Know the Surprising Signs of a Weak Pelvic Floor

If you’ve ever leaked when you laughed, even if it was only the tiniest bit, you already know what can happen when your pelvic floor is getting weak. But that's just the tip of the iceberg when it comes to the symptoms you could (or might already) be experiencing due to a lack of strength in these small yet significant muscles.

Your pelvic floor muscles play a crucial role in supporting your pelvic organs and controlling bladder, bowel, and sexual function — and yet, they often go unnoticed until something goes wrong. (Wondering where, exactly, your pelvic floor muscles are located? Check out this diagram.)

Sometimes these muscles can become tight and overactive, causing all sorts of pain-related symptoms. Other times, they can become weak and underactive. When this happens, it can lead to another set of frustrating symptoms that can impact your bowel and bladder control, as well as sensations during sex. The good news is that all types of pelvic floor dysfunction — and all of their symptoms — can be treated with pelvic floor physical therapy. 

Keep reading to better understand the symptoms of a weak pelvic floor, and the steps to take to feel back in control of your symptoms.

5 Signs of a Weak Pelvic Floor

A weak or underactive pelvic floor leads to much more than bladder leaks. Here are five signs to look for.

1. You feel less of the good kind of intensity during sex

When your pelvic floor muscles are weak or underactive it can impact the way sex feels. Unfortunately, out-of-shape pelvic floor muscles provide less resistance and contraction during penetrative sex. They also reduce blood flow to your clitoris during arousal.

While pain is most often a sign of pelvic floor tightness, weak pelvic floor muscles can lead to feeling less friction or pressure during penetration. And orgasms can feel weaker or harder to come by.

2. Your bladder leaks a little — or a lot (aka, urinary incontinence)

Urinary incontinence looks different for everyone. For some, urinary incontinence is just a little leakage when you have a cold. For others, it’s losing full control of your bladder during a boot camp class. Bladder leaks happen when the pelvic floor muscles aren’t strong enough to take on additional daily pressures like sneezing, laughing, running, or picking up that Louis Vuitton Neverfull (that you actually did manage to fill).

Whatever it looks like, bladder leakage is never normal — and it’s not something you have to put up with. Pelvic floor PT can help.

3. It feels like something is falling out of your vagina (aka, pelvic organ prolapse)

Weak pelvic floor muscles aren’t able to support the pelvic organs (bowel, bladder, and uterus) — especially if your muscles or ligaments have been injured during a vaginal childbirth.

That means one or more organs may descend lower in the pelvis, leading to pelvic organ prolapse. Symptoms of pelvic organ prolapse can range from a sensation of mild pressure to seeing tissue drop out of the vagina.

You might feel symptoms get worse after long periods of standing or at the end of the day, since underactive muscles don’t usually have the endurance needed to maintain the proper position of your organs throughout the day.

4. You have low back, hip, or pelvic pain

Your hips, low back, and pelvic joints rely on the support of your pelvic floor muscles. As part of your deep core, weak and underactive pelvic floor muscles can lead to joint instability and discomfort or aches in your lower back, hips, or pubic joint. Usually, the pain will feel worse after physical activity or prolonged sitting.

5. You can't hold back gas (or poop)

Weak pelvic floor muscles may struggle to support the closure of your anal sphincter. You might find yourself unable to control the release of gas or sometimes even liquid or solid stool. Nerve injury in this area is common after a vaginal delivery, which can impact pelvic floor muscle strength as well.

What does it mean to have a weak pelvic floor?

The pelvic floor consists of muscles and connective tissues that form a sling of support at the base of your pelvis. To do what they need to do, these muscles need to have adequate strength, endurance, and coordination to properly support the pelvic organs and maintain healthy bowel, bladder, and sexual function.

When the pelvic floor muscles are weak or underactive, they don’t have the necessary tension and responsiveness to perform their supportive functions effectively. This can lead to a range of issues that can put a damper on your day-to-day life.

Weakness in the pelvic floor muscles can occur for several reasons:

• Pregnancy and childbirth: The weight of pregnancy and the process of vaginal delivery can stretch and weaken pelvic floor muscles.
• Aging: As we get older, pelvic floor muscles naturally lose some of their strength and tone.
• Chronic straining: Repeated straining during bowel movements or persistent coughing can gradually weaken the pelvic floor.
• Hormonal changes: Menopause can lead to a decrease in estrogen, which may affect pelvic floor muscle strength.
• Lack of exercise: Like any muscle group, the pelvic floor can become weak from lack of use or targeted exercise.
• Larger body sizes: When not able find body weight that’s comfortable for you, excess weight may put additional strain on the pelvic floor muscles and potentially lead to weakness over time‍
• Trauma: When it comes to trauma, we tend to associate it more with a “fight or flight” response, and increased muscle tension and pain. But trauma manifests differently in every body. Sometimes, trauma can cause us to “turn off” our muscles or dissociate from certain areas of the body as a means of survival. And this can lead to underactivity and weakness.

If you notice any of the signs listed earlier in this post, it’s important to know that you don’t have to deal with them on your own.

Reach out to a pelvic floor physical therapist at Origin today. With the right treatment and exercises, you can regain strength, improve function, and feel good in your body.