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Do I Have Pelvic Floor Dyssynergia?

The most common pelvic floor conditions are incontinence and prolapse, and there’s a good chance you’ve heard of those.

Have you heard of the less common disorder known as pelvic floor dyssynergia?  

Nearly a quarter of women in the United States are impacted by one or more pelvic floor disorders,1 but not many know about dyssynergia. 

Let’s look at the symptoms, causes and treatments for this pelvic floor dysfunction.

Understanding the Pelvic Floor

To understand pelvic floor dyssynergia, you need to first understand the important role of the pelvic floor in women’s health. 

The pelvic floor is a group of muscles and tissues that act like a hammock to support and hold in place the important organs in your pelvis — such as your vagina, bladder and bowel.2

Here are the other important functions performed by the pelvic floor:2

  1. Provides Muscle Control: The pelvic floor muscles play a part in moving waste from your body. That’s done by coordinating with organs like your urethra (which carries pee out of your body), and your anus (which passes stool from your body). Squeezing holds waste in, and relaxing lets it out. 
  2. Protects Your Organs and Spine: Pelvic floor muscles help to absorb pressure from actions like heavy lifting or coughing.
  3. Helps With Sex and Orgasm: These muscles provide blood flow and help with vaginal contractions during sex and orgasm.
  4. Supports Childbirth: The pelvic floor supports vaginal delivery during childbirth.

Pelvic Floor Disorders

There are a number of conditions that can afflict a woman when her pelvic floor muscles aren’t working properly. Known as pelvic floor disorders, they happen when those muscles are injured, or most often when they are weakened. 

The three main pelvic floor disorders that result from a weakened pelvic floor are urinary incontinence, fecal incontinence, and pelvic organ prolapse.1 

Not all conditions are caused by weakened muscles, however. 

Pelvic Floor Dyssynergia

Most of us don’t realize the role of pelvic floor muscles in our bodily functions until something goes wrong. In the case of removing waste, the muscles contract to prevent waste from leaking until you reach the washroom. Then those muscles relax to allow waste to leave the body. The muscles work in a coordinated way without us even knowing.

However, when you’re afflicted with pelvic floor dyssynergia, those important muscles are not coordinated, making it hard to have a proper bowel movement. The muscles don’t relax like they should, and the end result is constipation.

Women with pelvic floor dyssynergia may have trouble completing a bowel movement, or have trouble knowing when they’re ready for a bowel movement.3

Symptoms of Pelvic Floor Dyssynergia

You might wonder if you’re constipated, and if so, if you have dyssynergia. Not everyone likes to talk about poop, but having proper bowel movements is important to your overall health. 

What is a “normal” bowel function? It doesn’t necessarily mean every day. It could be every three days, but your stool should be well formed and soft enough that you can poop without straining.4 

As a side note, straining to poop, such as when you’re constipated, can lead to weakened pelvic floor muscles and eventually pelvic disorders. If you really want to know about healthy bowel movements, the Bristol Stool Chart may help. 

If you’re suffering from constipation on a regular basis, you may have pelvic floor dyssynergia. Here are other symptoms:

  • excessive straining when you do have a bowel movement5
  • pain during a bowel movement6
  • needing to using your fingers to help you have a bowel movement5
  • pooping less than three times a week5
  • trouble peeing5
  • pain in your lower back5
  • pelvic floor pain5
  • pain or discomfort during sex6
  • muscle spasms in the pelvis6
  • intense pressure or pain in the lower stomach, vagina, or rectum 6

Causes of Pelvic Floor Dyssynergia

It’s not certain what causes pelvic floor dyssynergia. However, there do seem to be some common factors that can lead to this condition:6,7

  • being overweight
  • advanced age
  • having pelvic surgery
  • suffering a traumatic injury to the pelvic floor or rectum, such as from sexual abuse or other trauma
  • overuse of the pelvic muscles
  • nerve damage in the pelvic floor
  • pressure on your pelvic floor from pregnancy and vaginal childbirth

Treatment for Pelvic Floor Dyssynergia

The first step in treating pelvic floor dyssynergia is to receive a proper diagnosis. There are a number of tests that can be performed to determine whether the constipation and other issues you’re having are caused by pelvic floor dyssynergia.

These include tests that will measure the muscle strength in your anus, the reflex activity and movement in your pelvic floor muscles, or an MRI to examine the structures in your pelvic floor, rectum and sphincter.8

Once diagnosed, there are a number of possible treatments for pelvic floor dyssynergia.

Nutrition Therapy 

In some instances, changes to diet can help alleviate the symptoms of pelvic floor dyssynergia by making it easier to have a bowel movement. Modifications like drinking more water or increasing your fiber intake might make a difference. Ask your doctor for guidance nutrition or seek the help of a licenced dietician.9

Physical Therapy

Pelvic floor physical therapy, led by a physical therapist trained in pelvic floor conditions, can help you learn how to properly relax your muscles and treat muscle spasms. 

For instance, biofeedback is one tool to train pelvic floor muscles. In this treatment, a small sensor is placed in the rectum and provides feedback to you and your therapist to help understand what your muscles are doing. Another option is rectal balloon retraining, which can teach the pelvic floor muscles how to relax and eliminate stool.4

Pelvic Floor Exercises 

A therapist can also help you learn exercises that will strengthen muscles in your pelvic floor.9

For instance, it may be recommended that you start a regimen of Kegel exercises. These pelvic floor exercises involve tightening and then releasing the muscles in your pelvic floor to strengthen them. 

For some pelvic conditions, research has proven that pelvic floor exercises help keep pelvic floor muscles “fit,” and can be used as an effective treatment or as a preventative measure. Even those without a pelvic dysfunction should perform Kegels as a form of prevention, including healthy women as young as those in their 20s.

There are tools available to help, like the INNOVO Urinary Incontinence Kit. These “smart shorts” help you perform 180 perfect Kegels in 30 minutes. Subscribe to the INNOVO newsletter to receive a $25 discount code for your purchase.

Exercise

Movement in general is good for your pelvic floor, and can help stimulate peristalsis—the wave-like muscle contractions that move food through your digestive tract. Movement also brings blood flow to the intestines.  

Something as simple as a daily walk can help stimulate your bowel, especially after meals. You can also try simple stretching exercises like cat-and-cow or child’s pose to help relax your central nervous system and promote peristalsis.4

Pain Management and Relaxation

Other approaches include options to manage your pain and stress, such as muscle relaxants, acupuncture, or other alternative therapies.9 

If your condition is caused by tight pelvic muscles, then Kegels may not be the answer. Hypertonic pelvic floor is when the muscles in your lower pelvis are in a state of constant contraction. 

In this instance, you should seek guidance on relaxation techniques for your pelvis and your whole body. Activities like warm baths, yoga, or learning stretches that will relax your pelvic floor muscles may help.6

Surgery

Some pelvic floor dysfunction is the result of a structural issue. For instance, rectal prolapse can sometimes lead to pelvic dyssynergia. In these instances, you may need surgery to correct the condition.9

See A Doctor 

It’s estimated that up to 20% of people regularly experience constipation.4 That doesn’t mean everyone with constipation has pelvic floor dyssynergia, but it’s worth seeing a doctor for proper diagnosis if you’re suffering from frequent constipation. 

Use our Physician Finder to find a doctor near you with expertise in women’s health who can answer your questions about constipation, pain and other possible dyssynergia symptoms. You can also seek guidance on other women’s pelvic health issues, like pelvic floor physical therapy or pelvic floor muscles exercises.