muscles.
- Bladder or bowel dysfunction which causes the pelvic floor muscles to work extra hard.
Diagnosing Pelvic Floor Dysfunction
Women who are experiencing pelvic pain including lower abdominal, rectal, vaginal, and urethral pain, urinary frequency or urgency, inability to have sex or pain with sex, or difficulty with emptying the bowels may have an overactive pelvic floor. The best way to diagnose this condition is to schedule a consultation appointment with one of our providers, who will perform a physical exam to determine the cause of pain.
Pelvic Floor Dysfunction Treatment Options
The main goal of treatment for overactive pelvic floor muscles is to get the muscles to relax and then strengthen them. This can be achieved through a number of techniques including the following.
Biofeedback
This is a very common treatment that is done with the help of a physical therapist. Biofeedback may be used in a variety of different ways to retrain the pelvic floor muscles. One technique may include using special sensors and video to monitor the pelvic floor muscles as you try to clench or relax them. A physical therapist may then give feedback and work with you to improve muscle coordination. In many cases, physical therapy may also be done at the same time as biofeedback therapy.
Medications
Medications directed at decreasing pelvic spasms, reducing nerve sensitivity, and eliminating constipation can all contribute to alleviating pelvic pain.
Antispasmodics
Oral diazepam (Valium) has been used for years to reduce pelvic pain. Valium serves as a muscle relaxant, therefore, when given in small doses up to two times a day, some women will achieve pelvic floor relaxation. Valium can also be delivered in the form of a suppository. When inserted into the vagina up to four times a day, many women with severe pelvic muscle spasm will enjoy relief.
Neuropathic pain relievers
When antispasmodics are unsuccessful, the nervous system might be the source of pain. In this instance, medications aimed at diminishing nerve sensitivity can be very helpful. Gabapentin in an oral form or topical cream can diminish nerve pain.
Stool softeners
Stool softeners are meant to keep bowel movements soft and regular and are important for treating pelvic floor dysfunction. Some of these medications are over-the-counter and include MiraLAX® and Colace®.
Antidepressants
At higher doses, medications like amitriptyline (Elavil) and nortriptyline (Pamelor) are effective antidepressants. However, at very low doses, these medications have proven effective in treating nerve pain in men and women.
Breathing Techniques and Relaxation
Certain breathing techniques that can be done at home can be very helpful for healing pelvic and vaginal pain. Many people with pelvic pain breathe shallowly, so learning to breathe through the diaphragm can reduce strain on the pelvic floor muscles, improve circulation, and reduce body tension. Relaxation techniques such as yoga, meditation, and warm baths can also be helpful.
Pelvic Wand Therapy
Using an intravaginal dilator/wand is also a therapy option. This treatment can improve pelvic floor pain due to tension in the pelvic floor or tender areas. The wands are meant to be used to give the area that is experiencing tenderness a massage to reduce pelvic pain.
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