An Introduction to Pelvic Floor Anatomy and Function in Women & Men
The Pelvic Floor is finally starting to get the press it fully deserves in our culture. As a Physical Therapist who specializes in pelvic health, I often see magazine articles, websites and new products being developed to help educate, empower and support pelvic floor function.
But I am willing to bet that most of us are not very familiar with the unique architecture and function of this remarkable part of our body. Read on for an anatomy lesson on the pelvic floor and learn about all the important bodily functions it plays a key role in.
The pelvic floor complex is comprised of 10 muscles in female bodies and 8 muscles in male bodies that are formed into three layers. The following is a tour through each of those layers’ structure and function.
Functions of Your pelvic floor muscles
- Pumps Fluids
Layer 1: Muscles that support sexual and support functions
In female bodies, layer one pelvic floor muscles support the vaginal and anal openings by forming the band of tissue between the vagina and the anus (perineum). These muscles help with blood flow to the clitoris during arousal and hug the vaginal opening.
These muscles are often injured or torn during vaginal childbirth.
In male bodies, layer one is also helpful for sexual functioning by maintaining erection, plays a role in urination, and provides muscular support to the area between the testicles and the anus (perineum). Weakness in these muscles can contribute to urinary leakage and erectile dysfunction.
In both male and female bodies, the external anal sphincter is also part of layer one muscles. The anal sphincter plays a big role in coordinating defecation.
Layer 2: Muscles that coordinate and control urination
Female bodies are more prone to issues with urinary incontinence for several reasons: they lack a prostate gland, have a shorter urethra, may experience the stress and strain of pregnancy and childbirth, and lose estrogen which may negatively affect continence. Luckily, the second layer of pelvic floor muscles offers some compensation for this. Male bodies have just two muscles here, while female bodies have four that offer additional support around closing the urethra.
These muscles may be weak, poorly coordinated, or overactive which usually presents as urinary dysfunction: leakage, urgency, spraying, dribbling.
Layer 3: Muscles that support our pelvic organs
The third layer is relatively the same in both female male bodies and is busy with many functions. These muscles provide support for the pelvic organs (bladder, urethra, rectum and prostate in male bodies; bladder, urethra, vagina, uterus, and rectum in female bodies). They are important for sexual functioning and orgasm. The third layer of pelvic floor muscles also join in with a network of other muscles of the body to provide postural stability, coordinate with the diaphragm (the main breathing muscle) to assist in breathing, and even form a kind of pump to help move blood and fluids from the lower body back to the heart.
This layer is susceptible to stretch injury from pregnancy and childbirth, weakness from chronic straining (lifting, coughing, constipation), problems from nerve damage or surgery, and structural weakness that happens with loss of estrogen.
Overactivity in this layer can occur with chronic pain, trauma, musculoskeletal problems like low back or hip pain, surgery, clenching/stress and tension, and tailbone injuries.
Your hip bone’s connected to your …
There is one more muscle I’d like to highlight, that isn’t exactly a pelvic floor muscle but sometimes gets called part of the pelvic WALL. This muscle is interesting and unique in that it is actually a HIP muscle and it’s job is to externally rotate and stabilize the hip joint. BUT it literally attaches right into the pelvic floor. Sooo your hip bone IS attached to your pelvis just like the old song says!
This image shows the view of the pelvic floor looking from above. You can see the Obturator Internus muscle outlined in blue (with arrows) and the third layer of the pelvic floor outlined in red.
Research has found that this muscle is also an important factor in pelvic floor function and via it’s anatomy, it links hip and pelvic function.
Studies in both female and male bodies show that exercising this muscle can be just as effective as exercising your pelvic floor in relieving stress urinary incontinence or accidental urine leakage.
I bet you just got a pretty good education on a part of your body you didn’t know much about! In our next blog we’ll talk about how problems in pelvic floor muscle function occur and the symptoms this can cause.
If you like learning, stay tuned for future blog posts covering topics like …
- What happens when there is pelvic floor dysfunction?
- Why pelvic health is more than just kegels.
- What can I do about incontinence?
- What is pressure management and why is it important?
- What’s a prolapse? And do I need surgery?
- What’s all the fuss about constipation?
- …. And much more!
Who is Jennafer Vande Vegte MSPT, BCB-PMD, PRPC?
After graduating from Ithaca College, Jennafer began her career as a physical therapist at Spectrum Health in Grand Rapids, MI. Since 2002 Jen has focused her professional attention on treating women, men and children with pelvic health disorders. She is energized through education and enjoys her position as adjunct faculty at Grand Valley University, speaking at community events, organizing a regional pelvic floor mentorship and study group, and didn’t necessarily enjoy but survived part time home schooling her two daughters. She has been faculty for Herman and Wallace Pelvic Rehabilitation Institute since 2009 and loves to inspire other rehab professionals treating pelvic floor dysfunction. She is an author of the chapter, “Manual Therapy for the Pelvic Floor” which was published in the book, “Healing in Urology.” Jen was a contributing writer for the Pelvic Floor Capstone and Oncology and the Pelvic Floor for Herman and Wallace and also co-authored the continuing education course, “Boundaries, Self-Care and Meditation” with Nari Clemons. She is certified in pelvic floor rehabilitation and biofeedback for pelvic floor disorders. Outside of teaching and treating patients, Jen loves to spend time with family and friends, run, cook, travel, do yoga and snuggle with her doggo.