Do you have a constant urge to pee? Are you leaking urine? Do you feel pressure in your vagina? One of the most uncomfortable — and awkward — conditions that afflict women are pelvic floor disorders.

One in three women will experience a pelvic floor disorder in the course of her lifetime. Yet, many won’t talk about it. Research suggests women often wait about six and a half years to talk to their doctor about their bladder problems.

Your pelvic floor is the group of muscles and ligaments in your pelvic region. Contracting and relaxing these muscles allows you to control your bowel movements and urination.

Typically, the pelvic organs — the bladder, uterus, vagina and rectum — are supported and held in place by the pelvic floor. Sometimes this support system becomes stretched or torn, making it hard to control the pelvic floor muscles.

Life events or conditions can weaken the pelvic muscles or tear connective tissue. Some causes of pelvic floor disorders include:

• Childbirth (particularly vaginal delivery)
• Pelvic surgery (hysterectomy)
• Radiation treatment in the pelvic area
• Menopause
• Aging
• Extreme physical activity or lifting of heavy objects
• Conditions such as obesity, constipation or a long-lasting cough
• Genetic or hereditary factors

Pelvic floor disorders include bladder and bowel problems and prolapse of the female organs:

• Urinary incontinence (UI). UI is common among women, with close to 18 million women dealing with some form of incontinence. There are two main types of UI:
  • Stress – urine leakage during certain activities, such as sneezing, coughing or exercise
  • Urge (overactive bladder) – urine leakage after a sudden urge to go
• Pelvic organ prolapse. When this occurs, the pelvic floor muscles weaken, causing one or more of the pelvic organs to fall downward into or out of the vagina. Its name depends on which organ is affected:
  • Cystocele – the bladder protrudes into the vagina, creating a bulge
  • Uterine – the uterus bulges or slips into the vagina
  • Vault – the top of the vagina drops down into the vaginal canal
  • Rectocele – the rectum bulges into the back wall of the vagina
  • Urethrocele – the urethra bulges into the vagina
  • Enterocele – the small intestine bulges against the back wall of the vagina

Not sure if you may have an issue? Use this screening tool to find out. If you answer "yes" to one or more of the below questions, talk to your physician about your symptoms and ask to be referred to a urogynecologist:

Bladder control symptoms

• Do you lose urine when you cough, sneeze or exercise?
• Are you using the bathroom so often it disrupts your day?
• Do you find yourself making a mental note of where all the bathrooms are when you enter a building?
• Do you find it hard to make it to the bathroom, maybe even having an accident sometimes?
• Are you using pads or other forms of protection to absorb bladder leakage?

Prolapse symptoms

• Are you experiencing pressure or bulging in your vagina, especially after standing for long periods?
• Do you feel something protruding or coming out the vaginal opening?
• Have tampons become too uncomfortable to use or do they fall out?
• Have you ever been told your uterus or bladder has dropped?
• Has your urine stream become weak or turned into a spray?

Many women experience a pelvic floor disorder. If you're one of them, you don’t have to live with it. Find a doctor now so you can get back to life as usual.

The Women’s Center for Pelvic Medicine at Edward-Elmhurst Health has board-certified, fellowship-trained urogynecologists who specialize in the treatment of pelvic floor disorders. We offer surgical and non-surgical approaches to the management of urinary incontinence, voiding difficulties, uterine and vaginal prolapse, genitourinary fistulas and mesh-related complications.

Roberta Blandon, M.D., is a urogynecologist with the Women’s Center for Pelvic Medicine at Edward-Elmhurst Health. Read her profile. 

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