I recently found myself waking up multiple times at night to go to the bathroom. I found that I could hardly make it to the bathroom during the day, whether I was at work, home or out and about.  I would wet my pants when I laughed, coughed or sneezed. I finally gave in and purchased incontinence pads. Things got worse after I had COVID in February, so I finally made an appointment to get a script for Physical Therapy. I got my PT for April, only to be told a week prior to my appointment that Pelvic Floor PT was no longer offered at many PT facilities. Appointments, if you could get one were booking months out.  

Does any of this sound familiar? My advice: Don’t be embarrassed, don’t suffer and for goodness sake, you don’t have to wet your pants or be stuck wearing pads.  

Who is at risk of Pelvic Floor Dysfunction? 

Approximately one-third of adult women experience some kind of pelvic floor dysfunction. The primary causes include pregnancy, obesity and menopause. Some women born with naturally weaker connective tissue are genetically predisposed to developing pelvic floor dysfunction.  

How do I know if I have incontinence? 

The biggest tip-off that you have incontinence is if you can’t always control when you pee. You may also have incontinence if you have the following symptoms:  

  • You need to pee a lot (more than eight times a day) 
  • You wake up multiple times at night because you have to pee 
  • You feel like you need to pee badly and that feeling comes on quickly and strongly (called urge incontinence) 
  • You accidentally pee when you laugh, cough, or exercise (called stress incontinence) 
  • You can no longer hold it when you put your key in the door, or after eating certain foods like chocolate, citrus fruits, spicy foods, or fizzy beverages. (these are called triggers)  


We know as a new mom, there’s a lot to juggle. Life with a new baby, lack of sleep, breastfeeding, and adapting to other changes to your body is challenging to say the least. Having to deal with urinary or fecal leakage, could add to the stress of being a new mom. 

Postpartum pelvic floor dysfunction only affects women who have given birth. Pregnancy and the changes pregnancy make to the pelvic floor cause postpartum pelvic floor dysfunction, not the method of delivery, so you may develop postpartum pelvic floor dysfunction whether you deliver by caesarian or vaginally. 

Hormonal and physical changes related to pregnancy and delivery (either vaginal or C-section) may increase your risk of pelvic floor complications. Stress on the pelvic girdle, as well as the pelvic floor muscles and connective tissues can stretch or damage the pelvic floor. This can cause discomfort, pain, and functional impairments, such as a loss of bladder control. 

We recommend seeing one of the care providers at The Birth Center or going back to your delivery provider to address your symptoms and concerns. However, if you’re not improving or experiencing complications, we may recommend physical therapy. 

Post Covid Pelvic Floor Dysfunction 

The most common symptom of coronavirus infection is a continuous cough which can last for several weeks after the initial infection.  Coughing is known to put pressure on your diaphragm and pelvic floor muscles and increase the risk of developing stress urinary incontinence. The World Health Organization and other researchers are looking at this possibly overlooked symptom of COVID.   

Gotta Go? Bladder Dysfunction During Perimenopause and Menopause 

Reduced levels of estrogen starting around menopause can cause thinning of the lining of the urethra, the short tube that passes urine from the bladder out of the body. The surrounding pelvic muscles also may weaken with aging, known as “pelvic relaxation.” As a result, women going into midlife and beyond are at increased risk for urinary incontinence, or the involuntary leakage of urine.  

Non-invasive Treatment of Pelvic Floor Disorders 

While surgery or medication may not be your only course of action, there are non-invasive treatments. For myself, I found that doing my Kegals (properly) and strengthening my core muscles have helped dramatically in only a few weeks. My physical therapist has taken a holistic approach, looking at my lifestyle, the foods I eat and my fluid intake. (I had to do a 2 day pee journal).  

Before Starting Treatment 

Dr, Internet may not be your friend. Certain health conditions can worsen urine leakage. Talk to your health care provider about treating these conditions.  

If your incontinence issues are interfering with your life, don’t put off making an appointment with one of our care providers to initiate treatment or to get a referral for further treatment.   

For a more detailed see this short presentation on Pelvic Floor: Dysfunction, Myths & Solutions from Action Potential. https://www.youtube.com/watch?v=TW1YATQXseU&t=7s