What is Pelvic Floor Dysfunction?

The pelvic floor is a group of muscles that sit at the base of your pelvis. They support your bladder, bowel, and in women, the uterus. These muscles need to be able to contract, relax, and coordinate properly. When they do not, it is called pelvic floor dysfunction. This might sound technical, but really it just means the pelvic floor is not doing its job the way it should. And when that happens, you start noticing symptoms that can affect your everyday life - from how often you need the toilet, to your comfort during exercise or intimacy. The good news is that pelvic floor dysfunction is very treatable with the right support.

By Amirah Azhar BPhty(Hons), Dip.Phys., CMP – Team Lead and Senior Pelvic Health Physiotherapist at Habit Health

What are the symptoms of pelvic floor dysfunction?

Pelvic floor dysfunction shows up in lots of different ways, and no two people experience it exactly the same. Some of the most common pelvic floor symptoms include:

• Leaking urine when you cough, sneeze, laugh, or exercise
• Needing to rush to the toilet often, sometimes without much warning
• Trouble emptying your bladder or bowel fully
• Constipation or straining during bowel movements
• A heavy, dragging, or bulging sensation in the pelvic area
• Pain during intercourse, tampon use, or pelvic exams
• Ongoing pelvic, hip, or lower back pain

Some people experience only one or two of these, while others might have several. Either way, if these symptoms sound familiar, they are worth paying attention to.

What causes pelvic floor dysfunction?

There is no single cause. It often develops from a mix of different factors that build up over time. Some of the most common pelvic floor causes include:

• Pregnancy and childbirth – carrying extra weight, hormonal changes, and vaginal delivery can all place pressure on the pelvic floor
• Surgery – pelvic or abdominal surgery can affect how the muscles work
• Constipation or straining – years of pushing and pressure on the pelvic area take their toll
• Trauma or injury – for example, falls, accidents, or pelvic fractures
• Hormonal changes – menopause can affect tissue strength and muscle support
• Lifestyle factors – heavy lifting, high-impact exercise, or chronic coughing
• Stress and tension – some people unconsciously clench their pelvic floor muscles

Both men and women can develop pelvic floor dysfunction, and it can happen at any age.

Pelvic floor dysfunction in men

Pelvic floor dysfunction is often talked about in relation to women, especially around pregnancy and menopause, but men have a pelvic floor too and they can experience problems when those muscles do not work properly.

For men, pelvic floor dysfunction symptoms can include:

• Difficulty controlling the bladder or bowel
• Needing to rush to the toilet more often than usual
• Straining to pass urine or difficulty starting the flow
• Ongoing pelvic or lower abdominal pain
• Pain or difficulty with erections or ejaculation

The causes are varied, but common ones include prostate surgery, ongoing straining with constipation, heavy lifting, trauma to the pelvic area, or chronic coughing. Stress and habitual muscle tension can also play a part.

Is treatment the same for men and women?

The core principles of pelvic floor dysfunction treatment are the same for both men and women. A pelvic health physiotherapist will assess whether the muscles are weak, overactive (too tight), or not coordinating properly, then design a plan to address that.

What differs is the focus:

• For women, treatment often addresses issues linked to pregnancy, childbirth, or menopause, such as prolapse or pain during intercourse.
• For men, treatment may focus on bladder control, bowel function, or recovery after prostate surgery, such as managing leakage or urgency.

In both cases, treatment might include personalised exercises, manual therapy, bladder and bowel training, relaxation strategies, and education. The exact approach will always depend on the individual’s symptoms and needs.

How is pelvic floor dysfunction diagnosed?

Because the pelvic floor is hidden inside the body, you cannot check it yourself. A pelvic health physiotherapist is trained to assess these muscles safely and respectfully.

An appointment usually starts with a chat about your symptoms, your health history, and what you are noticing day to day. From there, the pelvic floor physio may do an external exam, and with your consent, an internal exam to check how your pelvic floor muscles are working.

This helps us see whether the muscles are too weak, too tight, or simply not coordinating properly. Once we know what is happening, we can tailor treatment to you — not just give you a one-size-fits-all plan.

Can pelvic floor dysfunction go away?

For many people, yes. With the right treatment, symptoms can improve a lot and often resolve completely. For others, especially where there are ongoing health conditions or changes related to ageing, the goal is to manage symptoms so they do not interfere with daily life.

The important thing to know is that pelvic floor dysfunction does not usually get better on its own. If anything, symptoms can become more noticeable over time. The sooner you get assessed, the easier it is to treat.

What does pelvic floor dysfunction treatment involve?

Treatment is never one-size-fits-all. Pelvic floor dysfunction treatment is always designed around what your muscles are doing and what your symptoms are.

It might include:

• Personalised exercises – not just Kegels, but the right kind of exercises for your muscles
• Manual therapy – gentle hands-on techniques to release tightness or improve muscle control
• Bladder and bowel training – strategies to help with urgency, leakage, or constipation
• Breathing and relaxation work – learning how to relax the pelvic floor properly
• Lifestyle advice – small changes to exercise, lifting, or daily habits that reduce strain
• Education and support – so you understand what is happening and how to manage it

Sometimes we also work alongside your GP or other specialists to make sure you are getting the right care across the board.

Getting help for pelvic floor dysfunction

Pelvic floor problems can feel embarrassing to talk about, but they are much more common than you think. You are not alone, and you do not have to put up with symptoms. Pelvic health physiotherapist can help you understand what is going on and guide you through treatment. With the right support, you can get back to living life without constantly worrying about your pelvic floor.

Need help with pelvic floor dysfunction?

Habit Health has experienced pelvic health physiotherapists across New Zealand.

Book an appointment today and take the first step toward recovery.