What are PFDs & why should we care?


By Samantha Pulliam, Assistant Professor and Director, UNC Urogynecology and Reconstructive Pelvic Surgery

When you’re a Urogynecologist, you somehow end up knowing a lot about the personal lives of your friends! Imagine having your OB-GYN on speed dial – for any question that you think of, not just the ones troubling enough to make you go to the doctor. Over the past few months, I have received panicked calls from THREE of my closest friends from high school, each one detailing symptoms of a pelvic floor disorder. For awhile I wondered what was going on to generate this flood of calls. After all, I (and all of my friends) are still in in our forties – still young! But the truth is, what we know about pelvic floor disorders makes these calls not so surprising after all.

Pelvic floor disorders (PFDs) are very common. We know that at least 1/3 of women in the US have PFDs, including problems like urinary incontinence, accidental bowel leakage, and prolapse of the pelvic organs. This is not just a problem experienced by older women. One in four women in their forties have at least one of these problems too, so no wonder so many of my friends are calling me!

Urinary incontinence can be a real bummer.  Some women leak with exercise like running or jumping, or when they cough, sneeze, or laugh. Others leak urine suddenly, when they feel the need to urinate they can’t get their pants down fast enough! It can also be an expensive problem – some women spend up to $900 a year on things like incontinence pads and diapers.

Bowel control problems can be devastating as well. Some women who experience these problems are afraid to leave their house for fear of having an accidental in a public place, or carry a change of underwear with them “just in case.”

Pelvic organ prolapse is the descent of the vaginal walls or the uterus out through the opening of the vagina, and can feel like a tampon that isn’t in far enough. It is often discovered in the shower or after a long, active day when the prolapse has come down a little further, and a bulge of tissue can be seen at the vaginal opening.

Too many women have suffered too long in silence with these disorders. The truth is, it’s important to talk about these issues – even if it feels a little awkward. Most likely, you will find out that more and more of your friends are going through the exact same thing!

There are so many things that women can do to help with PFD’s, and the first step is talking about it. There are some amazing treatment options out there, and although surgery is sometimes a solution, it is certainly not the only one. There are lifestyle and behavioral changes that can dramatically improve symptoms, as well as medications, exercises, and physical therapy that can make the pelvic floor function more effectively. There are also vaginal devices that can be used to help control symptoms of urinary incontinence, accidental bowel leakage and pelvic organ prolapse.

So even if YOUR best friend isn’t a OB-GYN, make a plan to talk about PFD’s with the lovely ladies in your life – you will find you are not alone! AND make a plan to talk about it with your healthcare provider. Working with the right people, including urogynecologists, nurse practitioners and pelvic floor physical therapists, can be a step toward a healthier and happier you.


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