Does it hurt when you have sex or when you orgasm? Do you ever leak after a sneeze or a cough? Or maybe you get up more than once at night to go to the toilet? All these may be signs of a pelvic floor disorder.The pelvic floor muscles support the pelvic organs and control bladder and bowel functions, explains Professor Linda Cardozo, spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG) . They are shaped like a sling that runs from your pubic bone to the base of your spine.“If you are on the toilet and you try to stop yourself urinating, if you contract your pelvic floor muscles you will stop the flow,” says chartered physiotherapist and pelvic expert Ruth Jones . This should not be done as an exercise, she warns, but it explains how to identify the muscles.Pregnancy and childbirth, as well as obesity, chronic constipation or any other activity that has a high impact on the pelvic floor muscles can lead to pelvic floor disorders, including urinary or anal incontinence, constipation, abdominal pain, painful sex, and even organ prolapse. Little data is available, but a study from 2003 reported that at least one-third of adult women are affected.“The pelvic floor muscles can work too hard as well as not work hard enough and be weak,” says physiotherapist Jones. “Part of the problem is understanding if your problems are because you are working those muscles too hard or not working them hard enough.”If the muscles are too tense, people often experience pain, even during intercourse or while orgasming. “It is really, really important that you relax your pelvic floor muscles as much as you can – if you think that the intercourse is going to hurt, you’re more likely to contract even more,” Jones adds.Weak pelvic floor muscles, on the other hand, can cause incontinence, reduced sensitivity during sex and pelvic organ prolapse, Professor Cardozo reports. Although Jones points out that it isn’t always a case of lack of strength.“Let’s say [a woman] went through childbirth and part of the muscles were damaged, it might come off as a problem of attachment. [The muscles] can’t contract, so they can’t support the bladder or urethra,” she says.Touching some of the most intimate spheres of personal life, pelvic floor disorders affect people’s physical health, social life, relationships, career, domestic routine and daily activities. The ramifications for an individual's mental health can be dramatic.“Many can become very depressed and anxious. They feel like they're not being able to live a complete life if they are not able to be physically intimate with somebody,” Jones says. She has had clients who would not leave the house because they were too afraid they were going to wet themselves, or who couldn’t sit down or wear jeans, because of the pain.Elaine Miller is an Edinburgh-based physiotherapist specialising in pelvic health, and has experienced pelvic floor disorder first hand. “After I had children, I was leaking,” she admits. “It certainly affected my mood, because you just don’t feel good about yourself. [Even] from a societal point of view, the people who leak either they are usually very old, very young or very infirm.”Her pelvic floor issue first started about 12 years ago but, to begin with, she didn’t do anything about it. “I didn’t bother. I think it’s really common that women, they recognise [incontinence] as a problem but don’t make it a priority to fix it,” she says. And research seems to confirm this, with one study showing that it takes, on average, between three and 10 years for women to seek treatment.