Frequently asked questions

Pelvic floor dysfunction is more common than many people realize. While symptoms like pelvic pain, bladder issues, or discomfort can feel isolating, you’re not alone.

For women, research suggests that up to 1 in 3 experience pelvic floor dysfunction at some point in their lives, with prevalence increasing with age, particularly after menopause.

For men, pelvic floor issues are also significant but often underrecognized. Studies estimate that chronic pelvic pain affects roughly 2–10% of men, and many experience prostate-related concerns over time, including Benign Prostatic Hyperplasia. In some cases, symptoms commonly attributed to conditions like prostatitis may occur without a clear infection, and can instead be related to pelvic floor dysfunction.

The encouraging news is that pelvic floor dysfunction is treatable, and conservative care such as physical therapy is often recommended as a first-line approach for improving symptoms and restoring function.

Female pelvic pain can have many different causes, and it’s often influenced by a combination of factors. Some of the most common include:

• Recurrent infections: Frequent vaginal or bladder infections

• Underlying medical conditions: Gynecologic, urologic, dermatologic, or gastrointestinal disorders

• Medications: Certain prescriptions, including oral contraceptives, acne treatments, and hormone therapies for conditions like Endometriosis and Polycystic Ovarian Syndrome

• Surgical or physical trauma: Childbirth, hysterectomy, or pelvic organ prolapse repair

• Musculoskeletal issues: Hip dysfunction, sacroiliac joint dysfunction, piriformis syndrome, scoliosis, or leg length differences

• Lifestyle factors: Prolonged or excessive sitting

• Hormonal changes: Menopause

• Chronic pain conditions: Vulvodynia, Interstitial cystitis / bladder pain syndrome

• Other contributing factors: Vaginal childbirth or genital cutting

Pelvic pain is highly individual. If you’re experiencing symptoms, even if the cause isn’t clear, booking an evaluation can help identify the root issue and guide effective treatment.

Male pelvic pain can stem from a variety of physical, medical, and lifestyle factors. Common causes include:

• Surgical procedures: Such as vasectomy, treatments for Benign Prostatic Hyperplasia, or prostatectomy

• Injuries or trauma: Issues involving the spine, hip, knee, or ankle, as well as accidents

• Musculoskeletal dysfunction: Hip dysfunction, piriformis syndrome, scoliosis, or leg length differences

• Exercise-related strain: Excessive training or sudden changes in exercise routines

• Prolonged sitting: Extended periods of sitting can contribute to pelvic discomfort

• Bowel-related strain: Chronic constipation and frequent straining

• Genital practices: Jelqing or other attempts at genital enhancement or foreskin restoration

• Post-infection sensitivity: In rare cases, lingering pelvic pain may occur after bladder, prostate, or sexually transmitted infections have resolved

Pelvic pain is often complex and unique to each individual. If you’re experiencing symptoms, contact us to help identify the underlying cause and guide effective treatment.

Incontinence is the loss of bladder or bowel control, meaning urine or stool may leak when you don’t intend it to. It can range from occasional minor leaks to a more frequent or urgent need to go, and it’s more common than many people realize.

Types of urinary incontinence

• Stress incontinence: Leakage occurs during physical activity or pressure, such as coughing, sneezing, laughing, or exercising.

• Urge incontinence (overactive bladder): A sudden, strong urge to urinate followed by leakage before reaching the bathroom.

• Mixed incontinence: A combination of stress and urge incontinence symptoms.

• Overflow incontinence: The bladder doesn’t empty fully, leading to frequent or constant dribbling.

• Functional incontinence: Physical or cognitive challenges (like mobility issues) prevent getting to the bathroom in time.
  

Types of bowel (fecal) incontinence

• Urge fecal incontinence: A strong, sudden need to have a bowel movement that’s difficult to control.

• Passive fecal incontinence: Leakage occurs without awareness or warning.
  

Incontinence can be caused by factors like muscle weakness, nerve issues, hormonal changes, or underlying medical conditions, and it’s often treatable. If you’re experiencing symptoms, book a consultation to determine the cause and the best path forward.

An internal exam can offer valuable insight into pelvic floor health, but it’s not always necessary, especially at your first visit. In most cases, we don’t perform internal exams during initial sessions. The decision depends on your symptoms, condition, pain level, and, most importantly, your comfort.

Care begins with a collaborative, patient-centered approach focused on external assessment and treatment. By evaluating movement, posture, and the muscles and tissues connected to the pelvic floor, we can often make meaningful progress without internal work. This also helps the body relax and can make any future internal treatment more comfortable, if it’s ever needed.

Your comfort is always the priority. Everything is explained beforehand, your consent is required at every step, and you’re free to decline or stop at any time. Alternative approaches are always available.

Research shows that this comprehensive approach to pelvic floor therapy is highly effective and is often recommended as a first-line treatment for concerns like incontinence, pelvic pain, and pelvic organ prolapse.

The pelvic floor muscles play a vital role in everyday health and function. Their main responsibilities include:

• Sphincteric (Control): Help prevent urinary and fecal leakage by controlling the bladder and bowel.

• Support: Provide support for internal organs, including the bladder, uterus (in females), and rectum.

• Stability: Contribute to core strength and help stabilize the spine and pelvic girdle.

• Sexual Function: Enhance sensation and satisfaction during sexual activity.

• Circulation Support (“Sump Pump”): Assist with circulation by helping move blood and lymphatic fluid from the lower body back toward the trunk.
  

These muscles work continuously, often without you noticing. When they’re not functioning properly, it can lead to symptoms like pain, incontinence, or instability, but with the right care, they can often be retrained and strengthened.

Pelvic floor dysfunction can develop for a variety of reasons, often influenced by a combination of physical, hormonal, and lifestyle factors.

Common risk factors include age and hormonal changes, particularly after menopause, as well as pregnancy and childbirth, especially with multiple deliveries or complications such as tearing or assisted delivery (forceps or vacuum). Excess body weight, chronic illness, and certain medications may also contribute.

A history of pelvic or abdominal surgery, including gynecological procedures or prostate-related surgeries like radical prostatectomy, can impact pelvic floor function. Conditions such as Benign Prostatic Hyperplasia (prostate enlargement) may also play a role for men.

Everyday habits matter too. Chronic straining from constipation or heavy lifting, prolonged sitting, and smoking can place ongoing stress on the pelvic floor. Additionally, factors like anxiety and stress may contribute to increased muscle tension and dysfunction.

While these factors can increase risk, they don’t guarantee you’ll develop pelvic floor issues, and many are manageable with the right care and guidance.

While not all cases can be prevented, there are simple, effective habits that can help support a healthy pelvic floor and reduce your risk over time.

Maintaining regular bowel habits is key. Aim for soft, easy-to-pass stools by staying well hydrated (urine should be a light, pale yellow) and avoiding straining. When using the toilet, sitting with your knees slightly higher than your hips(such as with a small stool) can help promote better positioning and reduce pressure.

It’s also important to avoid unnecessary “just in case” trips to the bathroom, as this can disrupt normal bladder function. Addressing issues like a chronic cough and practicing deep, diaphragmatic breathing instead of shallow chest breathing can further reduce strain on the pelvic floor.

Supporting your overall health matters too. Maintaining a healthy body weight, staying physically active, and managing daily stress all contribute to better pelvic floor function.

Finally, targeted pelvic floor exercises can be very beneficial, but proper technique is essential. Working with a pelvic floor physical therapist ensures exercises are done correctly and tailored to your specific needs.