Pelvic Floor Dysfunction

(For Men and Women)

Pelvic Pain – Includes pain in the groin, low back, hips, sacro-iliac joint pain, pain with intercourse, pain with urination, pain with bowel movements, abdominal pain.

Pudendal Neuralgia: Click for more information

  • Pelvic pain with sitting, but improvement with standing or sitting on a toilet seat.
  • Burning, stabbing pain in the vagina, labia, clitoris, penis, scrotum, perineum, anus, and rectum
  • Tailbone pain
  • Feeling of foreign object in vagina and/or rectum
  • Urinary, bowel and/or sexual dysfunction
  • Discomfort with tight clothing.
  • Pudendal nerve block may decrease symptoms

Disorders of the Bladder/Bladder Dysfunction:

  • Urinary Incontinence
    • Stress Urinary Incontinence
    • Urge Urinary Incontinence
    • Mixed Incontinence
  • Urgency
  • Frequency
  • Incomplete Emptying
  • Urinary Retention
  • Difficulty with initiation
  • Pain before, during, after urination
  • Nocturia (frequent night time urination)
  • Enuresis (bed wetting in the night)
  • Interstitial Cystitis/Painful Bladder Syndrome
    • Pain or burning before, during or after urination
    • Pelvic pain
    • Urinary urgency, frequency, retention
    • Nocturia (urinating frequently at night)
    • Dysparuenia (pain with intercourse)
    • Back, suprapubic, and/or abdominal pain

Disorders of the Bowel/Bowel Dysfunction:

  • Rectal pain
  • Urgency
  • Frequency
  • Retention
  • Incomplete Emptying
  • Difficulty with initiation
  • Bowel/Fecal Incontinence
  • Constipation
  • Diarrhoea
  • Hemorrhoids
  • Irritable Bowel Disorder (IBS): constipation, diarrhea
  • Inflammatory Bowel Disease (IBD)
    • Crohn’s Disease
    • Ulcerative Colitis

Sexual Dysfunction:

  • Pudendal Neuralgia
  • Pelvic Pain
  • Dyspareunia → Pain with intercourse
  • Pelvic Congestion
    • Chronic dilatation of the pelvic veins → slow flow of blood → venous blood accumulation and congestion.
    • Pelvic congestion can lead to chronic pelvic pain, dysparuenia, urinary frequency and urgency, infertility, erectile dysfunction, and possible back and leg pain. Sometimes, there is a dull ache, which is aggravated by physical activity (especially with standing).
    • Physical Therapy aims to improve circulation through myofascial release, massage, lymph drainage, stretching and strengthening exercises and postural modifications.
  • Pelvic Inflammatory Disease (PID)
    • It is an infection of the reproductive organs associated with scar tissue formation or adhesions. PID may result in chronic pelvic pain, infertility, ectopic pregnancy, and abscess formation.
    • Symptoms of PID include lower abdominal pain, fever, painful intercourse, painful urination, foul smelling vaginal discharge, irregular menstrual bleeding, and pain in the right upper abdomen.
    • Physical therapy can improve the mobility of reproductive connective tissue by breaking down scar tissue and adhesions with resultant increase in blood flow. The improved blood flow will wash out toxins, which can decrease pelvic pain.


  • Erectile Dysfunction
  • Varicocele


  • Endometriosis
  • Skin Lesions: Lichens Planus, Lichens Sclerosus
  • Vaginusmus (shortened, weak, tight vaginal and pelvic floor muscles)
  • Vulvodynia
  • Vulvar Vestibulitis
  • Pelvic Floor Organ Prolapse:
    • It occurs mainly due to pelvic floor muscle weakness. Pelvic floor muscle weakness coupled with repeated muscle straining (during childbirth, chronic constipation, chronic coughing, heavy lifting), abdominal surgeries (hysterectomies, c-section), estrogen deficiency and/or obesity can lead to pelvic floor organ prolapse.
    • Uterine Prolapse → Herniation of the uterus into the vagina.
    • Cystocele → A cystocele is the fall of the bladder into the vagina. It can lead to incomplete emptying of the bladder and/or urinary leakage.
    • Enterocele → Herniation of the small intestine between rectum and vagina.
    • Rectocele → A rectocele is the herniation of rectal tissue in the vagina. Symptoms may include constipation and/or pelvic pain.
    • Pelvic floor organ prolapse may be prevented and managed through correct body mechanics (during coughing, lifting), avoidance of straining, controlling and treating constipation, weight control, and pelvic floor muscle strengthening. Sometimes, a physician may prescribe a pessary (a device which holds the pelvic organs up and can be used with pelvic floor muscle strengthening exercises to re-educate the muscles.