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With so many factors affecting a naturally complex region of the body, it’s little surprise that pelvic-floor dysfunction doesn’t look the same for everybody. In fact, says pelvic-floor physical therapist Riva Preil, PT, DPT, author of The Inside Story: The Woman’s Guide to Lifelong Pelvic Health, there are two broad categories of dysfunction: At one end of the spectrum is pelvic-floor tightness, or overactivity; at the other end is pelvic-floor weakness, or underactivity.

Symptoms of Pelvic-Floor Tightness:

A common symptom of tightness is often feeling like you need to pee. This happens because the muscles around the urethra (the tube that empties urine from the bladder) are tense and overactive. “The muscles never fully relax when you’re trying to urinate, so you constantly feel like there’s still more urine in the bladder,” she explains.

Or, you may be constipated — another symptom of overactivity — except it’s the muscles around your rectum (the last several inches of the large intestine) that are tight.

Some people with pelvic-floor tightness may also notice that they can’t stay erect during sex, says Preil. “Male sexual functioning is so dependent on blood flow, and if muscles are tight, it can restrict that blood flow.”

Symptoms of Pelvic-Floor Weakness:

On the other end of the spectrum, a telltale sign of pelvic-floor weakness is urinary incontinence, or difficulty holding in your pee. “That’s when you have those experiences of running or jumping on a trampoline with your kiddo, and you pee yourself a little bit,” says Brooke Cates, founder and CEO of The Bloom Method, a pre- and postnatal fitness program.

Another symptom of weakness is pelvic-organ prolapse, which occurs when one or more pelvic organs (the uterus, bladder, or rectum) drop into the vagina or bulge into the anus, causing discomfort. “Women will report a feeling of fullness in the pelvic floor, almost like a tampon is only partially inserted,” Preil explains.

Cates notes that either category of pelvic-floor dysfunction could lead to the same symptoms; leaking urine, for instance, could be caused by tightness or weakness.

Moreover, Preil adds, people can experience both tightness and weakness at once. And it’s possible that one could lead to the other (i.e., if left unchecked, tight and overactive muscles can become weak).

Pelvic-floor health is an important, yet often overlooked, component of overall well-being. Discover how to keep this group of muscles strong and healthy by learning more at “Your Fit and Functional Pelvic Floor“, from which this article was excerpted.

Lauren Bedosky

Lauren Bedosky is a Twin Cities–based health-and-fitness writer.

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