Did My Asthma Cough Affect My Pelvic Floor?

I recently started pelvic floor physical therapy hoping it could help address the cause of my ongoing pelvic pain. During the assessment, my therapist noted my pelvic floor muscles were both very tight and weak.

Now, I know weak pelvic floor muscles are not at all uncommon in women, except... I am 31, I have not been pregnant nor given birth, and am not overweight. I also, thankfully, do not have the usual symptoms of pelvic floor issues.

However... despite all my best efforts to manage my asthma, I have had a chronic cough since 2008. This leads to the question, did asthma affect my pelvic floor?

What is pelvic floor dysfunction?

Pelvic floor dysfunction is, essentially, when the muscles of the pelvic floor do not work as they should. They can either be too tight (hypertonicity), too relaxed (hypotonicity), or poorly coordinated.¹

Several different muscles stretch from the back of your pelvis to the front, forming the lower part of your "core muscles" and supporting the bladder and large intestine, as well as the uterus in people assigned female at birth.²

Pelvic floor dysfunction can be linked to a variety of symptoms. Vulvodynia (chronic vulvar pain) led to my pelvic floor assessment, but for many, especially those identifying as women, they may seek care due to incontinence issues (bladder or bowel), or just the opposite, such as chronic constipation, difficulty peeing, or pain during sex.¹

What causes pelvic floor issues?

Anything that increases pressure on the pelvic floor—from various directions—can cause pelvic floor dysfunction. This includes not just vaginal childbirth and chronic cough as mentioned above, but also chronic constipation, or even under-use or decreased muscle tone that just happens with aging.³

For me, my pelvic floor dysfunction symptoms only include chronic pain (which may be from a skin condition, that verdict is not in yet), however, my assessment found both muscle tightness (hypertonicity) and muscle weakness. Taking everything into account, it is still hard to say if my asthma and 15 years of coughing are contributory to my pelvic floor dysfunction. Solid maybe? But, what is not hard to say is, without a doubt, chronic cough stemming from asthma and other respiratory conditions absolutely contribute to pelvic floor dysfunction.

It's more common than you think

Look, y'all. Pelvic floor issues, whether related to asthma coughing or not, are common and still hardly anybody is talking about them.

The issue of nobody talking about this, whatever their symptoms are, is that people continue to not talk about it. Including with their doctors! AND THERE ARE SOLUTIONS!

You know what my biggest challenge writing this article was? There were so many things I could reference, including from academic hospitals and health systems, about how to get help for pelvic floor issues, it took me awhile to find the answer to my question about how cough contributes to pelvic floor issues.

So, yeah. It's common.

Finding help for pelvic floor issues

Whether you are experiencing pain or are not quite making it to the bathroom to pee, do not struggle alone! First, you are very far from alone, and second, many things and people can help. Not only can people help, they want to help! Y'all, they made it their job!

Your primary doctor, or if you have one, your gynecologist, can be a great first stop to help assess things and help you figure out next steps.

Pelvic floor physical therapy is also a potentially incredible tool, customized to your specific needs. While my PT didprescribe me the stereotypical Kegel exercises, she made sure I'm doing them right (yep, it's possible not to!) and explained why not to do too much, too fast. I wouldn't have guessed I could overwork my pelvic floor, but here we are!

Yes, obviously a type of physical therapy based in manual muscle manipulation happening inside my vagina was awkward at first. It is also nothing like a pelvic exam, and it took about 15 seconds to get over it. It is just another day at the office for my PT, and she did release my coccygeus muscles while we talked about our holiday plans!

Please don't let this scare you off! Pelvic floor physiotherapy can still help without internal work and even without internal assessments if you aren't okay with that! The most important thing is that a PT will be able to understand and figure out how work with all the little specific quirks of your body and specific challenges, especially where it comes to pelvic floor issues!

Pelvic floor dysfunction and asthma

It all comes down to this: no matter what is causing pelvic floor issues or how they affect you... if you have them, they're affecting you, just like your asthma is! And you deserve the best care possible to manage your symptoms, for whatever you're dealing with.

Has anyone experienced pelvic floor issues (like pain, incontinence, or prolapse) with a connection to your asthma?