How Weak Pelvic Floor Muscles Play a Role in Urinary Incontinence

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Urinary incontinence tends to strike when you least expect it. Whether you accidentally leak when you let out a laugh or feel a sudden urge to go at the worst moment, the anxiety of not knowing when your next accident may happen can, understandably, take a major toll on how you feel in your body, both physically and mentally.

If you’ve been dealing with this issue, rest assured that it’s very treatable, as long as you check in with a doctor as early as you can. Once you have an open conversation about your symptoms, it’s likely that you’ll discuss an area of the body called the pelvic floor—and how its proper functioning is essential for keeping your urinary muscles, including those in your bladder, in tip-top shape.

How does the pelvic floor influence urinary incontinence?

First, a little 101: The pelvic floor is a group of hammock-like muscles that stretch across the bottom of the pelvis. With the help of surrounding tissues, the pelvic floor keeps the bladder, urethra, intestines, rectum, and reproductive organs like the uterus and vagina where they need to be, according to the National Institutes of Health (NIH). That’s why the strength of your pelvic floor is so crucial, Rachel Benjamin, DPT, a licensed physical therapist at Spaulding Rehabilitation Hospital in Boston, tells SELF. “Your pelvic floor is constantly changing throughout your life,” she says, so being aware of its role in stabilizing different parts of your body is so important. 

When the pelvic floor muscles are doing their thing, you can hold in urine when you need to and go to the bathroom when you’re ready. If these muscles become compromised in some way—say, they become too tight, too weak, or stretched out—that’s when urinary incontinence can develop, Farzeen Firoozi, MD, the director of female pelvic medicine and reconstructive surgery at Lenox Hill Hospital in New York City, tells SELF.

The two most common types of urinary incontinence include stress urinary incontinence (SUI) and urge incontinence (overactive bladder). SUI occurs when some kind of force—a laugh, cough, sneeze, or challenging deadlift, for example—puts too much pressure on the bladder or abdomen. In turn, the sphincter muscles in the urethra, which help control the flow of urine, release and open a bit, causing you to leak.

Urge incontinence, on the other hand, is characterized by a strong, sudden urge to pee, regardless of how much urine you’re holding in, per the US National Library of Medicine. “The bladder almost develops a brain of its own, and it signals itself to contract,” Dr. Firoozi says. Many things can cause an overactive bladder, including certain infections, bladder stones, neurological problems, and nerve damage; in many cases, it’s hard to identify a specific cause.

Beyond pee leakage, other signs of pelvic floor dysfunction can include frequently needing to use the bathroom, constipation, painful urination, painful sex, lower back pain, or a sensation of heaviness in any part of your pelvic area.


What causes pelvic floor dysfunction?

Lots of things can affect the health of your pelvic floor muscles, but here are the biggies to be aware of, per the NIH:

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