Pelvic Floor and Aging: Common Issues and Solutions

By Pelvic Health Physical Therapy on 2/2/2024

older adults

As individuals age, the pelvic floor, a group of muscles that support the pelvic organs, can undergo changes that may lead to various issues.

Common problems associated with the pelvic floor and aging include:

Pelvic Organ Prolapse (POP):

This occurs when the pelvic organs, such as the bladder, uterus, or rectum, descend into the vaginal space due to weakened pelvic floor muscles. It can cause discomfort, pressure, or a bulging sensation. Although this issue occurs in pregnant and postpartum women, this issue occurs in menopausal women due to low levels of estrogen, which provides the building blocks to provide support to the connective tissues.

Urinary Incontinence:

Weakening of the pelvic floor muscles may result in urinary incontinence, where individuals may experience leaks or loss of bladder control, especially during activities like coughing, laughing, or exercising. Individuals may also show signs of higher-than-usual urgency including feeling the urge to urinate when your key is in the lock of your house or when water is running.

Sexual Dysfunction:

Changes in pelvic floor function can contribute to sexual issues, including pain during intercourse or a decrease in sexual satisfaction.


Weak and/or pelvic floor muscles may affect bowel movements, leading to difficulties in passing stools and an increased risk of constipation.

Solutions and Management:

Pelvic Floor Exercises:

Strengthening exercises for the pelvic floor, known as Kegel and Reverse Kegel exercises, can help improve muscle tone and reduce symptoms. Regular practice can enhance bladder and bowel control.

Physical Therapy:

Pelvic floor physical therapy involves stretching and strengthening exercises, myofascial releases, visceral mobilizations, electrical stimulation, ultrasound, shockwave therapy, and biofeedback to address muscle imbalances and promote better function.

Lifestyle Modifications:

Maintaining a healthy lifestyle, including regular exercise, improved hydration, increasing (or decreasing) fiber intake, improving toileting habits, and improving sleep hygiene can also assist with restoring pelvic floor function.

Weight Management:

Excess weight can put additional strain on the pelvic floor. Maintaining a healthy weight can help prevent or alleviate pelvic floor issues. Please consult with a registered dietician or your primary care physician if you are thinking of going on a diet.

Medical Interventions:

In some cases, medical interventions addressed by your urogynecologist, gastroenterologist, or proctologist such as surgical procedures may be recommended to address severe pelvic organ prolapse or other related issues.

Hormone Replacement Therapy (HRT):

For postmenopausal women, hormone replacement therapy may be considered to address hormonal changes that can affect pelvic floor function.

It's important to consult with healthcare professionals, including gynecologists, urologists, or physical therapists, to determine the most appropriate solutions based on individual circumstances. They can provide personalized advice and treatment options tailored to specific pelvic floor issues and overall health.

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