Pelvic Floor Dysfunction: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pelvic Floor Dysfunction?
A primary care doctor or a gynecologist, a doctor who treats the female reproductive system, can check for pelvic floor problems. A urogynecologist, a doctor trained in pelvic floor and bladder problems in women, can also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is pelvic floor dysfunction?
The pelvic floor is a group of muscles that form a sling or hammock across the bottom of the pelvis. These muscles hold the pelvic organs in place so they can work correctly. The pelvic organs include the bladder, the urethra, the intestines, and the rectum. In women they also include the uterus, cervix, and vagina.
Pelvic floor dysfunction happens when the pelvic muscles and connective tissue weaken or are injured. Doctors also call it a pelvic floor disorder. The most common types are pelvic organ prolapse, bladder problems, and bowel control problems. In women, prolapse happens when weak muscles can no longer hold a pelvic organ in place, so it drops or presses into the vagina. The sources for this topic mostly describe these problems in women.
Symptoms
Common symptoms include:
- Feeling heaviness, fullness, pulling, or aching in the vagina, which gets worse by the end of the day or during a bowel movement.
- Seeing or feeling a bulge, or something coming out of the vagina.
- Having a hard time starting to urinate or emptying the bladder completely.
- Needing to urinate often or in a hurry.
- Pain while urinating.
- Leaking urine when you cough, laugh, or exercise.
- Frequent urinary tract infections.
- Leaking stool or having a hard time controlling gas.
- Constipation.
- Trouble making it to the bathroom in time.
Causes and who gets it
Pregnancy and childbirth are the main causes of a weak or injured pelvic floor. Other causes include being overweight, radiation treatment, surgery, and getting older.
Leaking urine, called urinary incontinence, can happen in women or men. Leaking stool, called fecal incontinence, can also happen in women and men. It can come from a weak anal sphincter, the ring of muscles that keeps the anus closed.
How doctors diagnose it
A doctor may be able to diagnose a pelvic floor problem with a physical exam. During a routine pelvic exam, a doctor may see or feel a bulge. A bulge can mean prolapse. The doctor will also ask about your health. This includes pregnancies, past surgery, and the medicines you take.
Depending on your symptoms, you may need more tests. For bladder control problems, one test is cystoscopy, which looks inside the bladder. Urodynamics checks how well the bladder and urethra work. For bowel control problems, anal manometry checks how strong the anal sphincter muscles are. A colonoscopy or sigmoidoscopy looks inside the colon for signs of disease. Dynamic defecography checks the pelvic floor and rectum during a bowel movement.
Treatment
Kegel exercises are special pelvic muscle exercises, and they are one treatment. A pessary is a support device that helps some women. Surgery and medicines are other treatments.
When to see a doctor
See a doctor if you have symptoms such as problems with bladder or bowel control. You should also be checked if you see or feel a bulge in the vagina, or if you often get urinary tract infections.
Call 911 or go to the emergency room if you have severe belly pain or pressure, fainting, or trouble breathing. Also go if you have chest pain or discomfort that lasts two minutes or more.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can do a first exam, order first tests, and refer you to a gynecologist, a urogynecologist, or another specialist.
Common questions
What problems count as pelvic floor disorders?
The most common ones are prolapse, bladder problems, and bowel control problems. The medical word for leaking urine or stool is incontinence.
What causes pelvic floor problems?
Pregnancy and childbirth are the main causes. Being overweight, radiation treatment, surgery, and getting older can also play a part.
Can men have pelvic floor problems?
Yes, some of these problems can happen in men. Leaking urine and leaking stool can both happen in men as well as women.
Can pelvic floor problems be treated without surgery?
Yes, some treatments do not use surgery. A pessary is a support device that helps some women.
Sources
- NICHD (National Institutes of Health) - About Pelvic Floor Disorders (PFDs)
- MedlinePlus - Pelvic Support Problems
- NICHD (National Institutes of Health) - How are pelvic floor disorders (PFDs) diagnosed?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
