For the past year, urologists have seen an uptick in patients with urinary frequency and infections, bladder pain, and pain radiating from the tailbone. These are just some of the concerns related to the muscles surrounding and supporting the urinary tract and bowel function, called the pelvic floor.
Why are more women and men experiencing pelvic floor dysfunction?
Doctors say the pandemic may be to blame.
“In my practice over the past year, I’ve noticed a significant increase in the severity of pelvic floor dysfunction,” says Laura Martin, D.O., female pelvic medicine specialist and reconstructive surgeon with the University of Miami Health System. “It’s likely a result of increased stress surrounding the pandemic amidst normal life stressors. Emotional stress, such as anxiety and depression, can contribute to pelvic floor disorders. Prolonged activity with improper positioning, such as sitting at the computer all day, can also cause imbalances that affect the musculoskeletal system.”
The patients who seem to be most affected have bladder pain syndrome or interstitial cystitis, high tone pelvic floor, dysfunctional voiding, IBS, and those with urgency-frequency of urination. Male patients can be affected by the same issues, though generally, less frequently.
“Patients may be experiencing other problems with similar symptoms like urinary or vaginal infections, so it’s important to speak to a doctor,” Dr. Martin says.
“There’s also a subgroup of patients with coccydynia, which is pain from the lumbar spine (lower back) typically experienced in the tailbone, but it can refer to the pelvic floor. Hip pathologies can also refer pain to the pelvic floor muscles,” says Andrea Wood, a certified pelvic rehabilitation practitioner with UHealth’s pelvic floor disorders physical therapy clinic.
“If you had any orthopedic musculoskeletal issues prior to the pandemic, the increased isolation and being at home may have further aggravated these issues due to lack of movement variability and increased sustained postures,” Wood says. “Additionally, if you had COVID-19, coughing places increased stress on the pelvic floor muscles. The relationship of the diaphragm (a primary muscle of breathing) and pelvic floor muscles can lead to pelvic floor muscle dysfunction, increased pelvic organ prolapse risk, and pelvic floor muscle pain.”
Pelvic floor dysfunctions can not only be painful and frustrating, they can also lead to further social isolation and poor self-esteem. Dr. Martin says, “Often there is a social impact to these conditions, as they may cause anxiety, embarrassment, or avoidance of certain situations, especially if there is not a known restroom nearby. It is also important to acknowledge the negative effect on sexual health and wellbeing.”
Don’t avoid getting help due to embarrassment.
“After an evaluation with a physician to rule out other health concerns, getting a referral to a trusted physical therapist specializing in pelvic health can help facilitate an individualized exercise program tailored to your needs. A great communicative medical team can help begin to solve pain puzzles like these,” Wood says.
She recommends getting a detailed assessment of your pelvic floor muscles and the surrounding musculature to diagnose the source of the problem. “This can help save time and prevent you from performing any exercises blindly that may prolong your condition, such as Kegels. A common misconception is that Kegel exercises (contracting and relaxing your pelvic floor muscles repeatedly) can help fix many pelvic issues. Often this is not the case and may actually aggravate pelvic pain. Learning how to properly relax your pelvic floor muscles and address any musculoskeletal imbalances surrounding the pelvis is sometimes more effective.”
Lowering your stress may help you avoid and relieve pelvic floor disorders.
Physical activity is a great way to clear your mind, spend time in nature, reduce stress on the body from prolonged sitting, and encourage blood circulation—all of which can help reduce symptoms of anxiety and depression. Consider taking up relaxing activities like yoga, walking, or swimming. However, “biking should be considered with caution, as this may cause more pelvic floor problems,” Dr. Martin says.
“Mental health exercises such as mediation, prayer, and practicing gratitude and compassion are also important for stress reduction,” she says. “Beyond this, you can receive guidance from religious figures or mental health providers that can provide coping skills for when life becomes overwhelming.”
Dana Kantrowitz is a contributing writer for UMiami Health News.
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