SAN FRANCISCO (KCBS RADIO) – Pelvic floor disorders affect roughly one in three women in the United States, leading many to suffer from a variety of symptoms, including bladder challenges and discomfort.
KCBS’ Bret Burkhart spoke to UCSF Health urogynecologist Dr. Abigail Shatkin-Margolis on this week’s episode of As Prescribed about these conditions.
“A typical patient [I see with a pelvic floor disorder] is either coming in feeling symptoms of vaginal bulge or protrusion from the vagina or uncomfortable sensation from the vagina,” the doctor explained. “It's identified that she has pelvic organ prolapse or a very common patient who comes to see us as somebody who really just doesn't have bladder control, feels increasing urgency, increasing frequency, needs to visit the bathroom often and has accidental leakage of urine at unintended or unwanted times.”
In most of these cases, the patients are usually not feeling any pain – and is different than pelvic pain issues.
“Pelvic floor disorders often have a lot to do with the anatomy and kind of where the pelvic organs are in relation to ‘normal,’” she explained. “Whereas pelvic pain, for instance, may not necessarily have anything to do with an anatomical change, but instead more to do with how there's nerve sensation or signaling from the pelvis to the pain receptors of the brain. We don't see it often within a urogynecology practice, but things like endometriosis or myofascial pelvic pain or dyspareunia, which is particularly pain with penetrative intercourse. These are also conditions that women unfortunately suffer from, but don't tend to fall under the category of pelvic floor disorders.”
As for prevention, the urogynecologist said doctors like her think about what some risk factors can be modified to cut down on the chance of developing such disorders.
She said some factors that can cause pelvic floor issues include pregnancy, the number of births that person may have had, the method of those deliveries, and weight.
One thing that can help people prevent such issues is thinking about how you use your pelvic floor muscles in day-to-day life.
“For instance, if you're going to lift something heavy or if you're going to pick your child up, it's really important that you try to exhale and contract both your abdominal core muscles, but also your pelvic floor core muscles,” Dr. Shatkin-Margolis stated. “Those types of habitual changes and working that into your daily activity routines really maintain protection for the pelvic floor and can likely reduce the likelihood that you have a pelvic floor disorder such as prolapse later in life.”
She noted that men can also experience pelvic floor disorders that present symptoms that are similar to women – particularly bladder and bowel issues. Some of those issues for men may also be related to prostate issues. Though, the doctor noted she exclusively works with female patients.
But for women who have pelvic floor disorders, Dr. Shatkin-Margolis said it is not something to be ashamed of or something to manage in silence.
“There are highly educated, highly trained subspecialists like myself who want to help women who are suffering from pelvic floor disorders,” she said. “There is such a profound change in women's quality of life when they do have treatment. So for example, like pelvic organ prolapse, there are both surgical and non-surgical things we can do to help women. A very common non-surgical thing we can recommend is pelvic floor physical therapy to help strengthen the pelvic floor muscles and reduce the symptoms of prolapse.”
That therapy can be up to 50 percent effective in some patients. There are also some surgical and non-surgical solutions to help manage bulge symptoms.
For urinary symptoms, the doctor said there are a wide range of potential solutions for patients.
“Aside from physical therapy, basic daily behavior and dietary changes that can improve bladder control,” Dr. Shatkin-Margolis explained. “We also have medications, acupuncture-like therapies, and even we use Botox in the bladder very often to help with bothersome urgency, frequency, and incontinence.”
She said these solutions are very effective and “very available”.
“We just want to get the word out there so that we welcome women in and empower them to really insist on an improvement in their quality of life.”