It’s 3 am. Do you know where your pelvic floor is?

You may have heard a friend talking about her pelvic floor or you’ve seen a pelvic exercise printable on Pinterest. Maybe your doctor mentioned it during a routine exam. But what exactly is the pelvic floor? Where is it, what does it do — or in many cases not do?

Your pelvic floor supports several organs and when it is weakened or not functioning properly, it can lead to a number of uncomfortable and inconvenient disorders.

If you are one of the millions of women getting up several times in the middle of the night to go to the bathroom, wearing pads every day, having painful sex, feeling heaviness and vaginal bulging, or sprinting to the bathroom, here’s what you need to know.

What is the pelvic floor?

Your pelvis is a bone, so you may assume the pelvic floor is also made of bone; however, the pelvic floor is an area of muscles that resembles a hammock spanning from the pubic bone to the bottom of the spine. These muscles support and help to control the vagina, uterus, bladder, urethra and rectum. When the pelvic floor weakens, those organs can drop and may have trouble functioning normally.

Imagine a trampoline taut and sturdy, holding up and supporting the weight of your body as you jump. The base of the trampoline expands and contracts based on your movement and control. Now, picture the trampoline fibers beginning to wane, the middle sags, the function worsens and control becomes difficult. The pelvic floor can weaken like this. That’s why it’s important to watch for symptoms that, while common, can mean you have a pelvic floor disorder.

How do I know my pelvic floor isn’t doing its job?

Because the pelvic floor is supporting several different organs, you may experience a variety of symptoms depending on how the structure of the pelvic floor has shifted. Many women will experience incontinence, which is the leaking of urine. Others may have trouble emptying their bladder or bowels. Some are always running to the bathroom, are up going at 3 am or have pain during sex. Often as the pelvic floor weakens, a woman may start to feel a heaviness down below and eventually even a physical bulging of tissue presents itself externally, which is a sign of pelvic organ prolapse. Any and all of these symptoms can happen separately or together.

How did this happen?

There is often no single cause for pelvic floor disorders, but childbirth, age, hormonal changes, obesity, smoking, constipation and chronic heavy lifting are usually factors.

Is there anything I can do?

Yes! Talk to your health care provider about all of your symptoms. Don’t be embarrassed; pelvic floor disorders are very common. Chances are you know several other women experiencing the same issues as you, they’re just not talking about it. Solutions can include physical therapy, home exercises, medication or non-invasive surgery. The takeaway is that these inconvenient and uncomfortable changes in your body, though very common, deserve treatment. You don’t have to live with pelvic floor issues.

Who can help?

As part of a relatively new field of medicine, a urogynecologist is an OB-GYN with additional training and expertise in the evaluation and treatment of conditions that affect the female pelvic organs, as well as the muscles and tissue that support these organs.

The Women’s Center for Pelvic Health at Anne Arundel Medical Center has a fellowship-trained team of doctors and nurse practitioners who specialize in the care of female pelvic health disorders. Team members collaborate on care for patients of all ages, from those with minor issues to individuals suffering from complex conditions requiring advanced surgery and care. For each patient, they will conduct a thorough review of medical history, conduct a physical exam, lab studies and advanced imaging and testing to develop individualized treatment plans based on your needs and goals.


Kay Hoskey, MD, is a urogynecologist with AAMC’s Women’s Center for Pelvic Health.

Contact the Women’s Center for Pelvic Health at 443-481-1199 to schedule a consultation to help guide you to the right solutions to meet your needs and health goals.

Originally published April 23, 2018. Last updated May 14, 2019.

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