One of every nine women has surgery for pelvic floor disorders throughout the lifespan. Yet, these conditions are rarely talked about, and many people do not know what they are or what causes them.

What Are Pelvic Floor Disorders?

There are two types of problems that women experience that are caused by vaginal birth and advancing age:

1) One occurs when the pelvic organs (bladder, uterus, vagina, and rectum) fall downward and bulge out through the opening of the vagina. This problem is referred to as pelvic organ prolapse.

2) The second refers to problems women have controlling their urine flow or their bowels. This is referred to as incontinence and can be a problem of urinary or fecal incontinence.

A woman may have problems with incontinence, with pelvic organ prolapse, or both.

What Leads to Pelvic Organ Prolapse?

When the muscles and ligaments that support the vagina and hold it in place fail and the vagina falls down, the other pelvic organs, which are next to the vagina, fall down as well.

The most damaging thing for both the pelvic muscles and ligaments is when a woman delivers a baby. During childbirth, the pelvic muscles have to stretch a great deal for the baby to come out of the vagina. This sometimes causes an injury to the muscle that leaves it weaker than it originally was. Other times, the nerve that controls the muscle is damaged so that the muscle does not contract to hold the pelvic organs up.

When the muscle fails, often the ligaments, which are fibers that attach the vagina and uterus to the walls of the pelvis, catch the organs and hold them in place for a while. However, the ligaments can be weakened and damaged, as well. Vaginal delivery can cause a ligament or muscle to be damaged. Advancing age also weakens the ligaments in some women, as do some diseases or chronic smoking.

What Leads to Incontinence?

Urinary incontinence is when a woman cannot maintain urine control until it is convenient for her to empty her bladder. It can be caused by a weakening of the pelvic muscles and urethra (the tube that connects the bladder with the outside) or because of damaged ligaments. When weakened, the pelvic muscles and urethra cannot contract enough to hold urine in when stress is placed on them, such as during a strong cough or sneeze.

Urinary incontinence also occurs when a woman cannot control the muscles of the bladder. In these circumstances, the bladder will empty when it has reached a certain degree of filling (such as it does in children before toilet training) or when something happens to make the woman feel like she needs to urinate, such as the sound of running water.

Fecal incontinence, or bowel accidents, is caused

1) By a weakening of the sphincter muscle, which holds the stool in;

2) Because the pressure of the bowel contents against the sphincter muscle is too great; or 3) a combination of these factors. The most common cause of injury to the sphincter muscle is vaginal delivery.