The National Institutes of Health report that almost 24 percent of all American women age 20 and up are affected by pelvic floor disorders. This means that millions of individuals deal daily with these conditions and their consequences, like urinary or fecal incontinence or pelvic relaxation.

Obviously, pelvic floor disorders affect women in a personal and deeply intimate way. These conditions cause discomfort. Too often, and needlessly, they also can cause embarrassment and leave women silent, confined to their homes, and depressed.

Fortunately, there’s hope. The new subspecialty of urogynecology and reconstructive pelvic surgery has developed to help meet the needs of women with these problems. In addition, modern medicine has made huge strides in recent years in pelvic health research. New medical and surgical treatments have been developed. Progress continues.  In fact, doctors now have more—and more effective—treatment options than ever before. Plus, public education is demolishing the wall of silence and isolation surrounding these conditions. Many women now feel comfortable seeking help and talking to health care professionals.

One of the most important things any woman can do is learn more about these conditions. While individual situations vary greatly, we can talk in valid, general terms about these disorders.

To start, we need to know some anatomy. Women have muscle and connective tissue—known as the pelvic floor—at the pelvis’ opening. This floor holds in place the pelvic organs—the uterus, bladder, bowel, and rectum. The pelvic floor can stretch, weaken, or become tense. If this happens, pelvic organs may drop or, in medical terms, “prolapse.” Organs can go into the vagina or protrude from its opening outside the body. Pelvic problems can produce pain, difficulties with the bladder and bowels, and pain during sexual intercourse. The three most common disorders are pelvic organ prolapse and urinary and fecal incontinence. A patient may have more than one disorder.

Pelvic floor disorders have a variety of causes. Typical ones include vaginal childbirth, obesity, stress, chronic coughing, and straining during bowel movements. These disorders can occur at any age but the likelihood increases as women get older. An NIH study found that these conditions occurred only with about 10 percent of women aged 20 to 39 years. However, that rose to almost 27 percent for women aged 40 to 59, to almost 37 percent for women aged 60 to 79 years, and to about 50 percent for women 80 or older.

In addition, the chance of pelvic floor disorders increases with the number of times a woman gives birth. NIH reported that almost 13 percent of women who had never given birth reported having one of these conditions. That advanced to about 18 percent of women who had one child, to close to 25 percent of women who had two children and to more than 32 percent for women who had three or more children.

Naturally, treatment varies with the disorder. The patient’s general health and other conditions also will determine the best course to follow. Many patients find that their needs can be met with therapy that enhances the function of pelvic floor muscles. For example, Kegel exercises can improve urinary incontinence. These involve contracting the muscles that control urine flow.

Some patients benefit from medical treatments. Biofeedback also is an aid in pelvic floor muscle coordination and rectal and bladder sensation.

Surgery can be another option. In recent years, new surgical procedures and technology have achieved remarkable results. For instance, minimally invasive transvaginal and/or robotic surgery represent impressive advances. Minimally invasive procedures offer unique benefits. These operations require only small incisions compared to the larger ones needed in early treatments. As a result, the more modern approach can lead to quicker recoveries, less scarring and lower chances of infection.

I’ve seen thousands of patients and many dramatic improvements. Women who are affected by pelvic disorders should be proactive in getting help. If you have a pelvic disorder, you should:

• Seek help early. This will allow you to resume a normal, healthy life, and it will prevent a problem from getting worse.

• Learn all you can. You can glean much from qualified health care professionals. The Internet can be a source of information. Two of the most reliable sites are www.nichd.nih.gov/health and www.augs.org.

• Find a qualified doctor with whom you feel comfortable. Be sure to ask him/her about his/her experience, specialized training, and credentials. Choosing the right physician can have a profound positive effect on your health—physically and emotionally.

• Don’t be embarrassed. Remember you’re not alone. Pelvic disorders affect millions of women. Many of them found that modern medicine had the right solution for them. 

Christopher J. Walshe, M.D., FACOG, FACS is a fellowship-trained reconstructive pelvic surgeon and urogynecologist with Atlantic Uroygnecology in Suffolk. His office can be reached 757-686-4655.