The pelvis contains a bowl of muscles that support the bowels, uterus, bladder, prostate and rectum. Muscles in the pelvic floor can become tight or loose, and dysfunction of their strength and function is associated with a long list of symptoms for women, but sometimes also for men.
Pelvic pain can develop when pelvic floor muscles are too tight, and can lead to painful intercourse, vulvar pain, constipation, low back pain, and pain with urination or urinary leakage. These symptoms of pelvic pain can be attributed to short, tight, tender pelvic floor muscles, often with myofascial trigger points. Myofascial pelvic pain describes pain within the pelvic floor musculature, connective tissue of the pelvis, and the associated fascia.
However when pelvic floor muscles are too weak, this leads to pelvic organ prolapse, or when the rectum, bladder, or uterus starts to fall into the vaginal canal. Women with pelvic organ prolapse often have symptoms of urinary or fecal leakage as well.
Management of myofascial pelvic pain syndrome often is best addressed through pelvic floor physical therapy, pelvic floor muscle training, and bladder and bowel lifestyle modification guidance. Biofeedback, electrical stimulation, trigger point injections into the muscles, topical hormone and medication cream, laser and heat therapies, as well as oral medications are also options for pelvic floor dysfunction symptoms.
Symptoms of pelvic floor dysfunction in women:
- Pain with intercourse
- Back pain
- Urinary leakage, urgency, or nighttime urination
- Vulvar pain or irritation
- Difficulty with sexual arousal
Symptoms of pelvic floor dysfunction in men:
- Testicular ache
- Pain with erections or ejaculation
- Low back pain
- Urinary changes