If you are experiencing issues like incontinence or painful/frequent trips to the bathroom, you may have pelvic floor dysfunction. To diagnose this condition, you might be required to have a pelvic floor examination. In this article, we’ll go over what a pelvic floor exam is and what you can expect if you need to get one.

What is the Pelvic Floor?

A group of muscles found in the base of your torso, the pelvic floor plays an important role in supporting the organs of the pelvis (including the bladder, intestines, and uterus). It also helps maintain continence, or the voluntary control of urination and defecation. Issues with the pelvic floor, called pelvic floor dysfunction, can lead to a number of problems including pain during sex, erectile dysfunction, trouble releasing a bowel movement, or leaky urine or stool. These problems can be caused by several factors ranging from traumatic injuries to pregnancy to surgery to being overweight to simply getting older.

Signs that you might have pelvic floor issues that need to be examined and addressed include:

• Frequently needing to go to the bathroom
• Feeling like you need to force it when you use the bathroom
• Stopping and starting many times when using the bathroom
• Long-term constipation
• Straining to pass a bowel movement
• Leaking stool or urine
• Painful urination
• Lower back pain
• Pain in the pelvic region

If you think you might have pelvic floor dysfunction and want to check out the health of your pelvic floor, it may be a good idea to see a specialist for a pelvic floor exam.

What Is a Pelvic Floor Exam?

A pelvic floor exam is, like it sounds, an examination of the pelvic floor. It is usually performed by a physical therapist specializing in the pelvic floor. Generally, a pelvic floor exam will be performed both internally and externally so that the physician can get as complete an understanding as possible of the whole area and what might be going on, since often, pelvic floor issues will also be accompanied by problems with the back, hips, and/or core.

What to Expect From the Pelvic Floor Exam Experience

The pelvis is a sensitive area and many people who have to have a pelvic floor exam for the first time end up feeling nervous and uncertain about what to expect. While it will be different with every healthcare practitioner and clinic, there are a few things that are generally the same during all pelvic floor exams. Here is what you can expect, more or less.

As with most doctor’s visits, your experience will begin with some paperwork. Then, your therapist will come meet you and take you to a private care room. You’ll introduce yourselves and have an opportunity to chat and talk about various things like:

• What brought you in for the examination
• What symptoms you are experiencing
• Who referred you
• Your lifestyle, such as daily drinking and eating habits
• Your pain levels during different activities
• How many times you go to the bathroom a day

Next, there will be an evaluation, which will include things like moving around, testing, and taking measurements to find if there might be any involvement of the back, hips, or core.

Before you begin the pelvic exam, your therapist will probably tell you what you can expect. You’ll have the option to decline the internal exam or delay it to a later date. If you don’t do the internal exam, your therapist will do their best to treat you with the information they have available.

If you do agree to an internal exam, you’ll be left alone to undress from the waist down and cover yourself with sheets. Your therapist will come back when you’re ready and perform the pelvic floor examination. They may first check for signs of irritation, pain, or swelling of the vulva. Then, using lubricant to make you more comfortable, they’ll examine you internally, seeking to evaluate the state of your internal pelvic muscles, find any tightness, and see how the muscles are moving and how much control you have over them. You may be asked to do Kegels, bear down, and/or cough. The therapist may feel around externally to try to find any tight spots. None of this should feel painful, although it may be uncomfortable.

After the internal exam, you’ll have the chance to put your clothes back on privately before your therapist comes back to discuss their findings. They’ll go into detail about what they found in your evaluation, how it has been affecting you, how it may be causing your symptoms, and what might be happening with your pelvic floor.

They will also discuss with you your treatment plan moving forward, which will depend heavily on the root cause of your pelvic floor issues. Sometimes, it may be as simple as doing Kegels at home regularly. In other situations, you may need pelvic floor relaxation exercises, hip stretches, or core strength exercises. You may be asked to come back for pelvic physical therapy, with frequency and length of treatment being dependent on the exact issues you’re having.

Your therapist will make their best effort to give you as full an understanding of your pelvic floor issues as possible, giving you the opportunity to ask any questions that you might have. You may be referred to other specialists who can help you in case your pelvic floor problems are connected to another issue such as GI problems, nutrition, or psychological factors.

In Conclusion

Again, it’s important to note that every therapist, clinic, and patient is different, and your exact pelvic floor exam experience may vary from what you see above. Hopefully, this overview can be a helpful tool at giving you the information you need to feel calm and prepared for your pelvic floor exam. It’s perfectly normal to feel nervous or scared about this type of examination, but any good pelvic floor specialist will agree that it should only happen with your permission, when you are ready, relaxed, and feeling empowered.