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Many people take their pelvic health for granted until something goes wrong. Pelvic health refers to the health of the organs and musculoskeletal system of your body's pelvic region, including your bladder, uterus, or prostate, as well as the tissues that hold them in place. Like other organs in your body, your pelvic organs are subject to infection and disease, which can be detected with regular screenings by your primary care provider, gynecologist, or urologist. But did you know that many symptoms of pelvic dysfunction are related not to the pelvic organs, but to the basic muscles and skeletal structure of your pelvis?

A variety of muscles and ligaments connect to and between the bones of your pelvis to create a bowl-shaped area that cradles the pelvic organs; this group of muscles and ligaments is commonly known as the "pelvic floor". For some people, the muscles of the pelvic floor can become weakened and damaged, causing dysfunction and a variety of uncomfortable symptoms.

The early symptoms of pelvic floor dysfunction can be subtle, and can worsen over time, so it is sometimes difficult for both patients and clinicians to get a diagnosis right away. Some symptoms of pelvic floor dysfunction are:

- Stress incontinence (loss of control over the release of urine or stool during an act of sudden physical exertion such as sneezing, jumping, or running)

- Bladder urgency with urinary incontinence

- Lower back pain

- Constipation

- Painful urination

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- Pelvic pain, pressure, or "heaviness"

- Sexual dysfunction

- Organ prolapse

Pelvic floor dysfunction is like many health concerns: it is best and most easily treated when it is detected early. There are several avenues for detection and diagnosis of pelvic floor dysfunction. Your primary care provider, urologist, or OB/GYN clinician may evaluate your symptoms and health history, and discover signs of pelvic floor dysfunction during a pelvic exam. Each of these avenues for diagnosis will likely lead to a referral for physical therapy, where your condition will be evaluated and may include a musculoskeletal assessment, surface EMG, and a pelvic exam to determine the pelvic floor dysfunction and enable the physical therapist to design a customized treatment program.

Often the most effective and least invasive option to treat pelvic floor dysfunction is physical therapy. While each person's treatment program will depend on their individual symptoms and circumstances, most physical therapy programs will include exercise to restore proper musculoskeletal balance and alignment. Patients will often be seen for hour-long sessions once a week for 4 to 10 sessions.

By learning about the symptoms of pelvic floor dysfunction, and by speaking to your healthcare provider, you can identify and treat this issue before it becomes a permanent health concern. Detection and early treatment are the keys to success in maintaining your pelvic health.

Barbara Baribeau is a physical therapist in the Physical Therapy and Rehabilitation Department at Brattleboro Memorial Hospital who has specialized in pelvic floor dysfunction for over 20 years. To make an appointment, speak to your primary care, Ob/Gyn, or urology healthcare provider for a referral. AnnMarie Gorham is a Women's Health Nurse at Brattleboro Ob/Gyn, a department of BMH. Her office can be reached at 802-251-9965. Briana Gwaltney is a Family Nurse Practitioner at BMH Urology who specializes in Women's Health. Her office can be reached at 802-251-8720.