Pelvic Floor Condition
Pelvic Floor Dysfunction
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
Your bladder, bowels, sex life and comfort all depend on a group of muscles most people never think about. When the pelvic floor is too tight, too weak, or out of sync, the symptoms show up everywhere: urgency, leaking, constipation, pain with sex, pelvic aching. Pelvic floor dysfunction is common, and it is treatable once the actual pattern is identified.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Pelvic Floor Dysfunction
The pelvic floor is a bowl of muscles and connective tissue at the base of the pelvis. It supports the bladder, bowel and reproductive organs, controls when urine and stool are held and released, contributes to sexual function, and works with the diaphragm and deep abdominal muscles to stabilize the trunk.
Pelvic floor dysfunction means these muscles are not working as they should. Broadly, there are two patterns. In an overactive pelvic floor, the muscles are too tight and cannot relax, which causes pain, urgency, difficulty emptying and pain with sex. In an underactive pelvic floor, the muscles are too weak or slow to respond, which causes leaking and a feeling of heaviness. Many people have a mix, and tight muscles can also be weak because they never fully relax and reset.
The most important step is identifying which pattern you have. Generic Kegel exercises can help a weak pelvic floor but can worsen a tight one. Dr. Gordon assesses the muscles directly, then treats tension, trigger points and nerve irritation, coordinating with your physician and pelvic floor PT.
Pelvic Floor Dysfunction at a Glance
Also called
PFD, pelvic floor disorder
Who it affects
Men and women of all ages, including after childbirth, surgery, heavy training or long-term stress
Two main patterns
Overactive (too tight) and underactive (too weak), often mixed
Systems affected
Bladder, bowel, sexual function, pelvic pain and trunk stability
Main drivers
Muscle tension or weakness, poor coordination, nerve irritation, breathing and posture habits
The Gap in Care
What Tests Check, and What They Can Miss
Many people are told to do Kegels or are sent for bladder or bowel testing only. Without examining the muscles themselves, it is easy to treat the wrong pattern.
What routine testing is looking for
- Bladder or bowel disease
- Infection
- Prolapse on exam
- Structural findings on imaging
What often keeps symptoms going
- Whether the pelvic floor is too tight, too weak or both
- Trigger points that refer pain to organs
- Poor timing between the pelvic floor and breathing
- Hip and abdominal patterns that load the pelvis
- Nerve irritation along the pudendal pathway
These are only found with a direct assessment of the pelvic floor and surrounding muscles.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Urinary urgency, frequency or leaking
Going often, rushing to the bathroom, or leaking with coughing, sneezing or exercise.
Constipation or straining
Difficulty passing stool, straining, or feeling unable to empty completely.
Pelvic pain or pressure
Aching, pressure or heaviness in the pelvis, perineum or low back.
Pain with sex
Pain during or after intercourse or orgasm.
Difficulty starting urination
A hesitant or weak stream, or needing to push to start.
Tailbone or hip pain
Aching at the tailbone, sit bones or deep hip that tracks with pelvic symptoms.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Overactive muscles
Muscles that stay contracted cause pain, urgency, emptying problems and pain with sex.
Underactive or weak muscles
Muscles that are weak or slow to respond cause leaking and heaviness. Tight muscles can also test weak.
Poor coordination
The pelvic floor must relax to empty and contract to hold. When timing is off, both emptying and control suffer.
Breathing, posture and load
The pelvic floor works with the diaphragm and abdominals. Breath holding, bracing and posture habits change how it behaves.
Your First Visit
How Dr. Gordon Evaluates Pelvic Floor Dysfunction
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your physician's findings, imaging, medications and past treatments so he knows what has been ruled out and what has already been tried.
External and movement assessment
Assessment of the abdomen, hips, low back and breathing to see how the pelvic floor is being loaded.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Bladder, bowel and sexual function review
Dr. Gordon reviews your daily patterns so treatment targets what matters most to you.
Plan and coordination
A clear plan, plus communication with your physician or pelvic floor PT when that helps your care.
When to see a physician first
- Fever or chills with pelvic or urinary symptoms
- Inability to urinate
- Visible blood in the urine or stool
- Sudden, severe pelvic or abdominal pain
- Unexplained weight loss
- New numbness in the saddle area or loss of bladder or bowel control
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for pelvic floor dysfunction, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. For overactive patterns, treatment releases tight pelvic floor muscles and trigger points so the muscles can relax and work normally again. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture along the sacral and pudendal nerve pathways to support nerve signaling for bladder, bowel and pelvic floor control.
See servicesBetween visits
Home Plan & Team Coordination
Guidance on breathing, relaxation or strengthening as appropriate, and coordination with your physician and pelvic floor PT.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
Pelvic Floor Dysfunction Questions
Answers About Pelvic Floor Dysfunction
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
It depends on your pattern. Kegels can help a weak pelvic floor but may worsen a tight one. Dr. Gordon assesses first, then recommends.
No. Men commonly have pelvic floor dysfunction, often presenting as pelvic pain, urinary symptoms or sexual changes.
Common causes include childbirth, surgery, heavy lifting, chronic constipation, high-impact sport, long-term stress and prolonged sitting.
Yes. PT is excellent for retraining coordination and strength, and Dr. Gordon's treatment adds direct release of tension and trigger points.
Most people need eight to twelve sessions with reassessment along the way.
No. The pelvic floor muscles are examined externally, with no internal exam. Treatment options are explained before anything begins, and nothing is done without your consent.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For pelvic floor dysfunction, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Pelvic floor dysfunction can affect people of every gender, and Dr. Gordon treats adults of all genders and identities.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a physician for your pelvic symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioFurther Reading
Men Have Pelvic Floors Too: Signs Something Is Off
From the blog: Men have a pelvic floor that helps control the bladder, bowel and sexual function. The everyday signs that it may be too tight or out of sync.
Erectile Dysfunction and the Pelvic Floor: The Muscle Side of ED
From the blog: Two small pelvic floor muscles help an erection reach full firmness. How weak or tight muscles can add to ED, and why a urologist visit always comes first.
Book an Evaluation for Pelvic Floor Dysfunction
Book a full evaluation with Dr. Gordon and learn whether your pelvic floor is too tight, too weak or both, and what to do about it.
Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms
Common Symptoms of Pelvic Floor Dysfunction
Further Reading
Leaking When You Cough, Laugh or Run: Stress Incontinence Explained
From the blog: Leaking with a cough, laugh or run is stress incontinence. Why it happens, what works first, and why Kegels alone do not help everyone who leaks.
Hip Pain and the Pelvic Floor: How One Can Drive the Other
From the blog: Deep hip pain and pelvic floor symptoms often show up together. How the obturator internus links the two, and why treating only one can leave you stuck.