**Pelvic Floor Dysfunction**

The pelvic floor muscles line the bottom, front, sides, and back of the pelvis and provide a hammock-like structure that supports the pelvic organs such as the bladder, prostate, uterus, and rectum (see diagram). Besides providing support, they're responsible for the complex relaxing and contracting that enables us to urinate and defecate properly and even enjoy sexual intercourse. These muscles are always interacting with the pelvic organs. For example, urination involves relaxation of these muscles while the bladder contracts. Sometimes, these muscles either spasm or simply don't interact as they should with the pelvic organs. We call this "pelvic floor dysfunction" (PFD).Pelvic floor dysfunction can give rise to lots of uncomfortable sensations and even frank pain. To make matters more complicated, PFD can exist along with problems such as interstitial cystitis, irritable bowel syndrome, prostatitis. fibromyalgia, and others. Pelvic floor dysfunction has lots of other names in the medical literature such as proctalgia fugax, coccygodynia, levator ani syndrome, Hinman's syndrome, tension myalgia of the pelvic floor, and non-neurogenic-neurogenic bladder. The symptoms of PFD may vary greatly depending upon what part of the muscle complex is affected. These may include: *Difficulty initiating the urine stream *Straining with urination *Pain with urination *Starting and stopping of the urine stream *Sensation of incomplete bladder emptying or the sensation of needing to urinate almost

...... immediately after urinating *Pelvic pressure or pain *Frequent daytime voiding *Constipation *Pain with orgasm *Pain with vaginal penetration (superficial and/or deep) *Increased discomfort when sitting for long intervals