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Published in on Aug 28th 2026

Signs You May Have Pelvic Floor Dysfunction

Leaking urine when you cough or exercise, pain during sex, or regularly struggling with constipation can be easy to dismiss as typical inconveniences related to childbirth or aging. However, these symptoms are often signs of pelvic floor dysfunction, a commonly overlooked condition that affects approximately 1 in 4 women and can significantly impact daily life.

If you are experiencing such changes, know that treatment is available. Here are some of the most common signs of pelvic floor dysfunction and when to speak with your OB/GYN about finding relief.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles and connective tissue that support the bladder, bowel, uterus, and vagina. These muscles work continuously, often without you noticing, to hold pelvic organs in place, control the release of urine and stool, and stabilize the core during everyday movement. They also play a role in sexual function.

When the pelvic floor is working properly, these muscles contract and relax in coordination, giving you control over bladder and bowel function. Pelvic floor dysfunction develops when these muscles become too weak, too tight, or lose the coordination needed to function properly.

Common Signs of Pelvic Floor Dysfunction

Symptoms of pelvic floor dysfunction can vary from person to person and may develop gradually.

Common signs include:

• Urinary leakage, especially when coughing, laughing, sneezing, or exercising
• A feeling of pressure or heaviness in the pelvis, sometimes described as a bulging sensation, that may worsen throughout the day
• Constipation or straining during bowel movements, including a sense of incomplete emptying
• Pain during intercourse, ranging from mild discomfort to more significant pain
• Difficulty fully emptying the bladder, including trouble starting your urine stream, experiencing a start-and-stop flow, or feeling as though your bladder is not empty even after going to the bathroom

What Causes Pelvic Floor Dysfunction?

Pelvic floor dysfunction has been linked to several causes and risk factors, including:

• Pregnancy and childbirth: Carrying a pregnancy and delivering vaginally can stretch and weaken the pelvic floor, particularly with larger babies or multiple deliveries
• Aging and menopause: Muscle tone naturally declines with age, and the drop in estrogen during menopause can further weaken pelvic tissue
• Chronic straining: Ongoing constipation, heavy lifting, or persistent coughing can place repeated pressure on the pelvic floor
• Pelvic surgery: Procedures such as a hysterectomy can affect the surrounding muscles and supportive tissue
• Obesity: Carrying excess weight adds continuous pressure on pelvic organs and musculature

How Is Pelvic Floor Dysfunction Diagnosed and Treated?

Diagnosis typically begins with a conversation about your symptoms and medical history, followed by a physical and pelvic exam. Depending on your symptoms, your provider may also recommend additional testing to evaluate bladder or bowel function more closely.

Pelvic floor physical therapy is one of the most common and effective treatment approaches, which involves targeted exercises to improve muscle strength, coordination, and relaxation. Additional treatment options may include:

• Bladder training to help regain control over urination patterns
• Biofeedback, often used alongside physical therapy to improve muscle coordination
• Dietary and lifestyle adjustments, such as increasing fiber intake or limiting bladder irritants
• Medications to manage bowel or bladder symptoms
• In some cases, a vaginal pessary or other supportive devices

Most cases of pelvic floor dysfunction improve significantly with conservative treatment, and surgery is typically reserved for more advanced cases that don't respond to other approaches.

When to Talk to Your OB/GYN

If pelvic floor symptoms are affecting your comfort, daily routine, or overall quality of life, it's worth having a conversation with your OB/GYN.

At Pacific Women's OB/GYN Medical Group, our providers offer personalized, compassionate care for a full range of gynecological concerns, including pelvic floor dysfunction. We take the time to understand your symptoms and guide you toward the treatment approach that fits your needs.

You don't need to navigate these symptoms alone, and relief is often more achievable than it may seem. Schedule an appointment today to talk through your symptoms and learn more about your options.