Pelvic Floor Dyssynergia: Definition, Symptoms, and Treatments

August 7, 2023
Pelvic Floor Dyssynergia | Every Mother

Pelvic floor health is often overlooked–until you find that there’s an issue. The pelvic floor is responsible for providing key support to the pelvic organs, and when there’s a problem, it can be difficult to pinpoint exactly what’s wrong. 

In this article, we discuss pelvic floor dyssynergia–what it is, what the symptoms are, and what you can do to help. 

What is Pelvic Floor Dyssynergia?

Pelvic floor dyssynergia means the pelvic floor muscles have become uncoordinated, which creates challenges to control the functionality of muscles coordinated with the bladder and rectum. Healthy pelvic floor muscles lengthen and contract harmoniously to:

  1. (contract/tighten) prevent urine and stool from leaking (incontinence) and,
  2. (lengthen/relax) to void all waste during a bowel movement.

When pelvic floor dyssynergia is present, the muscles do not relax and contract in a coordinated manner, resulting in "dysfunction". Understanding how pelvic floor muscles function and learning how to control them is the first step to overcoming any symptoms of pelvic floor dyssynergia. 

Symptoms of Pelvic Floor Dyssynergia

While the symptoms of pelvic floor dyssynergia aren’t always the easiest to pinpoint, here are some of the most common symptoms that might point you in the right direction:

Difficulty having a "normal" bowel movement. Which can manifest as:

  • Inability to identify when you are ready to have a bowel movement
  • Failure to pass stool through your rectum
  • Not being able to void the bowels completely
  • Constipation or straining when having a bowel movement
  • Less than three bowel movements per week
  • Having to use your fingers to help you have a bowel movement (digital evacuation)

Difficulty urinating "properly," meaning;

  • Not being able to release urine easily (often a thin urine stream is present)
  • Urinary hesitancy (sitting or standing to urinate, and there is a delay before urine begins to stream)
  • Incapability to void the bladder completely

Pain in your lower back

Pelvic floor pain

What Can Cause Pelvic Floor Dyssynergia?

Pelvic floor dysfunction is more common than you think and can occur at any age. It is important to note that although the word "dysfunction" comes with a heaviness of negativity, the representation of pelvic floor dyssynergia is simply the disruption of living a healthy and everyday life induced by way of pelvic floor issues. 

So, what can cause a pelvic floor issue? Although anyone can experience pelvic floor dyssynergia at any age, there can be contributing factors that are commonly seen, such as:

  • Being overweight
  • Advanced age
  • Pelvic surgery (such as a C-section)
  • Traumatic injuries to the pelvic area
  • Pregnancy and childbirth
  • Overuse of the pelvic muscles
  • Injuries due to trauma or sexual abuse
  • Nerve damage in the pelvic floor

Who Gets/Can Get Pelvic Floor Dyssynergia?

This condition affects men and women at any age and stage in life but is common in postpartum women over the age of 20.

Types of Pelvic Floor Dyssynergia

Clinically speaking, the most commonly seen patients who experience pelvic floor dyssynergia are those who can't have a bowel movement due to muscles contracting when they attempt to bear down. According to the Journal of Neurogastroenterology and Motility, there are four total degrees of pelvic floor dyssynergia defecation recognized:

  • Type 1: The patient can bear down an adequate pushing force (rise in intra abdominal pressure) and a paradoxical increase in anal sphincter pressure.
  • Type 2: The patient cannot generate enough pushing force for a bowel movement, but exhibits opposing anal sphincter contraction.
  • Type 3: The patient can develop an adequate pushing force (increase in intrarectal pressure), but either has absent or incomplete (< 20%) anal sphincter relaxation (i.e., no decrease in anal sphincter pressure).
  • Type 4:The patient cannot generate an adequate pushing force and demonstrates an absent or incomplete anal sphincter relaxation.

When to see a Physician for Pelvic Floor Dyssynergia

Pelvic floor dyssynergia is not typical to self-diagnose. There can be many reasons for urinary and bowel issues, so if you notice changes during bathroom use or start experiencing the symptoms mentioned above, contact your primary care doctor, gynecologist, or pelvic floor physical therapist for an evaluation.

pelvic floor dyssynergia treatments | Every Mother

Treatments for Pelvic Floor Dyssynergia

Treatment can include pelvic floor therapy, medications, stress management, or even alternative therapies, such as acupuncture, depending on the type and severity of pelvic floor dyssynergia. Pelvic floor physical therapy is a combination of education for relaxation techniques you can perform and also manual stretching of the pelvic floor by a trained physical therapist and at home with a dilator or pelvic wand.

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